Efficacy of a short-term physical exercise intervention on stress biomarkers and mental health in adolescents with ADHD: A randomized controlled trial.

Introduction: The purpose of this study was to examine the effects of 30 min of social media (SM) use on salivary cortisol, countermovement jump, reaction time, agility, and anaerobic capacity. Methods: Ten physically active college students (five males and five females) completed the randomized, repeated-measures, crossover design study. Participants completed two trials: 30 min of SM or 30 min of a neutral video. Heart rate and blood pressure were measured during treatment. Salivary cortisol, affect, and Stroop task scores were measured before and after treatment, then participants completed several high-intensity exercise tasks. Treatments were administered at least 48 h apart. Results: No significant differences were found between treatments for vertical jump (median = 0.63 cm; P = 0.18), running reaction time (median = − 0.035 s; P = 0.65), local reaction (median = − 0.32 in; P = 0.71), agility (median = − 0.46 s; P = 0.47), and anaerobic run time (median = 2.5 s; P = 0.39). No significant interaction was found for the Stroop task ( F (1,9) = 0.86; P = 0.38) or salivary cortisol ( F (2,18) = 0.75; P = 0.49) between treatments over time. Conclusion: SM use before exercise did not negatively affect exercise performance, Stroop task scores, or stress after acute treatment.

Multicenter comparison of LC-MS/MS, radioimmunoassay, and ELISA for assessment of salivary cortisol and testosterone.

Determination of hair cortisol by liquid chromatography coupled to mass spectrometry (LC-MS/MS) as biomarker of chronic stress and application to academic students.

Salivary cortisol concentration in western performance horses and riders: Associations with performance.

ABSTRACT Background Societal inequities place some groups of expectant parents, such as those who experience discrimination based on race and class, at greater risk for prenatal depression and stress. Objective The goal of this pilot trial was to assess the feasibility and efficacy of an intervention to reduce depressive symptoms and stress (self‐reported and physiological) among families with low‐income during early pregnancy. Method Participants included 46 dyads, 24 of whom were assigned to the PREParing for Parenthood (PREP) intervention group and 22 to the usual care group. PREP consisted of six psychoeducational group sessions during pregnancy taught by paraprofessionals in a community setting. Interviews were completed at baseline, post‐intervention, and 6 to 8 weeks postpartum to assess for symptoms of depression (Center for Epidemiologic Studies Depression Scale), perceived stress (Perceived Stress Scale), and physiological stress via salivary cortisol. Indicators of intervention feasibility were also collected. Results Results revealed a decrease in depressive symptoms (Cohen's d = .53) and self‐reported stress (Cohen's d = .62) for mothers in the intervention group compared with the control group. Intervention group mothers also had lower physiological stress post‐intervention compared with the control group. No effects were observed for partners. Most participants attended at least five of six intervention sessions and reported high satisfaction with the intervention. Conclusion and Implications The accessible nature of the PREP program makes it a promising intervention to reduce perinatal maternal mental health inequities. Findings contribute to the field of family science by developing and testing one of the first prevention programs to take a family systems approach to promoting mental health during early pregnancy.

Cortisol is built into the circadian clock mechanism, but it is also the body’s natural response to stress. Insight into sex-specific cortisol fluctuations may elucidate individual differences in physiological and pathological patterns. This cross-sectional study examined sex-specific adaptation to stress induced by COVID-19 pandemic and lockdown in foreign medical students at I. Horbachevsky Ternopil National Medical University, Ukraine (TNMU). Salivary cortisol was analyzed using cluster-based mathematical modeling to identify natural groupings in the data. Perceived stress was measured using Perceived stress scale-10 (PSS-10). The academic success was accessed from the official records of the TNMU. Average value of area under the curve (AUC) of daily salivary cortisol from the whole sample showed that men had higher cortisol than women. Mathematical clustering explained shift of the cortisol peak, and divided sample into 5 clusters—two of which had predicted daily cortisol pattern and represented most participants (65.6% men and 73.6% women), while the rest had aberrant daily cortisol pattern. Females had higher total PSS-10 score than males. PSS-10 subscales correlated with aberrant daily cortisol pattern. Unexpectedly, COVID-related circumstances did not have impact on participants’ academic success.

Cortisol, a key biomarker of hypothalamus-pituitary-adrenal (HPA) axis activity, is central to early stress regulation and neurodevelopment. While prior studies have linked maternal and infant cortisol to child outcomes, less is known about their synchrony during early infancy, a time of rapid neuroendocrine development. In this longitudinal study, we examined cortisol coupling and the correlation with maternal adverse childhood experiences (ACEs) in 305 mother-infant dyads from São Paulo, Brazil. Salivary cortisol was collected at ~ 1month (32.3days) and 6months postpartum. We assessed intra- and interindividual cortisol dynamics and coupling using bivariate latent change score modeling. Maternal and infant cortisol were positively correlated at baseline (r = 0.319, p < 0.001) and at 6months (r = 0.208, p = 0.003), suggesting early attunement that diminishes over time. Mothers and infants showed negative self-feedback, where higher baseline cortisol predicted smaller changes (mothers: B = -0.654; infants: B = -0.615; both p < 0.001). Maternal ACEs predicted elevated maternal cortisol at baseline (B = 0.126, p = 0.026) but did not affect the rate of change. These findings reveal early HPA synchrony and gradual decoupling, and highlight the lasting effects of maternal adversity on postpartum stress physiology.

Nurse fatigue has become an escalating global concern due to chronic nursing shortages, especially among ICU nurses. Scientific and effective assessment of fatigue is beneficial for strengthening nurse occupational health management and reducing the turnover rate. Yet previous studies mainly relied on subjective self-reports, with limited integration of objective physiological measures in the nursing population. To investigate the fatigue status of ICU nurses and analyse related influencing factors, so as to provide a reference for formulating targeted intervention measures. From March 2025 to June 2025, a convenience sample was recruited from 9 intensive care units across two teaching hospitals in Beijing, China. Participation in the study was entirely voluntary, and only those who completed both the questionnaire and monitoring procedures were included. Data collected included demographic characteristics, fatigue levels, sleep-wake index, heart rate variability and salivary cortisol levels. In total, 140 nurses participated in the study. The average fatigue severity score among intensive care unit nurses exceeded the established clinical cut-off, and 92.9% of participants reported clinically significant fatigue. Among nurses working 8-h shifts, factors associated with fatigue included heart rate, low-frequency heart rate variability, total sleep time, circadian activity rhythm and cortisol levels after the shift. For nurses on 12-h shifts, predictors included the balance of sympathetic and parasympathetic nervous activity, total sleep time, circadian activity rhythm, cortisol levels before the shift and years of experience in the intensive care unit. Fatigue among nurses in intensive care units is high and is associated with disrupted sleep, reduced self-regulation ability and occupational stress. Interventions should be tailored according to shift type to effectively reduce fatigue. Recognising fatigue predictors enables the development of targeted interventions to mitigate fatigue, optimise work schedules and improve quality of care.

Heat-killed Lactiplantibacillus plantarum SNK12 (SNK), isolated from a traditional Japanese fermented food, has been suggested to influence sleep quality, but human data on sleep improvement with heat-killed lactic acid bacteria (postbiotics) remain limited. We conducted a randomized controlled trial to test whether heat-killed SNK (≥1 × 1011 cells/day for 4 weeks) improves sleep quality and alters stress-related immune and neuroendocrine biomarkers. Healthy adults received SNK or a placebo for 4 weeks. The primary outcome was the Oguri–Shirakawa–Azumi Sleep Inventory MA version (OSA-MA) factor “Sleepiness on Rising”; secondary outcomes were other OSA-MA factors and the stress-related biomarkers salivary cortisol and plasma tumor necrosis factor-α (TNF-α). Compared with placebo, SNK improved Sleepiness on Rising (p = 0.032) and Initiation and Maintenance of Sleep (p = 0.010). Salivary cortisol (p = 0.016) and plasma TNF-α (p = 0.037) were also lower with SNK, and no safety concerns emerged. These concomitant changes in subjective sleep indices and stress-related biomarkers are consistent with modulation of hypothalamic–pituitary–adrenal axis activity and inflammatory pathways along the gut–brain axis. SNK may, therefore, represent a practical postbiotic option to support sleep quality.

Stigmatized adults in the United States experience significant hypertension disparities that may be influenced by greater exposure to discrimination. Although discrimination is posited to contribute to hypertension disparities, researchers have largely focused on the role of experienced discrimination with limited examination of other types of discrimination, such as anticipated and vicarious discrimination. Existing research ignores intersectional discrimination, which obscures the experiences of those that face discrimination due to multiple stigmatized identities. This study addresses limitations of prior work by examining the influence of intersectional anticipated and vicarious discrimination on blood pressure in adults within their real-world contexts. This 7-day intensive longitudinal study uses an intersectional approach to examine the influence of daily and chronic forms of anticipated and vicarious discrimination on blood pressure and mediators of these associations. The proposed sample includes 400 adults (ages 18-64) living in New York City that are diverse in terms of ethnoracial, sexual, and gender identities. The study includes two in-person visits and a 7-day home assessment. Participants will complete a baseline structured interview, daily structured morning diaries, daily structured evening diaries, self-collection of saliva samples to assess salivary stress biomarkers, continuous wrist-worn actigraphy, and home blood pressure monitoring. We will test physiological (e.g., salivary cortisol), behavioral (e.g., sleep duration and physical activity), and affective (e.g., depressive and anxiety symptoms) factors to determine whether they mediate the influence of anticipated and vicarious discrimination on blood pressure. We will use multilevel linear models to estimate within- and between-person effects of daily and chronic anticipated and vicarious discrimination on blood pressure. My Heart, My Self addresses significant limitations in prior research on the link between discrimination and cardiovascular health. Our findings may shed light on effects of indirect forms of discrimination on blood pressure. This work will inform behavioral interventions that target anticipated and vicarious discrimination as risk factors for cardiovascular disease.

Objective: To evaluate the efficacy of a composite psychosocial intervention centered on guided singing intervention (GSI) combined with mindfulness meditation and cognitive-behavioral therapy (CBT) elements in palliative cancer care. Methods: In a randomized controlled trial, 200 adult oncology patients were assigned to an experimental group (n = 100; GSI+mindfulness+CBT plus usual care) or a control group (n = 100; usual care) over 8 weeks. Planned follow-ups were scheduled at 3, 6, and 12 months (T3, T4, T5). Outcomes included emotional expression and suppression scale, GAD-7, PHQ-9, VAS, WHOQOL-BREF, salivary cortisol, and singing self-efficacy scale. Results: Compared with controls, the experimental group showed significantly greater improvements in emotional externalization, anxiety/depression reduction, pain relief, quality of life, cortisol reduction, and vocal self-efficacy at T2 (all p &lt; 0.01). Conclusion: An active, participatory intervention integrating guided singing, mindfulness, and CBT can modulate autonomic function, enhance emotional externalization, and strengthen peer support, offering a feasible, low-cost, and scalable nonpharmacological model for palliative oncology care.

Introduction : Disruptions in cortisol awakening response (CAR), changes in Profile of Mood States (POMS), and decreases in heart rate variability (HRV) have been associated with fatigue and strenuous exercise. Whey protein isolate (WH) may improve stress responses. Purpose : To determine the effects of WH supplementation on CAR, POMS, and HRV after strenuous exercise. Methodology : Eleven recreationally active females (19 &amp;plusmn; 2 yrs) completed a double-blinded, placebo-controlled crossover trial. Placebo (PL) was maltodextrin, and the intervention was 25 g of maltodextrin with 25 g of WH consumed prior to exercise. Exercise was 30 min at 70-75% VO 2peak (M = 21.7, SD = 0.1 ml/kg/min), 5 min rest, and 30 s Wingate anaerobic test (WAnT). HRV and POMS were recorded the following morning. Repeated measures ANOVA determined differences (p &lt; .05) in 60 min salivary cortisol AUCg (CAR), POMS, HRV, and WAnT fatigue index (FI). Pearson&amp;rsquo;s correlation and multiple regression identified associations between CAR, POMS, HRV, and FI. Results : CAR was significantly different ( p = .033) between Placebo (33.4 &amp;plusmn; 2.0 pg/dL*hr) and WH (30.9 &amp;plusmn; 0.8 pg/dL*hr), with no significant differences in POMS, HRV, or FI. There was a significant correlation between POMS and FI on Day 3 during PL ( r = -.582, p = .030). Neither CAR, POMS, nor HRV was able to predict FI (all p &gt; .05). Conclusions : Whey protein isolate may decrease CAR, but may have no effect on POMS, HRV, or FI, and no effect on short-duration sprint cycling performance. Limitations : WAnT performance was not affected; therefore, any association with reducing the physiological effects of central fatigue may be minimal. Practical applications may include a viable methodology for suppressing CAR in this type of participant. &amp;nbsp; Originality : The current study is unique in combining nutritional supplementation, exercise, and salivary cortisol post-exercise with female participants.

Background: Insomnia is prevalent and difficult to treat safely over the long term. Given the role of the microbiota-gut-brain axis in melatonin and hypothalamic-pituitary-adrenal (HPA) regulation, and preclinical evidence for Limosilactobacillus fermentum PS150, we evaluated whether a heat-treated formulation (HT-PS150) could improve sleep and modulate endocrine/circadian markers in adults with poor sleep. Methods: In a randomized, double-blind, placebo-controlled trial, 84 adults aged 20-60 years with PSQI ≥ 5 and ISI < 22 were assigned to receive either placebo or HT-PS150 for eight weeks. Outcomes included patient-reported sleep (PSQI, ISI), anxiety/depression (GAD-7, PHQ-9), quality of life (QLESQ-SF), gastrointestinal symptoms (VAS-GI), wrist actigraphy (Fitbit Inspire 3), and sleep-relevant biomarkers measured from urine, saliva, and/or blood samples (melatonin, cortisol, orexin, serotonin, GABA, and/or norepinephrine). Repeated measures were analyzed using generalized estimating equations. An exploratory proportional regulation analysis classified individual biomarker changes as up- or down-regulated and compared proportions between study arms. Per-protocol analyses required ≥80% compliance. Results: Improvements in the primary outcomes, PSQI and ISI, were observed over time in both groups, while no significant group × time interactions were detected. In exploratory proportional analyses, a higher proportion of participants in the HT-PS150 group exhibited up-regulated nocturnal melatonin secretion and improved daytime plasma orexin levels, as well as a tendency toward greater reductions in nocturnal salivary cortisol compared with placebo. In subgroup analyses with higher baseline insomnia severity (ISI ≥ 8), HT-PS150 was associated with greater improvements in PSQI (notably sleep duration and efficiency) and reduction in anxiety (GAD-7) upon post hoc testing. Conclusions: Although group mean scores on sleep symptom scales did not differ significantly in the full cohort, HT-PS150 appeared to modulate sleep-wake regulation by enhancing nocturnal melatonin secretion, attenuating HPA-axis activity, and stabilizing wakefulness. Clinical benefits were most evident among participants with greater baseline symptom burden, suggesting potential utility in more symptomatic populations.

Inhibitory control is crucial for humans to select useful information from the complex environment. The bilateral DLPFC, which is implicated in inhibitory control, was activated under psychological stress. The present study investigated the influence of acute psychological stress on inhibitory control process using the color-word Stroop task. The stress was induced by the Trier Social Stress Task (TSST). After TSST (stress group) or placebo TSST (control group), the male participants performed a color-word Stroop task, and their brain activity was measured using functional near-infrared spectroscopy (fNIRS). The results showed that elevated subjective stress, heart rate, and salivary cortisol were found in the stress than control groups, indicating that the stress had been induced successfully. Reduced RT Stroop effect (RTincongruent - RTcongruent) was found for the stress group compared to the control group. The fNIRS results revealed greater activation in bilateral dorsolateral prefrontal cortex (DLPFC) in the stress than control groups. In addition, the activation in left DLPFC was increased for the stress than control groups in incongruent trials, but not in the congruent trials, resulting in a larger magnitude of the activation Stroop effect (activationincongruent - activationcongruent) in the stress group. These results demonstrate that acute psychological stress may potentially improve inhibitory control in healthy men.

The changes of endocrine state of elite athletes have been mostly researched in regards of effects of strenuous training, the stress of competition, the risk of overtraining and the difference between sports. However, the baseline hormonal profile of athletes was not followed along from a young age to their adult careers. Since the selection into professional athletic institutions starts years before reaching adulthood, training influences both somatic and psychological developmental processes. A relatively novel non-invasive tool to easily follow young elite athletes’ progression on an endocrine level is the analysis of salivary biomarkers. We set our research goal to mapping out the endocrine profile of elite athletes and compare their results to the available recommended salivary ELISA non-athlete references. In the Sport Sciences and Diagnostic Research Centre of the Hungarian Handball Federation (between 2023–2025), we analysed 507 elite handball player’s (aged 13–35 ys) salivary cortisol, testosterone, and in case of female players, 17-β-oestradiol levels. The results of salivary resting hormone concentrations showed that adult male handball players had a high relative frequency of high testosterone levels, while female players had high prevalence of low oestradiol levels compared to non-athlete references. The cortisol concentrations showed different patterns in subadult and adult athletes, an increased level of cortisol in adult handball players was found. The detected salivary concentration in athletes and the analysis of age dependent patterns necessitates the creation of athlete-specific references and the extension of the non-athlete references into the younger, subadult age ranges.

Objectives: This systematic review and meta-analysis investigated whether salivary cortisol and alpha-amylase levels differ between patients with anorexia nervosa (AN) and healthy controls. Methods: A systematic literature search was conducted in PubMed, ScienceDirect, SpringerLink, and Scopus for relevant studies published up to December 2024. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Statistical heterogeneity was assessed using Cochran's Q and the I2 statistic. Results: Data on salivary alpha-amylase were extracted from six studies including 218 patients with AN and 220 healthy controls. No significant group difference was observed (SMD = -0.48; 95% CI, -1.05 to 0.10; I2 = 86%), though sensitivity analysis indicated significantly lower levels in AN (SMD = -1.12; 95% CI, -2.16 to -0.09; I2 = 82%). Salivary cortisol was assessed in 24 reports from 17 studies (517 patients with AN, 672 controls), revealing significantly higher levels in AN (SMD = 0.69; 95% CI, 0.54-0.85; I2 = 30%). Sensitivity analyses showed stable effect sizes. Meta-regression indicated that neither age nor body mass index significantly moderated the results. Conclusions: Salivary cortisol may serve as a reliable, noninvasive biomarker for AN, with potential utility in early identification and prevention of disease progression.

University exams are recognised as naturalistic stressors that may elicit psychosocial and physiological responses in students. This pilot study investigated the short- and long-term effects of exam-related stress on hypothalamic-pituitary-adrenal (HPA) axis activity, focusing on cortisol production and rhythmicity. Twenty-seven undergraduate students (aged 18-24 years) from a biological sciences programme participated. Hair cortisol concentrations were analysed for October (non-exam month) and November (exam month), while salivary cortisol was collected during 3 consecutive exam weekdays (Monday to Wednesday) at five daily time points to assess diurnal variation and the cortisol awakening response (CAR). Hair cortisol levels were significantly higher in November than in October, suggesting greater cumulative HPA activation during the exam period. Salivary cortisol displayed a general diurnal pattern and CAR across the week. Morning cortisol values showed a nonsignificant numerical increase across days, though overall daily cortisol output (AUC) remained stable. Exam periods may be accompanied by elevated cumulative cortisol exposure while short-term HPA rhythmicity remains preserved. The combined use of hair and salivary biomarkers offers a multidimensional and feasible approach to investigating acute and cumulative stress responses in students. Larger longitudinal studies incorporating behavioural measures are warranted to confirm these findings.

Orienteering demands integrated cognitive–physical performance, making it ideal for evaluating psychophysiological resilience. This study aimed to examine whether an orienteering-based intervention enhances autonomic regulation, endocrine adaptation, and emotional competence in adolescents. Seventy-two participants (36 in the intervention group, 36 in the control group) completed a 4-week orienteering program, with assessments at T1, T2, and T3. Core outcomes included RMSSD, SDNN, salivary cortisol, PSS-10, PANAS-C, and EISA-24. Emotional profile classifications and moderation analyses were performed. Statistical tests included repeated-measures ANOVA, t-tests, and stratified subgroup comparisons, executed using R software (R Computing, Austria). RMSSD improved from 44.7 ± 13.1 ms to 54.6 ± 13.5 ms (t = − 4.36, p = 0.002, d = 1.12); SDNN rose from 64.1 ± 13.9 ms to 72.1 ± 13.8 ms. Cortisol declined from 0.46 ± 0.17 to 0.36 ± 0.13 µg/dL (p = 0.004). PSS-10 scores dropped from 18.6 ± 4.5 to 14.7 ± 4.0. Positive affect rose by + 4.9 points (p = 0.003); weekly RPE declined from 12.6 to 11.1. Self-regulation increased by + 4.2 points, and resilient emotional profiles rose from 26.7% to 70.0%. Orienteering-based training significantly improved physiological regulation, stress reduction, and emotional resilience in adolescents.Trial registration: This trial was retrospectively registered with the UK Clinical Trials Registry (ISRCTN14846325). The overall study commenced on 01 May 2024 and was completed on 28 August 2024.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-025-27719-x.

Clarifying the etiology of mental disorders should lead to significant therapeutic and preventive measure improvements. Mental disorders are caused by genetic, epigenetic, and environmental factors. A valid assessment of environmental etiological factors is complicated due to a lack in methodologies. We aim todemonstrate how to optimally assess the environmental etiological factors with a special focus on stress. We searched the PubMed database up to December 2024 for relevant state-of-the-art references. The most frequently used stress assessment method involves self-reporting questionnaires. Blood or salivary cortisol, heart rate, respiratory rate, plethysmography readings, and electrodermal activity are biological markers of acute stress. Other biological markers such as hair and nail cortisol levels, telomere length, mitochondrial DNA copy number, and epigenetic markers are indicative of a history of stress. A quantitative prospective assessment of environmental etiological factors including their frequency, severity, total exposure length, timing, and possible accumulation is still needed. In addition, protective environmental factors of mental disorders should not be neglected.