Hair Cortisol Research Articles

Brief Report: An Examination of Curvilinear Relations Between Perceived Mother-Child Closeness and Maternal Hair Cortisol.

Interpersonal closeness has important health benefits; however, recent work suggests that in certain contexts, closeness can come at a cost. In the current study, curvilinear relations between mother-child closeness and health (e.g., depressive and anxiety symptoms and hair cortisol concentrations [HCC]) were tested. Our sample consisted of 117 mother (Mage=36.86) and child (Mage=73.07 months, 50.86% male) dyads. A quadratic relationship between maternal perceived closeness with their child and self-reported depressive and anxiety symptoms, along with overall hair cortisol output, was hypothesized. Path analysis suggested that the quadratic term was predictive of maternal cortisol (β=0.28, p=0.001) and depression (β=0.23, p=0.014), such that both high and low perceived closeness predict greater maternal depressive symptoms and HCCs as compared to moderate levels of closeness. Results are discussed in terms of parenting support and burnout.

Long-term hair cortisone and perceived stress are associated with long-term hedonic eating tendencies in patients with obesity

IntroductionLong-term biological stress, reflected in hair cortisol and cortisone levels, predicts future weight gain and metabolic deterioration. This is likely at least partially mediated by glucocorticoid-induced increases in hedonic overeating. Yet, the relationship between long-term biological stress and long-term hedonic eating tendencies remains to be elucidated. MethodsWe included N=108 adults with lifestyle-induced obesity (91 women, median body-mass-index=38.4 kg/m2) for our primary analysis investigating cross-sectional associations between long-term biological stress (hair cortisol and cortisone measured in the first 3 cm of scalp hair using liquid chromatography tandem mass spectrometry) and self-reported long-term hedonic eating tendencies (emotional and external eating, ‘Dutch Eating Behavior Questionnaire’, and trait food craving, ‘Food Craving Questionnaire-Trait’). In secondary analyses, we investigated the moderating role of long-term psychological stress (Perceived Stress Scale-14 score) on the relation between hair glucocorticoid levels and hedonic eating tendencies. ResultsHigher hair cortisone levels, but not higher hair cortisol levels, were associated with more food cravings after adjustment for sex and age (p<0.05). The association remained significant after additional adjustment for psychological stress (p<0.05). Psychological stress correlated positively with food craving and hedonic eating (p<0.05), and, in trend, with external eating (p<0.1). Stratification of stress groups (high vs. low psychological stress in addition to high vs. low biological stress) showed food cravings and emotional eating to be highest in the group with both high psychological-stress and high hair-cortisone (p<0.05), suggesting potential additive effects of different stress measures. ConclusionLong-term psychological and biological stress correlate with hedonic eating tendencies with potentially adverse additive effects on weight management and clinical features of obesity.

Hair cortisol concentration, a biomarker of stress, is gradually increased in patients with acute myocardial infarction before the acute episode

Abstract Background/Introduction Chronic stress is considered to be an important element of residual cardiovascular risk and modern guidelines recommend its systematic assessment and treatment. Its pathophysiologic contribution, however, in acute myocardial infarction (AMI) was not, until recently, easy to elucidate. This arises from difficulties in objectively quantifying stress levels using conventional research methods, like questionnaires. Purpose The purpose of our study was to measure stress levels at the days preceding an acute myocardial infarction using a solid biomarker, Hair Cortisol Concentration (HCC). Methods 102 consecutive patients with AMI (71 patients with ST-elevation Myocardial Infarction [STEMI] and 31 with Non ST-elevation Myocardial Infarction) from our institution were recruited for this study. We took hair samples from them to precisely measure HCC, which reflects cumulative cortisol levels for the time period preceding the acute event. We also did full clinical, biochemical and psychological evaluation. HCC levels were then compared with 50 age-matched healthy controls. Results To assess the temporal trend of HCC in hair segments, corresponding to specific time periods, we fitted linear mixed models. The mixed effects linear model including the main effects of time and group (AMI versus controls) and their interaction showed that cortisol concentration in hair increased over time with higher rate of increase in AMI patients versus controls (beta of interaction = 3.57; 95%CI: 1.74, 5.40; p &amp;lt; 0.001) The model explained a high percentage of the variance (conditional R2=0.940). No other baseline variable had a significant effect when added to the basic model. There was no significant difference between STEMI and NSTEMI (beta of interaction = 1.15; 95%CI: -1.330, 3.59; p = 0.358) Conclusions Hair cortisol levels, presumably reflecting stress levels, were gradually increasing before an acute myocardial infarction with higher rate of increase in patients compared to healthy controls. There was no significant difference between STEMI and NSTEMI patients. Picture 1. Predicted hair concentrations of cortisol over time prior to the event, based on linear mixed models.

Chronic stress is gradually accumulated and peaks prior the occurrence of Takotsubo Syndrome: preliminary results based on hair cortisol concentration

Abstract Background Takotsubo syndrome (TTS) is frequently triggered by stressful events suggesting that increased sympathetic activity has a role in its pathophysiology. Hair cortisol concentration (HCC) is a promising biomarker of excess chronic stress by measuring cortisol secreted into hairs over several weeks. Purpose We explored whether premorbid ongoing stress over several weeks assessed by HCC at 2 weeks intervals is associated with the occurrence of TTS. Methods A case-control prospective study was performed by recruiting 18 consecutive TTS patients and 36 age- and sex-matched individuals free from cardiovascular or psychiatric disease. Hair samples were collected from participants vertex. Provided that 1 cm of hair represents cortisol levels over ~1 month period, 2.5 cm of hair samples, with many strands each, were cut in equal parts of 0.5 cm, representing cortisol levels in time intervals of 0-15, 15-30, 30-45, 45-60 and 60-75 days prior to hair collection. Results All TTS patients were women with a mean age of 71.8±11.2 years. HCC was significantly higher in TTS group versus controls starting from 45 days prior to the event (Figure 1A). Based on the linear mixed effects model, HCC was higher in the TTS group compared to controls at any time point and increased over time starting from 75 days prior to the event, while the rate of increase was significantly higher in TTS versus controls (beta of interaction = 0.48; 95%CI: 0.36 – 0.60; p &amp;lt; 0.001). The model explained a high percentage of the variance (conditional R2 = 0.885). The plot of the predicted HCC over time by diagnosis group is shown in Figure 1B. Conclusions Our preliminary data suggest that accumulation of chronic stressful events may cause hypothalamic-pituitary-adrenal axis dysregulation and hyperactivity leading to HCC increase, and this might be implicated in the pathophysiology of TTS.Figure 1.Plot of observed and predicted HCC

No effect of infant nursery rearing on laboratory rhesus monkey dams’ social behavior or long-term cortisol profiles

While the behavioral and physiological impacts of nursery rearing in laboratory-housed infant monkeys have been well characterized, to date no studies have examined the impact on nonhuman primate dams of their infants being removed for rearing in the nursery. Despite the lack of evidence on the topic, anti-animal research groups often cite mother-infant separation and infant nursery rearing (NR) as a welfare concern for laboratory monkey mothers. As such, important policy decisions regarding research activities may result without adequate evidence. Therefore, we designed this study to examine behavioral and hormonal responses in laboratory monkey dams, who were part of independent long-term longitudinal studies, in response to their infants being NR or mother-peer-reared (MPR). We assessed social, self-care, environmental exploration, and abnormal behaviors for 30 days before and 30 days after parturition in rhesus monkey dams (Macaca mulatta, N=49). Infants were randomly assigned to be either NR (N = 27) or MPR (N = 22). We also analyzed hair samples for cortisol concentrations three times across the study period (Pregnancy, Neonatal Period, Peak Lactation). Dams of NR infants showed no gross behavioral differences relative to dams of MPR infants (all p’s>0.05). Dams of MPR infants showed expected increases in social grooming and social contact, and concomitant decreases in foraging and locomotion, in the 30 days post-partum compared to the 30 days pre-partum (p<0.01). Dams whose infants were NR or MPR showed no differences in hair cortisol concentrations across the study period (p>0.05). We conclude that, with respect to the behavioral and endocrine measures we assessed, nursery rearing of their infants is not detrimental to the welfare of laboratory-housed macaque dams.

A geo-gender-based analysis of human health: The presence of cut flower farms can attenuate pesticide exposure in African communities, with women being the most vulnerable.

The rapid expansion of the cut flower industry in Africa has led to pervasive use and potential exposure of pesticides, raising concerns for local communities. Whether the risks associated with pesticide applications are localised or have broader implications remains unclear. We measured biomarkers of real and perceived pesticide exposure in two Kenyan communities: Naivasha, where the cut flower industry is present, and Mogotio, where the cut flower industry is absent. We measured real exposure by the percentage of acetylcholinesterase (AChE) inhibition and perceived exposure by assessing hair cortisol levels, a biomarker of stress. Additionally, we conducted a demographic survey to evaluate the health and socioeconomic status of participants, as well as their perceptions of pesticide risks associated with the cut flower industry. Perceived pesticide exposure was more common in Naivasha (n = 36, 56%) compared to Mogotio (n = 0, 0%), according to community surveys. However, Mogotio residents had significantly higher mean hair cortisol levels (mean (x̄) = 790 ng/g, standard deviation (SD) = 233) and percentage of AChE inhibition (x̄ = 28.5%, SD = 7.3) compared to Naivasha residents, who had lower mean hair cortisol levels (x̄ = 548 ng/g, SD = 187) and percentage of AChE inhibition (x̄ = 14.5%, SD = 10.1). Location (proximity to cut flower farms) and gender were significant factors influencing pesticide exposure, with individuals living outside the cut flower industrial complexes being at higher risk. Women in both communities were the most vulnerable demographic, showing significantly higher mean hair cortisol levels (x̄ = 646 ng/g, SD = 267.4) and percentage of AChE inhibition (x̄ = 22.5%, SD = 12.4) compared to men hair cortisol levels (x̄ = 558.2 ng/g, SD = 208.2) and percentage of AChE inhibition (x̄ = 10.4%, SD = 13.1). A heightened awareness of the potential risks of pesticide exposure was widespread within cut flower industrial complexes. This may have led to a reduction in exposure of both workers and non-workers living within or close to these complexes. In contrast, communities living outside these complexes showed higher levels of exposure, possibly due to limited chemical awareness and a lack of precautionary measures. Despite this contrast between communities, women remained the most vulnerable members, likely due to their socioeconomic roles in African society. Monitoring women's pesticide exposure is crucial for providing an early warning system for community exposure.

Investigating thyroid function and iodine status in adolescents with and without paediatric major depressive disorder.

Depression has been associated with subclinical hypothyroidism and altered hypothalamic-pituitary-thyroid axis functioning. Adequate iodine nutrition is essential for healthy thyroid functioning. We therefore determined associations of iodine and thyroid status with paediatric major depressive disorder (pMDD) among Swiss adolescents and explored whether associations are sex-specific and mediated by stress. We conducted a matched case-control study in 95 adolescents with diagnosed pMDD and 95 healthy controls. We assessed depression severity using the Children's Depression Rating Scale-Revised and stress using the perceived stress scale (PSS) and measuring hair cortisol levels. We determined iodine status by measuring urinary iodine concentrations (UIC) and thyroid status by thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in serum. Median (IQR) UIC did not differ between cases (121 (87, 174) µg/l) and controls (114 (66, 183) μg/l, P = 0·3). Median TSH and FT4 were lower in cases than controls (TSH: 1·36 (0·91, 2·00) mlU/l v. 1·50 (1·18, 2·06) mlU/l, P = 0·039; FT4: 14·7 (12·9, 16·9) pmol/l v. 15·7 (14·3, 17·2) pmol/l, P = 0·004). The prevalence of hypothyroxinaemia (normal TSH; low FT4) was higher among female cases than controls (21 % v. 4%, P = 0·006). PSS scores were higher while hair cortisol was lower in cases than controls (PSS: 25 (20, 28) v. 11 (7, 15), P < 0·001; cortisol: 2·50 (1·34, 3·57) pg/mg v. 3·23 (1·79, 4·43) pg/mg, P = 0·044). After adjusting for confounders, the associations of TSH and hair cortisol with pMDD were no longer significant. Furthermore, TSH and FT4 were not associated with PSS scores and hair cortisol levels. Summarising, iodine nutrition was adequate for adolescents with and without pMDD. However, FT4 concentrations were lower in those with pMDD, and 1 in 5 female adolescents with pMDD were hypothyroxinaemic.

6676 Exposure to Neighborhood Violence Rewires Glucocorticoid Receptor Binding and Drives Proliferation and Invasiveness in Lung Tumor Samples

Abstract Disclosure: H. Heath: None. J. Yoo: None. S. Akter: None. A. Jain: None. V. Sharma: None. H. McGee: None. A. Soliman: None. A. Mohamed: None. A.K. Matthews: None. R. Winn: None. Z. Madak Erdogan: None. S. Kim: None. Background: Despite the lower rates and frequency of smoking, Black men experience a higher incidence of lung cancer compared to white men. This health disparity is even more prevalent in Black men from Chicago, suggesting local neighborhood factors impacting tumorigenesis. Preliminary data indicate that, compared to white men, Black men are more likely to reside in neighborhoods with high levels of violence and have elevated levels of hair cortisol. Objective: To understand the link between lung tumorigenesis and exposure to neighborhood violence, our objective is to investigate the chromatin recruitment of the receptor for cortisol, called the glucocorticoid receptor (GR), and to correlate this recruitment with target gene expression levels. Methods: Utilizing CUT &amp; RUN, we identified the gene binding sites of GR using 15 lung tumor and corresponding healthy tissue samples from lung cancer patients living in Chicago. GR recruitment to chromatin was correlated with the neighborhood homicide rate obtained using patients’ zip codes. Spatial transcriptome profiles for these 15 lung tumor samples were obtained from the Space Ranger pipeline and gene expression hot spots of GR target genes were visualized using Loupe Browser (10x Genomics). Results: GR recruitment to regulatory regions of chromatin increases with greater zip code level violence rates. In patients from high violence neighborhoods, tumor samples had higher magnitude of binding compared to normal neighboring tissue. In tumor samples from patients living in high violence compared to low violence neighborhoods, GR binding is seen in genes that are associated with increased tumor aggressiveness. Hot-spot analysis of these genes found strong co-expression of genes associated with proliferation and invasion in samples from high violence but not low violence neighborhoods. Conclusion: Exposure to neighborhood violence may impact tumor biology via increased GR recruitment to genes associated with proliferation and invasion. Presentation: 6/2/2024

Higher hair cortisol levels associated with previous cardiovascular events and cardiovascular risks in a large cross-sectional population study

BackgroundStress is today a common feature of patients seeking medical care and a growing public health issue in society. A method has been developed to measure biological chronic stress by Hair Cortisol Concentrations (HCC). This biomarker, for chronic stress, captures information about cumulative cortisol levels over the course of several months. Long-term stress might be one of the factors contributing to the onset of cardiovascular conditions and also affecting different risk factors. The aim of this study was to analyse the association between Hair Cortisol Concentrations and previous cardiovascular diseases and cardiovascular risk factors.MethodsThe method of measuring chronic stress by Hair Cortisol Concentration was applied in a large Swedish national observational cross-sectional study. A population-based random sample of N = 4,821 Swedish middle-aged men and women was analysed for hair cortisol levels in relation to diagnosed previous cardiovascular diseases and biologically measured cardiovascular risk factors.ResultsLong-term stress, measured by hair cortisol, was significantly associated with the classical cardiovascular risk factors hypertension and high cholesterol, but not smoking. Those with elevated HCC levels also had a significantly increased pre-history of myocardial infarction, type 2 diabetes, atrial fibrillation and by-pass surgery, but not regarding stroke, angina pectoris or sleep apnoea. Higher HCC was significantly associated (p < 0.001) with Body mass index and waist circumference, but only for females. HCC was also associated with the risk markers leukocytes, and high-sensitivity CRP, indicating a possible linkage between HCC and inflammation and hypothetically also the bodily immune defense. No association was found between perceived stress and HCC.ConclusionsAn overall conclusion of our results is that health care should put more emphasis on patients reporting that they have been exposed to long term stress. Altogether, these analyses of Hair cortisol levels in a large middle-aged population show that chronically elevated cortisol levels represent a relevant and significant factor associated with cardiovascular diseases and classical cardiovascular risk factors.

Body mass index across development and adolescent hair cortisol: the role of persistence, variability, and timing of exposure.

Research suggests a putative role of the glucocorticoid stress hormone cortisol in the accumulation of adiposity. However, obesity and weight fluctuations may also wear and tear physiological systems promoting adaptation, affecting cortisol secretion. This possibility remains scarcely investigated in longitudinal research. This study tests whether trajectories of body mass index (BMI) across the first 15 years of life are associated with hair cortisol concentration (HCC) measured two years later and whether variability in BMI and timing matter. BMI (kg/m2) was prospectively measured at twelve occasions between age 5 months and 15 years. Hair was sampled at age 17 in 565 participants. Sex, family socioeconomic status, and BMI measured concurrently to HCC were considered as control variables. Latent class analyses identified three BMI trajectories: "low-stable" (59.2%, n = 946), "moderate" (32.6%, n = 507), and "high-rising" (8.2%, n = 128). BMI variability was computed by dividing the standard deviation of an individual's BMI measurements by the mean of these measurements. Findings revealed linear effects, such that higher HCC was noted for participants with moderate BMI trajectories in comparison to low-stable youth (β = 0.10, p = 0.03, 95% confidence interval (CI) = [0.02-0.40]); however, this association was not detected in the high-rising BMI youth (β = -0.02, p = 0.71, 95% CI = [-0.47-0.32]). Higher BMI variability across development predicted higher cortisol (β = 0.17, p = 0.003, 95% CI = [0.10-4.91]), additively to the contribution of BMI trajectories. BMI variability in childhood was responsible for that finding, possibly suggesting a timing effect. This study strengthens empirical support for BMI-HCC association and suggests that more attention should be devoted to BMI fluctuations in addition to persistent trajectories of BMI.

Study protocol for a multicentre randomised controlled trial evaluating the efficacy of an online yoga intervention in high-grade glioma patients and their caregivers: the YINOTA-O-trial

IntroductionHigh-grade glioma patients and their caregivers often suffer from distress and a lower quality of life. Results from studies with patients with mixed cancer entities suggest that yoga can be...

Childhood adversity, stress reactivity, and structural brain measures in stress-related/neurodevelopmental disorders, and their comorbidity: A large transdiagnostic cross-sectional study.

Childhood adversity (CA), including childhood adverse life events, increases the risk for development of psychiatric disorders later in life. Both CA and psychiatric disorders are associated with structural brain changes and dysfunctional hypothalamic-pituitary-adrenal-axis. However, many studies investigated single diagnostic and single regions of interest of the brain, and did not take stress reactivity into account. We investigated associations of CA and cortisol levels with gray matter volume and cortical thickness, in a whole-brain manner. Primary analysis constituted of a transdiagnostic approach, followed by a moderation analysis to investigate the influence of diagnosis. Patients with stress-related and/or neurodevelopmental disorders and matched healthy controls underwent an magnetic resonance imaging scan, next to assessing hair cortisol levels and CA/life events. CA was reported by 62-72% of the patients versus 33% of the controls. Primary transdiagnostic linear regression analyses revealed that CA was not associated with gray matter volume, while childhood life events were associated with lower right thalamic volume. Hair cortisol was not associated with any lobe volume. None of the associations were moderated by diagnosis. In conclusion, CA is a risk factor that needs to be taken into account when investigating psychiatric disorders. Yet the relationship with structural brain changes and stress reactivity is less clear than postulated on the basis of more seed-based studies.

Hair cortisol sampling as a measure of physiological stress in youth with acute musculoskeletal pain

Stress physiology contributes to health outcomes. Hair cortisol concentration (HCC) is an objective measure of cumulative cortisol secretion associated with health, including pain. The aim of the current study was to describe associations between pre-injury stress physiology (as measured by HCC), acute pain characteristics and relevant demographic factors (i.e., BMI, age, sex, days since injury) in youth with an acute musculoskeletal (MSK) injury. Participants were 58 youth aged 11 to 17 with acute MSK pain. Participants completed self-report measures assessing pain intensity, pain catastrophizing, and pain interference. Hair was collected within 1 month after injury using hair cortisol collection procedures adapted from published research protocols. Correlations examining associations among HCC values and clinical/demographic factors revealed that higher HCC was associated with lower body mass index (BMI) and male sex. HCC was not associated with pain variables or age. Additional research is needed to clarify the relation between HCC and psychosocial variables to aid researchers in studying the role of pre-injury stress in acute MSK injury and pain recovery in youth.

Relationship between chronic diseases, hair cortisol concentration and welfare of housed dairy goats

The aim of this study was to evaluate the relationship between seroprevalence of chronic diseases, hair cortisol concentration (HCC), and welfare of dairy goats housed throughout a productive cycle. Sixty multiparous dairy goats, over four years old, were selected. An animal welfare assessment was conducted using health indicators for goats, according to the AWIN protocol. Blood samples were also collected for haematology and determination of seroprevalence of chronic diseases, hair samples for determination of HCC, milk samples for chemical composition and somatic cell counts, and faecal samples for parasite load. Small Ruminant Lentivirus (SRLv) had a prevalence of 71.66%, Mycobacterium avium subspecies paratuberculosis (MAP) of 5%, Leptospira interrogans of 40% and Ovine Gammaherpesvirus type 2 (OvHV-2) of 50%. The percentages of goats that tested positive for one, two or three diseases were 31.67%, 50% and 11.66%respectively. Haematological alterations included hyperproteinaemia (84.94 ± 1.58 g/L) and hyperfibrinogenaemia (6.11± 0.65 g/L) for those with one or two diseases, with significant differences being found (P &lt; 0.05). The welfare indicatorsrelated to health and the number of diseases were poor body condition, poor coat, poor udder conformation, andmucosal lesions (P &lt; 0.05). However, no significant differences were observed between HCC and the number of chronicdiseases in dairy goats (P &gt; 0.05). Higher concentrations of cortisol in hair were found at 150 days of lactation (16.65 ± 1.39pg/mg) compared to the mating season (9.55 ± 0.04 pg/mg) (P &lt; 0.05). No associations were found (P &gt; 0.05) betweenthe production, composition, and somatic cell counts in milk and cortisol concentrations and diseases. It was concludedthat the presence of chronic diseases in goats did not influence hair cortisol concentrations, possibly due to an effect ofadaptive tolerance to diseases, as occurs in other domestic species; however, there was an effect of the productive stage.

Evaluating the Effect of a Probiotic on Prevention of Diarrhea, Stress Response, and Social Interactions in a Colony of Macaca fascicularis

Background: Social housing changes are associated with diarrhea in macaques, presumably due to stress. Objective: Since probiotics are utilized in humans for diarrhea, we tested the effectiveness of a species- specific probiotic, SDPro™ (composition: ~2 billion CFU each of live Lactobacillus reuteri and Saccharomyces boulardii), to prevent relocation-associated diarrhea. Assessments of the gutmicrobiome and diarrhea severity were made. Behavioral observations and cortisol levels were examined after relocation to test the effects of the probiotic treatment. Methods: The probiotic was administered to 60 juvenile macaques of both sexes (Probiotic +) and outcomes were compared to 60 control (Probiotic -) macaques. The effects on gut microbiome composition were analyzed via 16s microbiome analysis in half the animals from both groups. Social behaviors were monitored twice-weekly in the morning and afternoon for five weeks following 10- days of SDPro™ administration in 56 subjects and hair cortisol was assayed. Results: Probiotic administration altered beta, but not alpha, diversity, and caused changes in taxa abundance at the phylum, genus, and species levels. The Probiotic + group was enriched in Firmicutes, Clostridium, and Lactobacillus and diminished in Bacteriodies (p’s &lt; 0.05) compared to controls. Although SDPro™ did not alter diarrhea incidence following relocation, it reduced diarrhea severity in males only. Males also exhibited higher cortisol levels than females but there was no probiotic effect. Probiotic treatment had minor behavioral effects; the typical reduction in locomotion seen in the afternoon was eliminated. Conclusion: The results suggest that SDPro™ may be a viable tool to prevent relocation-induced diarrhea in juvenile male macaques.

Echoes of conflict and displacement in maternal health: Life-course violence, timing, and maternal stress after childbirth at the northern Thailand-Myanmar border

Armed conflict, displacement, and related violence is escalating globally, concentrated among civilians and migrants in border areas, and poses grave harms to women and children. The current study investigates how women’s life-course experiences of conflict and displacement are linked to maternal stress and health outcomes after childbirth at the Thailand-Myanmar border, specifically stress, mental health, and cardiometabolic outcomes. Analyses are based on a cross-sectional population-based maternal and child health survey of 701 mothers, collected in 2017–18 in northern Thailand along the Myanmar border, including in camps, worksites, and residential homes. Results suggest that how conflict violence shapes contemporary stress and health depends on the outcome, level and timing of conflict violence exposure, and subsequent contextual threats and deprivation in displacement contexts. Past conflict violence was associated with symptoms of perceived stress (PS) and generalized anxiety disorder (GAD) but not depression. It was also associated with hypothalamic-pituitary-adrenal (HPA) axis activity (hair cortisol concentration) and adiposity (waist circumference and waist-to-hip ratio). Additionally, past conflict violence that began in childhood was particularly salient for PS, GAD, and adiposity; and level and timing of violence were salient jointly for HPA activity. Post-displacement factors also independently predicted higher blood pressure and played a potentially partial mediating role in the association between conflict exposure and both PS and GAD symptoms.

The impact of maternal vulnerability on stress biomarkers and first-trimester growth: the Rotterdam Periconceptional Cohort (Predict Study).

Is the degree of maternal vulnerability positively associated with stress biomarkers (stress hormones, C-reactive protein, tryptophan metabolites, and one-carbon metabolites), and does long-term exposure to stress hormones reduce first-trimester growth? The maternal vulnerability risk score is positively associated with concentrations of hair cortisol and cortisone and negatively with tryptophan, while higher hair cortisol concentrations are associated with reduced first-trimester growth without mediation of tryptophan. A high degree of maternal vulnerability during the periconception period is associated with impaired first-trimester growth and pregnancy complications, with consequences for long-term health of the child and future life course. However, due to the challenges of early identification of vulnerable women, the uptake of periconception care is low in this target group. Between June 2022 and June 2023, this study was conducted in a sub-cohort of 160 pregnant women participating in the Rotterdam Periconceptional Cohort (Predict Study), an ongoing prospective tertiary hospital-based cohort. One hundred and thirty-two women with ongoing pregnancies and available stress biomarker data were included in the analysis. Data on periconceptional social, lifestyle, and medical risk factors were collected via self-administered questionnaires, and these factors were used for the development of a composite maternal vulnerability risk score. Stress biomarkers, including stress hormones (hair cortisol and cortisone) and inflammatory and oxidative stress biomarkers (C-reactive protein, total homocysteine, and tryptophan metabolites) were determined in the first trimester of pregnancy. First-trimester growth was assessed by crown-rump length (CRL) and embryonic volume (EV) measurements at 7, 9, and 11 weeks gestation by making use of an artificial intelligence algorithm and virtual reality techniques using 3D ultrasound data sets. The associations between the maternal vulnerability risk score and stress biomarkers were identified using linear regression models, and between stress hormones and CRL- and EV-trajectories using mixed models. A mediation analysis was performed to assess the contribution of tryptophan. All associations were adjusted for potential confounders, which were identified using a data-driven approach. Several sensitivity analyses were performed to check the robustness of the findings. The maternal vulnerability risk score was positively associated with concentrations of hair cortisol and cortisone (pg/mg) (β = 0.366, 95% CI = 0.010-0.722; β = 0.897, 95% CI = 0.102-1.691, respectively), and negatively with tryptophan concentrations (µmol/L) (β = -1.637, 95% CI = -2.693 to -0.582). No associations revealed for C-reactive protein and total homocysteine. Higher hair cortisol concentrations were associated with reduced EV-trajectories (3√EV: β = -0.010, 95% CI = -0.017 to -0.002), while no associations were found with CRL-trajectories. Mediation by tryptophan was not shown. Residual confounding cannot be ruled out, and the external validity may be limited due to the study's single-center observational design in a tertiary hospital. There is mounting evidence that a high degree of maternal vulnerability negatively affects maternal and perinatal health, and that of the future life course. The results of our study emphasize the need to identify highly vulnerable women as early as possible, at least before conception. Our findings suggest that the chronic stress response and alterations of the maternal tryptophan metabolism are involved in maternal vulnerability, affecting first-trimester growth, with potential impact on the long-term health of the offspring. This study was funded by the Departments of Obstetrics and Gynecology and Clinical Chemistry of the Erasmus MC, University Medical Center, Rotterdam, the Netherlands, and the Junior Award granted by the De Snoo-van 't Hoogerhuijs Foundation in March 2022. There are no conflicts of interest. N/A.

Caring for a child with cancer: Parental competence, distress, and cortisol levels

Parents of children facing cancer are subject to psychological distress. In this study, we explored whether the time that had passed since a child’s cancer diagnosis was associated with parents’ distress levels and whether parental sense of competence (PSOC) moderated this association. Forty-four parents of children with cancer who were hospitalized during 2022 participated. Parents completed questionnaires and provided hair samples for the examination of hair cortisol concentration (HCC). Correlations indicated no significant association between time since diagnosis and distress indices. Yet, linear regression analysis revealed that PSOC moderated the association between time since diagnosis and parental HCC ( β = −0.36, p &lt; 0.05). For parents with low PSOC, time since diagnosis did not predict parental HCC. For parents with high PSOC, a longer time since diagnosis was associated with lower levels of parental HCC. Our results provide support for the clinical significance of PSOC as a target for intervention.

Links between ethnic discrimination, mental health, protective factors, and hair cortisol concentrations in asylum seekers living in Germany

ABSTRACT Objective: Asylum seekers often experience ethnic discrimination on the flight or in the host country, which may be associated with chronic stress and impaired mental health. Dysregulation of the hypothalamic–pituitary–adrenal axis, a known physiological correlate of chronic stress, can be assessed using hair cortisol concentrations (HCC). The present study aimed to investigate how different forms of perceived ethnic discrimination are associated with mental health outcomes, HCC, and protective factors in asylum seekers living in Germany. Methods: Somatic symptoms (PHQ-15), symptoms of posttraumatic stress (PDS), depressive symptoms (PHQ-9), different forms of ethnic discrimination (active harm, passive harm, institutional discrimination), and protective factors (in-group identification, social support) were assessed cross-sectionally in 144 asylum seekers (average age 32 years, average duration of stay in Germany nine months; 67% men). HCC were obtained from 68 participants. Multiple regression analyses were conducted and social support and in-group identification were tested as potential moderators. Results: Active ethnic discrimination was positively associated with all assessed mental health outcomes, and all forms of ethnic discrimination positively correlated with depressive symptoms. Ethnic discrimination was not associated with HCC. When controlling for other possible influences (e.g. age, gender, traumatic events), passive harm was negatively associated with depressive symptoms (β = −0.17, p = .033) and active harm was positively associated (β = 0.28, p = .022) with somatic symptoms. After the inclusion of the protective factors, the associations were no longer significant. Lower social support was associated with higher depressive symptoms (β = −0.35, p < .001), posttraumatic stress (β = −0.77, p < .001), and somatic symptoms (β = −0.32, p < .001), but did not moderate the associations between ethnic discrimination and the mental health outcomes. Conclusions: Perceived ethnic discrimination may negatively influence asylum seekers’ mental health but does not seem to be associated with HCC. Social support was associated with psychological symptom severity, but did not buffer the effects of ethnic discrimination on mental health.

Hair cortisol concentrations in clipped and combed hair and associations with characteristics, health status and stress in domestic cats

Hair cortisol concentrations (HCC) are measured to assess long-term HPA-axis activity and may represent a valuable non-invasive tool to evaluate chronic stress in cats. This study investigated combing as a novel, low-stress method for HCC assessment, as well as possible associations between HCC and cat characteristics in 167 owned cats. Hair was sampled at veterinary clinics through clipping and/or combing the cat, or at home by the owner combing the cat. A questionnaire was sent to cat owners, including inquiries about the cat’s sex, health status, and exposure to stress. HCC was quantified using a commercial cortisol assay kit. Despite variations within and between sampling methods, Spearman’s correlation and Bland–Altman plots revealed a moderate correlation between clipped and combed samples (rs = 0.61, LOA -5.51 ± 22.54). In multiple linear regression, variations in HCC were observed based on sex, health status and cat group size. No associations were found between HCC and stress as assessed by owners. Despite study limitations and remaining uncertainty regarding factors influencing HCC, combing presents a convenient approach for evaluating long-term HPA-axis activity in clinical settings. The association between health and HCC suggests alterations in cortisol levels that are related to disease processes and stress-inducing events associated with the disease.