Perceived stress,recurrent pain,and aggregate salivary cortisol measures in mid‐adolescent girls and boys

Measures of perceived stress have been criticized for theoretical inconsistency. However, the validated pressure activation stress scale has been suggested as a theoretically sound alternative. But it is unclear how pressure and activation stress relate to objective and subjective measures including commonly used aggregate cortisol measures and health complaints respectively. Specifically, this study aimed at investigating how pressure and activation stress were related to aggregate salivary cortisol measures and recurrent pain in mid‐adolescent girls and boys. Mid‐adolescents (119 girls and 56 boys) provided self‐reports in questionnaires on activation and pressure stress and recurrent pain (headache, stomach ache, neck/shoulder and back pain). Additionally, adolescents sampled saliva during an ordinary school day: (1) immediately at awakening; (2) 30 minutes after waking up; (3) 60 minutes after waking up, and (4) at 8 p.m. These samples were analyzed for cortisol. Hierarchical regressions showed no statistically significant associations between activation and pressure stress and cortisol, neither for girls nor for boys. However, activation and pressure stress were significantly associated with recurrent pain but only for girls. The findings may relate to subjective and objective measures reflecting distinct aspects of stress‐related functioning. However, the study participants included mid‐adolescents whose bodily systems are flexible and still relatively unaffected by the strain of their daily stress perceptions. To conclude, the non‐significant relationships between activation and pressure stress and commonly used aggregate measures of cortisol adds to the understanding of how perceived stress may relate to physiological functioning in the daily life of adolescents when using such aggregate measures.     

Cognitive performance and morning levels of salivary cortisol and alpha-amylase in children reporting high vs. low daily stress perception

The aim of the present study was to assess the effects of daily stress perception on cognitive performance and morning basal salivary cortisol and alpha-amylase levels in healthy children aged 9-12. Participants were classified by whether they had low daily perceived stress (LPS, n = 27) or a high daily perceived stress (HPS, n = 26) using the Children Daily Stress Inventory (CDSI). Salivary cortisol and alpha-amylase were measured at awakening and 30 minutes later. Cognitive performance was assessed using the Cognitive Drug Research assessment system. The HPS group exhibited significantly poorer scores on speed of memory (p < .05) and continuity of attention (p < .05) relative to the LPS group. The HPS group also showed significantly lower morning cortisol levels at awakening and at +30 minutes measures in comparison with the LPS group (p < .05), and mean morning cortisol levels were negatively correlated with speed of memory (p < .05) in the 53 participants. No significant differences were observed between both groups in alpha-amylase levels. These findings suggest that daily perceived stress in children may impoverish cognitive performance via its modulating effects on the HPA axis activity.     

Psychosocial stress and HPA functioning: no evidence for a reduced resilience in healthy elderly men

In order to investigate if HPA functioning is altered with age, the present study was conducted. Fifteen healthy elderly men (60-76 years; mean age 66.5 +/- 1.48 yrs.) and 12 younger adults (20-29 years; mean age 25.6 +/- 0.77 yrs.) collected salivary free cortisol profiles after awakening for basal HPA activity. Then, all subjects were exposed to the "Trier Social Stress Test" (TSST). This psychosocial stress protocol consists of a free speech and a mental arithmetic task of 13 minutes duration performed in front of an audience. Beside the assessment of endocrine and cardiovascular responses to the stressful task ratings of depression, mood and perceived stressfulness were obtained. Results show that younger and elderly men had similar morning cortisol profiles after awakening with both groups showing the expected rise after awakening (P=0.004). The TSST induced significant increases in ACTH, total plasma cortisol, saliva free cortisol, and heart rates (all P<0.0001). Regardless of age, both age groups showed comparable endocrine response patterns when confronted with the stressor. However, cardiovascular responses were significantly higher in younger men compared to elderly men (P=0.03). Catecholamine data revealed significant norepinephrine and epinephrine increases due to the stressor (both P<0.0001) with a trend toward elevated norepinephrine levels in elderly men (P=0.058). In sum, the investigated basal and response parameters of HPA functioning neither support the idea of a reduced resilience in healthy aged humans nor do they appear to strengthen assumptions derived from the so called "glucocorticoid cascade hypothesis".     

Exercise, pain, perceived family support, and quality of life in Korean patients with ankylosing spondylitis

Relations of habitual exercise and pain, perceived family support, and the quality of life in patients with functional class II for ankylosing spondylitis were explored. In a cross-sectional study perceived pain, family support, and quality of life were compared for 30 patients (23 women and 7 men whose mean age was 28.3 yr.+/-8.6 yr.) practicing exercise regularly and for 38 sedentary patients (31 women and 7 men whose mean age was 27.2+/-6.7 yr.). Exercising patients reported significantly lower pain, greater perceived family support, and increased quality of life than their sedentary peers. Pain ratings were significantly negatively correlated with the quality of life in both groups (r = -.26 in exercisers and r = -.50 in sedentary patients) and control group's perceived family support was significantly correlated .44 with quality of life. These results encourage further study of the associations of habitual exercise with perceived pain, family support, and quality of life.     

Chronic stress in the mother-infant dyad: Maternal hair cortisol,infant salivary cortisol and interactional synchrony

Stress physiology is shaped by early experience, with enduring effects on health. The relation of chronic maternal physiological stress, as indexed by hair cortisol, to infants’ stress systems and to mother-infant interaction quality has not been established. We examined maternal hair and salivary cortisol, six-month-old infants’ salivary cortisol, and mother-infant interaction in 121 mother-infant dyads. High maternal hair cortisol was related to higher infant average salivary cortisol concentration. Maternal hair cortisol and bedtime salivary cortisol were both uniquely related to infant bedtime salivary cortisol. Mothers with higher hair cortisol were more intrusive and had lower positive engagement synchrony with their infants. Maternal intrusiveness moderated the association of maternal hair cortisol and infant salivary cortisol, such that maternal hair and infant average salivary cortisol were related only when mothers were more intrusive. Maternal chronic physiological stress may upregulate infants’ developing stress systems, particularly in the context of lower mother-infant interaction quality.     

Cortisol and symptoms of psychopathology in Russian and American college students

Cortisol is a key player in the hypothalamus-pituitary-adrenal (HPA) axis response to stress, and has been related to symptoms of depression and other stress-related pathology. The present study investigated the relationship between cortisol and survey measures of stress and psychopathology as well as lifestyle in Russian and American college students. Salivary cortisol was collected upon awakening, 30 min later, at 4 p.m., and at 10 p.m. by Russian and American college students. Survey measures of anxiety and depression, as measured by the Hopkins Symptom Checklist (HSCL-25) were collected as well as scores on the Trauma History Questionnaire (THQ). In addition, measures of drinking-related problems, as measured by the Alcohol Use Disorder Identification Test (AUDIT) and the "Cut down, Annoyed, Guilty, Eye-opener" (CAGE) were also completed. Consistent with the typically observed empirical pattern, cortisol levels increased in the 30 min after awakening and then declined across the day. Women reported more symptoms of anxiety than did men in both Russian and American samples. American students reported more symptoms of depression than did Russian students, though Russian students reported more traumatic life experiences. Americans had higher cortisol levels overall, though Russian students had larger changes in cortisol levels across the day, associated with both greater morning rises and afternoon declines in cortisol. While more Russian students reported smoking, American students reported more problems associated with alcohol use as measured by the AUDIT. The relationship between stress and health, mediating factors of lifestyle and coping, and the impact of social transition in Russia are discussed.     

Differentiating the impact of episodic and chronic stressors on hypothalamic-pituitary-adrenocortical axis regulation in young women.

OBJECTIVE: The goal of this study was to examine the impact of episodic stress and chronic interpersonal stress on indices of HPA regulation. To explore the potential downstream consequences of altered HPA dynamics, the authors also assessed indicators of metabolic control and systemic inflammation. DESIGN: One hundred four medically healthy women between the ages of 15 and 19 participated. Following an in-depth interview of life stress, a sample of blood was drawn through antecubital venipuncture. Over the course of the next 2 days, participants gathered salivary cortisol samples. MAIN OUTCOME MEASURES: Cortisol morning response, cortisol daily output, glucocorticoid receptor (GR) mRNA, C-reactive protein (CRP), insulin, and glucose. RESULTS: The simple presence of episodic stress or chronic interpersonal stress was not reliably associated with cortisol output, GR mRNA, insulin, or glucose. When women were exposed to an episodic stressor in the midst of chronic stress they showed increased cortisol output and reduced expression of GR mRNA. By contrast, when women had low levels of chronic stress, episodic events were associated with decreased cortisol output and increased GR mRNA. Episodic and chronic stress also interacted to predict CRP, but not insulin or glucose. CONCLUSIONS: The impact of episodic stress is accentuated in the midst of chronic interpersonal stress and diminished in its absence. Simultaneous exposure to episodic and chronic stress may create wear and tear on the body, whereas exposure to episodic stress in the context of a supportive environment may toughen the body, protecting it against subsequent stressors.     

Enhancing effects of acute psychosocial stress on priming of non-declarative memory in healthy young adults

Social stress affects cognitive processes in general, and memory performance in particular. However, the direction of these effects has not been clearly established, as it depends on several factors. Our aim was to determine the impact of the hypothalamus-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) reactivity to psychosocial stress on short-term non-declarative memory and declarative memory performance. Fifty-two young participants (18 men, 34 women) were subjected to the Trier Social Stress Task (TSST) and a control condition in a crossover design. Implicit memory was assessed by a priming test, and explicit memory was assessed by the Rey Auditory Verbal Learning Test (RAVLT). The TSST provoked greater salivary cortisol and salivary alpha-amylase (sAA) responses than the control task. Men had a higher cortisol response to stress than women, but no sex differences were found for sAA release. Stress was associated with an enhancement of priming but did not affect declarative memory. Additionally, the enhancement on the priming test was higher in those whose sAA levels increased more in response to stress (r(48)?=?0.339, p?=?0.018). Our results confirm an effect of acute stress on priming, and that this effect is related to SNS activity. In addition, they suggest a different relationship between stress biomarkers and the different memory systems.     

Elevated content of cortisol in hair of patients with severe chronic pain: a novel biomarker for stress

Hair analysis has been used to reflect long-term systemic exposure to exogenous drugs and toxins. Several studies have demonstrated the feasibility of measuring endogenous steroid hormones, e.g. cortisol, in hair. Recently, a study in macaques showed a significant increase in hair cortisol levels induced by stress. We explored whether hair cortisol levels may be used as a biomarker for long-term stress in humans. Patients with severe chronic pain, aged 18 years or older, receiving opioid treatment for at least one year were recruited. Controls were non-obese (body mass index, BMI < 30 mg/kg(2)) adults. The Perceived Stress Scale (PSS) questionnaire was used to assess perceived stress over the last 4 weeks. A hair sample was obtained from the vertex posterior. Cortisol was measured using an enzyme-linked immunosorbent assay. We included fifteen patients (nine females and six males) and 39 non-obese control subjects (20 females, 19 males). PSS scores (median and range) were significantly higher in chronic pain patients (24: 12-28) than in controls (12: 3-31)(P < 0.001). Hair cortisol contents (median and range) were significantly greater in chronic pain patients (83.1: 33.0-205 g/mg) than in controls (46.1: 27.2-200 pg/mg) (P < 0.01). We conclude that hair cortisol contents are increased in patients with major chronic stress. Measurement of cortisol levels in hair constitutes a novel biomarker of prolonged stress.     

Neuroendocrine stress responses to an oral academic examination: No strong influence of sex, repeated participation and personality traits

Public speaking tasks have been widely used as laboratory stressors in human research. Fewer studies have investigated similar real life situations like oral examinations and results have been inconsistent. The present study investigated salivary cortisol (as a marker of hypothalamus-pituitary-adrenal (HPA) activity) and salivary alpha-amylase (sAA as a marker of sympathetic nervous system (SNS) activity) within the context of a university examination. Subjects were 40 undergraduate students who participated in an oral examination. Of these, 20 also participated in a second examination within a few weeks. Cortisol and sAA were measured immediately before and after the examination and on a control day. Additionally, subjects filled out personality questionnaires. A strong anticipatory increase in salivary cortisol and sAA as well as more modest further increases between the pre- and post-measurements were detected during the examination. Sex or oral contraceptive use had no influence on either measure. In addition, no significant differences between the first and second examination were observed. The findings indicate the neuroendocrine stress responses to laboratory stressors and to heralded real life stressors as well as the modulatory variables involved differ from each other.     

Effect of pre- and postcompetition emotional state on salivary cortisol in top-ranking wrestlers

The purpose was three-fold: (1) to investigate the effect of baseline, precompetition, and postcompetition stress on salivary cortisol levels in top-ranking Brazilian wrestlers (N = 17) participating in a national competition; (2) to estimate correlations among three stress measures (perceived stress, salivary cortisol, and physiological stress reaction); and (3) to compare cortisol concentrations between losers and winners. Salivary cortisol was collected at baseline, pre-, and postcompetition. Physiological stress reaction and perceived stress scores were measured just before warm-up for the competition. Analysis showed a significant main effect for testing time. Correlations among the stress measures were not significant. Analysis of covariance between the winners (n = 10) and the losers (n = 7) was also not significant. Salivary cortisol concentrations increased after the intense exercise of competition. The wrestlers did not perceive any physiological effects.     

Feeding upon awakening in breastfeeding and bottlefeeding mothers does not affect the awakening cortisol response

An acute breastfeeding stimulus is generally followed by a transient decrease in cortisol levels in mothers. It is currently not clear whether breastfeeding upon waking up would affect the awakening cortisol response (ACR), a significant increase in salivary cortisol levels occurring within 30-45 min after awakening. In the present study, we measured the amplitude and stability of the ACR in response to infant feeding in women who were exclusively bottle-feeding (n = 16), or breastfeeding (n = 13) or feeding their child solid food (n = 12). The results show that the type of infant feeding did not affect the amplitude and stability of the ACR. Given that the ACR has been reported to reflect physical and psychological well-being, our finding that infant feeding upon waking up might not be a confounding factor in ACR studies on the postpartum population represents valuable methodological information.     

The awakening cortisol response: methodological issues and significance

The awakening cortisol response (ACR) is a discrete and distinctive part of the cortisol circadian cycle. In healthy adults salivary free cortisol concentrations increase by between 50 and 160% in the first 30 min immediately post-awakening (approximate average increase of 9 nmol/l, range 4-15 nmol/l, estimated to be equivalent to about three secretory episodes). However there are no agreed norms for the absolute concentrations of free cortisol in saliva either immediately post-awakening (range of 4.7-18.5 nmol/l) or 30 min post-awakening (range of 8.6-21.9 nmol/l). This review explores reasons for these discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence. Although the physiological role of the ACR has not been clearly defined evidence is discussed that suggests it is under a distinct regulatory influence, different from the rest of the diurnal cortisol secretory cycle. Despite the difficulties associated with its measurement a range of studies have demonstrated an association between the ACR and psychosocial variables, stress and health. However it remains unclear whether positive affect and good health are consistently associated with larger or smaller awakening responses. It is early days in the search for the role and significance of the ACR. Its putative role in the regulation of physiological function across the day (e.g. the immune system) and its sensitivity to psychosocial variables make it a prime candidate as an intermediary linking mind and health.     

儿童受欺负与急性社会应激中应激反应的关系

研究旨在考察受欺负经历与儿童下丘脑-垂体-肾上腺轴系统应激功能的关系。根据受欺负得分挑选出52名受欺负和未受欺负儿童,考察两类儿童在特里尔社会应激测验(Trier Social Stress Test,TSST)中的皮质醇分泌及主观紧张度的特征差异。结果发现:(1)在TSST中,受欺负者的皮质醇浓度显著高于未受欺负者;(2)两类儿童在TSST中的主观紧张度不存在显著差异。研究结果与慢性应激破坏HPA轴应激功能的过程是从敏化到钝化的理论假说相一致。     

C-reactive protein polymorphisms are associated with the cortisol awakening response in basal conditions in human subjects

Cortisol affects the acute-phase response, but it is unknown whether C-reactive protein (CRP), an acute-phase reactant, also affects hypothalamus?pituitary?adrenal axis activity. In the present study, associations were explored between CRP haplotypes with plasma CRP concentrations and basal salivary cortisol level. We included 266 physically healthy Caucasian subjects (103 females and 163 males) aged between 18 and 65 years of whom 94 had a psychiatric disorder in a genetic association study. Six tag single-nucleotide polymorphisms capturing the common genetic variation of the CRP gene were genotyped (i.e. rs2808628, rs2808630, rs1205, rs1800947, rs1417938, and rs3091244) to yield common CRP haplotypes. Plasma CRP concentrations, the salivary cortisol awakening response (CAR) (0, 30, 45, and 60?min after awakening), and the diurnal cortisol decline (11:00, 15:00, 19:00, and 23:00 h) were assessed for 2 days. rs2808628, rs1205, rs1417938, and rs3091244 showed expected associations not only with CRP concentrations, but also with salivary cortisol levels during the CAR. Five well-characterized CRP haplotypes were arranged in ascending order according to increasing CRP levels. There was an inverse linear association between CRP haplotypes and cortisol levels during the CAR, but no association with the diurnal cortisol decline. Hence, genetic variants in the CRP gene that are associated with lifetime plasma CRP levels were also associated with salivary cortisol levels after awakening, in basal, non-inflammatory conditions.     

The association of sleep disturbances with endocrine and perceived stress reactivity measures in male employees

Evidence on the relationship between stress reactivity and sleep is conflicting. This study examined the association between disturbed sleep and perceived and endocrine stress reactivity independently of age, body mass index (BMI), and chronic stress. One hundred and twenty middle-aged men were exposed to the Trier Social Stress Test for Groups. The Pittsburgh Sleep Quality Index and the Perceived Stress Reactivity Scale were used to assess sleep and perceived stress reactivity, respectively. Endocrine stress reactivity was examined by assessing salivary cortisol levels. Regression analyses showed that men with disturbed sleep had blunted overall cortisol responses (b = −18.246, p = .044), but the association did not survive adjustment for age, BMI, and chronic stress. In contrast, poor sleep was associated with heightened perceived stress reactivity independently of age and BMI (b = 0.235, p = .005), but additional adjustment for chronic stress attenuated the relationship and only chronic stress remained a significant predictor of perceived stress reactivity (b = 0.470, p < .001). Cortisol and perceived stress reactivity were uncorrelated. In summary, our study indicates associations between sleep disturbances and stress reactivity were not independent of BMI and chronic stress levels, and endocrine and perceived stress reactivity were dissociated.     

Stress management: a randomized study of cognitive behavioural therapy and yoga

In this study, a stress management program based on cognitive behavioural therapy principles was compared with a Kundaliniyoga program. A study sample of 26 women and 7 men from a large Swedish company were divided randomly into 2 groups for each of the different forms of intervention; a total of 4 groups. The groups were instructed by trained group leaders and 10 sessions were held with each of groups, over a period of 4 months. Psychological (self-rated stress and stress behaviour, anger, exhaustion, quality of life) and physiological (blood pressure, heart rate, urinary catecholamines, salivary cortisol) measurements obtained before and after treatment showed significant improvements on most of the variables in both groups as well as medium-to-high effect sizes. However, no significant difference was found between the 2 programs. The results indicate that both cognitive behaviour therapy and yoga are promising stress management techniques.     

Cortisol response to behavior problems in FMR1 premutation mothers of adolescents and adults with fragile X syndrome: A diathesis-stress model

Mothers of adolescents and adults with fragile X syndrome (FXS) are faced with high levels of parenting stress. The extent to which mothers are negatively impacted by this stress, however, may be influenced by their own genetic status. The present study uses a diathesis-stress model to examine the ways in which a genetic vulnerability in mothers with the premutation of the FMR1 gene interacts with child-related environmental stress to predict their morning cortisol levels. Seventy-six mothers of an adolescent or adult with FXS participated in an 8-day telephone diary study in which they reported on the behavior problems of their son or daughter with FXS each day. We analyzed salivary cortisol collected from mothers at awakening and 30 minutes after awakening on 4 of these days. The results indicated that mothers with greater genetic vulnerability had a lower level of cortisol on mornings following days when their son or daughter with FXS manifested more episodes of behavior problems, whereas mothers with less genetic risk evinced the opposite pattern of higher morning cortisol in response to their child's behavior problems. This finding contributes to our understanding of gene-by-environment interactions and highlights the importance of interventions to alleviate parenting stress in mothers raising children with FXS.     

负性情绪对分泌型免疫球蛋白A的影响及其神经内分泌机制

本研究考察负性情绪条件下个体粘膜免疫功能与其交感神经系统、下丘脑-垂体-肾上腺皮质轴反应之间的关系。采用负性情绪图片为情绪应激材料,分析观看图片对个体心率、收缩压、舒张压、唾液皮质醇浓度和分泌型免疫球蛋白A(SIgA)浓度、分泌率的影响。结果发现:(1)负性情绪图片可以诱发被试明显的负性情绪,使其收缩压、舒张压、唾液皮质醇水平明显上升,SIgA水平下降;(2)相关分析表明,舒张压和心率变化趋势与被试的SIgA水平呈负相关;(3)实验说明由负性情绪图片诱发的情绪造成了SIgA下降,且与交感神经系统的变化有关。     

Biological and psychological factors associated with memory function in fibromyalgia syndrome.

Fibromyalgia is a stress-related disorder characterized by chronic pain, memory impairment, and neuroendocrine aberrations. With the hypothesis that biological and psychological symptoms may underlie the cognitive problems, the relative influences of neuroendocrine function and psychological factors on declarative memory were examined among 50 women with fibromyalgia. This within-group analysis controlled for age, education, pain, and relevant medications. Neuroendocrine function and depression had significant independent associations with memory function. Higher log-transformed mean salivary cortisol levels were associated with better performance on both immediate and delayed visual recall and with delayed verbal recall. Depressive symptoms were negatively associated with verbal recall. These findings suggest that a basic disorder of endocrine stress responses may contribute to the cognitive symptoms experienced by fibromyalgia patients.