Salivary Cortisol Samples Research Articles

Salivary Cortisol Concentration Is an Objective Measure of the Physiological Response to Loud Music.

Purpose: This study examines the potential associations between salivary cortisol concentrations and subjective stress test scores in healthy individuals subjected to sound-related, psychological, and physical stressors. Methods: This study employed a single-center observational cross-sectional design, with a sample size of 36 subjects recruited from a tertiary referral audiology center. Between 2023 and 2024, the study recruited subjects with normal hearing, baseline salivary cortisol levels, and subjective stress levels. The participants were requested to complete an STAI-Y1 questionnaire and provide salivary cortisol samples before and following exposure to sound-related, psychological, and physical stress tests. Results: Exposure to psychological and physical stressors significantly increased STAI-Y1 scores (Friedman's test, χ2 = 57.118, df = 2, p = 0.377). This increase was greater than that observed in response to loud, favorite music (Friedman's test, χ2 = 57.118, df = 2, p < 0.0001). The salivary cortisol concentration significantly increased in all three provocation tests (Friedman's test, χ2 = 95.264, df = 5, p < 0.0001). Furthermore, there is no significant difference in salivary cortisol concentrations between the three pre-test and post-test measurement intervals, indicating a comparable stress-inducing pattern regardless of the nature of the stimulus (Friedman's test, χ2 = 95.264, df = 5, p > 0.05). Conclusions: Exposure to loud favorite music increases salivary cortisol concentrations, as does acute physical and psychological stress. Interestingly, unlike psychological and physical stress, loud music was not objectively perceived as stress, which may mask the physiological signs of stress, potentially increasing the risk of both acute and chronic stress-related health outcomes.

Sample size calculations based on day-to-day variability of stress biomarkers in persons with dementia and their family caregivers

Introduction: Accurate estimates of intra-individual variability are necessary for proper design of clinical trials and epidemiological studies where the stress biomarkers cortisol and dehydroepiandrosterone sulfate (DHEA-S) are measured for dyads of persons with dementia (PWDs) and their family caregivers (FCGs). The aim is to determine the number of consecutive sampling days required to detect effect differences in clinical trials, and to accurately estimate regression coefficients in epidemiological studies where stress biomarkers are exposure variables in regression models with future disease as outcome. Methods: Clinical trial data from dyads of PWDs and their FCGs were used. Salivary cortisol and DHEA-S samples were collected five days a week, for eight consecutive weeks. From this data, we created formulas and graphical tools for the number of required sampling days needed to detect effect differences, and we calculated number of days needed for regression coefficients to be estimated with&lt;10% bias. Results: A total of 5791 salivary samples from 34 dyads were used. For morning cortisol, five consecutive sampling days at baseline and an equal number of days at study termination is sufficient to detect a treatment difference&gt;5% of baseline level with&gt;20 dyads per group. When stress biomarkers are used in epidemiological studies at least six consecutive sampling days are required. Conclusion: Based on a large number of consecutive measurements of stress biomarkers we calculated the sufficient numbers of sampling days for clinical trials and for epidemiological studies to produce credible results. Our findings will aid researchers in the study design phase.

Morning Salivary Cortisol Has a Positive Correlation with GAD-7 Scores in Patients with Ulcerative Colitis.

Objectives: Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions of the gastrointestinal tract, comprising ulcerative colitis (UC) and Crohn's disease (CD). Earlier onset of IBD symptoms has been linked to a higher prevalence of depression and anxiety. Evidence supports that cortisol abnormalities correlate with the development and severity of autoimmune diseases. The primary aim of this study was to investigate the correlation of morning salivary cortisol levels with self-reported mood (depression and anxiety) and quality of life in patients with IBD. Methods: This was a prospective, single-center study including outpatients with IBD. Enrolled patients provided a one-time morning salivary cortisol sample and electronically completed a one-time survey encompassing self-reported quality of life (Short Inflammatory Bowel Disease Questionnaire (SIBDQ)) and mood (Patient Health Questionnaire 8 (PHQ-8), General Anxiety Disorder-7 (GAD-7)). Results: A total of 36 patients (UC, n = 21) were included in the study. There was no correlation between morning salivary cortisol and depressive symptoms (PHQ-8: r = 0.007, p = 0.968) or quality of life (SIBDQ: r = -0.095, p = 0.606). However, there was a trend towards a positive correlation between self-reported anxiety symptoms by GAD-7 and salivary cortisol (r = 0.347, p = 0.052). A subgroup analysis showed a positive correlation between morning salivary cortisol and GAD-7 scores in patients with UC (r = 0.535, p = 0.015), but not in patients with CD (r = 0.064, p = 0.843). Conclusions: This pilot study is the first to associate cortisol with anxiety symptom severity in UC. Further research is needed to investigate the link between salivary cortisol, neuropsychiatric disease, and IBD outcomes.

The Living Lab at Home: Feasibility and Acceptability of Multimodal In-Home Data Collection Among Youth Across the Developmental Spectrum.

Dynamic, real-time, in-home methods of data collection are increasingly common in child health research. However, these methods are rarely cocreated or used with families of youth with developmental disabilities. We aimed to determine the feasibility of codesigned methods for in-home data collection for youth across the developmental spectrum. Sixteen youth (14-18 years) with autism spectrum disorder, cerebral palsy, and/or chronic pain completed 14 days of data collection, wearing an accelerometer, answering Ecological Momentary Assessment (EMA) questionnaires, and collecting salivary cortisol samples. Participants completed a poststudy interview regarding their experiences. Data were analyzed for feasibility, quantity, and quality. At least 1 EMA response was provided on 73% of days, with 54% of the total number of administered prompts answered before the next prompt arrived. In total, 77% of participants wore the accelerometer ≥10 hours for at least 7 days. Adherence to 8-day saliva sampling after accounting for protocol violations and dry samples was 28%. No significant adverse events were reported aside from mild emotional distress (25%). Families reported generally high satisfaction, willingness to participate again, and acceptability, with moderate burden and interference. Qualitative interviews described: (1) the research question's value to the family as a motivator of engagement; (2) in-home data collection is not a passive or neutral experience; (3) personalized approaches and context are important to families; and (4) a clear need for continued iteration and engagement. In-home multimodal data collection is potentially feasible for families across the developmental spectrum but requires iteration based on family feedback to increase adherence.

Exposure to diesel-related particulate matter, cortisol stress responsivity, and depressive symptoms in adolescents

Exposure to air pollution is associated with higher risk for psychopathology; however, the mechanisms underlying this association are not clear. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis in response to stress has been implicated in depression. Here, we estimated annual exposure to particulate matter (PM) from diesel emissions in 170 9- to 15-year-old adolescents (56 % female) using their residential addresses and data from nearby monitoring sites. We obtained salivary cortisol samples from participants while they completed a social stress task and calculated area under the curve with respect to ground (AUCg) and with respect to increase (AUCi) in order to assess cortisol responsivity during stress. Participants also reported on their depressive symptoms and sleep disturbances. Greater exposure to diesel PM was associated with lower cortisol output (AUCg) during stress, which was associated with higher depressive symptoms, particularly for adolescents with more sleep disturbances. Importantly, these effects were independent of household and neighborhood socioeconomic disadvantage and exposure to early adversity. Thus, HPA-axis dysfunction may be one mechanism through which environmental pollutants affect adolescents’ mental health.

Cortisol concentrations in substance use disorder patients undergoing short-term psychotherapy incorporating equine interaction compared to cognitive behavioral therapy: A preliminary study

Psychotherapy incorporating equine interaction (PIE) is emerging as an effective supplemental substance use disorder (SUD) treatment. Benefits are attributed to decreased stress levels associated with the presence of the horse, however, research concerning stress parameters related to short-term equine interaction during SUD treatment is limited. Therefore, the purpose of this preliminary study was to investigate cortisol concentrations in SUD patients participating in PIE for two weeks compared with those in traditional cognitive behavioral therapy (CBT). Salivary cortisol samples were collected from two populations of SUD patients: 1) PIE participants (n = 18) and 2) CBT participants (n = 5). The impacts of the therapy type and the week of sampling were analyzed using a mixed linear model in SAS. Significance level was set at P ≤ 0.05. When comparing PIE to CBT, no impact associated with therapy type was determined (P = 0.74). Cortisol concentrations lacked significant changes during the two-week period for both therapeutic interventions. While short-term intervention lacked improvement in cortisol levels for both therapy types, further research is warranted to determine the most effective approach and duration of therapy.

8267 A Case of Pineal Gland Cyst and Adrenal Adenoma- Is this a New Syndrome?

Abstract Disclosure: M. Siddiqui: None. U. Rafat: None. S. Shaik: None. J.L. Gilden: None. Background: The Pineal Gland receives information through a complex multi-neuronal pathway and is responsible for the secretion of melatonin, a hormone regulated by circadian rhythm and suppressed by light stimuli. Melatonin is involved in biological rhythms and regulates immunomodulation, temperature homeostasis and maturation of hypothalamic-pituitary and gonadal axis, and can also modulate thyroid, prolactin, growth hormone, cortisol, and ACTH activity. Other effects include downregulation of thyroid activity. In addition, studies have shown that pineal body extracts can cause a minor increase in the zona glomerulosa and fasciculata of the adrenal gland. Case: A 54-year-old male with recurrent nephrolithiasis, obstructive sleep apnea and chronic rhinosinusitis, first presented to Endocrinology Clinic in 2018 for evaluation of an incidental adrenal adenoma (CT abdomen -2.8 cm, less than 10 Hounsfield units, left sided lipid rich adrenal adenoma). He had new onset erectile dysfunction, decreased libido, and fatigue. Initial lab work including LH, FSH, TSH, midnight salivary cortisol, ACTH, plasma cortisol AM, free and total testosterone, aldosterone, plasma and urine metanephrines/normetanephrines were all normal. MRI brain-1 cm thin-walled pineal cyst with internal characteristics compatible with proteinaceous benign pineal cyst. He was then lost to follow-up for 5 yrs due to the COVID pandemic. He had tried taking “testosterone protein builders”, but his symptoms remained. In addition, he now has twice weekly dull occipital headaches, relieved by ibuprofen. Lab tests-elevation in 1of 2 MN salivary cortisol samples at 0.58 mcg/dL (nl≤0.09), ACTH 12pg/mL(0-47), IGF1 261 ng/mL(50-317), and low total testosterone 222 ng/dl (250-1100) Free testosterone 36 pg/mL(35-155), borderline low TSH 0.386 µIU/ml(0.55-4.78), Free T3 and Free T4 were normal, thyroid antibodies-negative . Rest of the hormone evaluation was otherwise normal, LH 4.90 mIU/mL(1.5-9.3), FSH 11.10 mIU/mL (1.4-18.1), Prolactin 6.8 ng/mL(2.1-17.7). Thyroid Ultrasound-homogeneous echogenicity of the thyroid gland without discrete thyroid nodules. Repeat MRI brain- benign pineal cyst which was stable with no midline shift or mass effect. Repeat CT adrenal gland-lipid rich adrenal adenoma slightly reduced in size from 2.8 to 2.4 cm. Lab tests returned to normal one month later. Conclusion: Although it is unclear whether there is an exact association between this patient’s pineal cyst and adrenal adenoma, there have been intermittent hormonal abnormalities and symptoms consistent with hypogonadism and/or adrenal, also possibly related to the pineal abnormality. Although more research needs to be conducted explaining the relationship between the pineal and pituitary, and the adrenal gland, this clinical case suggests that there may be a relationship between these two abnormalities and symptoms. Presentation: 6/2/2024

Impact of Six Months of Three Different Modalities of Exercise on Stress in Post-Treatment Breast Cancer Survivors

Abstract: Background/Objectives: Extensive evidence suggests that exercise is physically and mentally beneficial for cancer survivors. This study reports on changes in self-reported stress, physiological biomarkers for stress (salivary cortisol), and HR-QOL constructs for fifty breast cancer survivors participating in one of three different exercise programs over 6 months. Methods: Fifty post-treatment breast cancer survivors were randomized to either therapeutic yoga-based exercise (YE), comprehensive exercise (CE) (aerobic, resistance, flexibility), or choosing (C) their own exercise activities. Participants completed the Perceived Stress Scale (PSS), Medical Outcomes Short-Form 36® (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Five samples of salivary cortisol were collected on two consecutive days. The 10 samples were used to calculate the diurnal rhythm slope. Outcome measures were repeated after six months. Results: All groups improved in HR-QOL measures of PSS; PSQI sleep quality components of latency and daytime functioning; and five of the ten SF-36 scales (Mental Component Scale, Social Functioning subscale, Mental Health subscale, Physical Component Scale, Physical Functioning subscale). Although the CE group observed the most favorable change in cortisol (−0.183), where cortisol slope changes approached significance (p = 0.057), but no significant decrease in cortisol between groups were noted. Conclusion: Our results suggest that it is the engagement of, rather than the specific type of exercise, which is associated with improved HR-QOL. However, longer-term studies with better adherence monitoring and larger sample sizes are needed to better determine clinical impact.

Emotion dysregulation and posttraumatic stress symptom severity: The influence of cortisol reactivity following idiographic emotion inductions.

Emotion dysregulation plays a central role in the etiology and maintenance of posttraumatic stress symptoms (PTSS). Individual differences in physiological responses to emotionally evocative events may influence the strength of this association. The objective of this study was to test whether cortisol reactivity following idiographic emotion induction tasks moderated the relation between emotion dysregulation and PTSS severity. Participants were 94 community women currently experiencing intimate partner violence and using substances (age: M = 40.5 years; 35.2% Black; 61.5% unemployed). PTSS severity was assessed at baseline via a clinician-administered diagnostic interview. Participants provided a self-report of emotion dysregulation at baseline. Samples of salivary cortisol were collected pre-, during, and postidiographic emotion inductions during an experimental session. A significant emotion dysregulation by cortisol reactivity interaction was found (b = 0.18, p = .02). Emotion dysregulation was related to PTSS severity for those with high (b = 0.13, p < .001), but not low (b = -0.001, p = .99), levels of cortisol reactivity following idiographic emotion inductions. Findings provide novel evidence of the interplay of emotion dysregulation and cortisol reactivity, an indicator of hypothalamic-pituitary-adrenal system axis stress reactivity, following emotionally evocative stimuli in relation to PTSS severity. Information from this study may help to identify individuals who are at highest risk of more severe PTSS. Future work is needed to replicate findings among diverse populations impacted by trauma (e.g., veterans, men). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ethnic Identification and Stress: Examining HPA Axis Reactivity in Response to a Discrimination Related Laboratory Stressor

Through processes of colonization, American Indians and Alaskan Natives (AI/AN) have faced continuous, ongoing efforts to diminish their unique ethnic identities. Maintaining a robust ethnic identity may shield against harms related to colonization, such as ethnic discrimination. Ethnic discrimination is a psychosocial stressor with implications for the reactivity of our main stress axis, the hypothalamic-pituitary-adrenal (HPA) axis. However, whether ethnic identification buffers against ethnic discrimination remains unclear. The current study examined the stress-buffering effects of two facets of ethnic identification – exploration and commitment – on HPA reactivity in 303 urban-dwelling AI/AN using samples of salivary cortisol collected throughout a discrimination-based stressor task. Building on the rejection-identification hypothesis and other related theories, we hypothesized that ethnic identity exploration will predict greater HPA axis reactivity and commitment will predict lesser HPA axis reactivity. Findings revealed that exploration and commitment were both positively related to stress levels, contrary to expectations that commitment would weaken the relationship between discrimination and stress. Results align with broader findings suggesting ethnic identity can intensify stress responses to discrimination. These findings contribute to a deeper understanding of discrimination-related stress and ethnic identification as they relate to ongoing health disparities and challenges experienced by AI/AN communities.

The interaction of oxytocin and nicotine addiction on psychosocial stress: an fMRI study

The anxiolytic effect of oxytocin (OXT) on psychosocial stress has been well documented, but the effectiveness under the interference of other factors still requires in-depth research. Previous studies have shown that nicotine addiction interacts with OXT on psychosocial stress on the behavioral level. However, the underlying neural mechanism of interaction between OXT and nicotine addiction on psychosocial stress has not been examined, and we conducted two experiments to reveal it. Firstly, after intranasal administration of randomized OXT or placebo (saline), a group of healthy participants (n = 27) and a group of smokers (n = 26) completed the Montreal Imaging Stress Task (MIST) in an MRI scanner. Secondly, a group of smokers (n = 22) was recruited to complete a transcranial direct current stimulation (tDCS) experiment, in which anodal tDCS was applied on subjects’ anterior right superior temporal gyrus (rSTG). In both experiment, subjective stress ratings, salivary cortisol samples and the amount of daily cigarette consumption were obtained from each participant. Analysis of variance were applied on both behavioral and neural data to examine the effects of OXT and nicotine addiction, and correlation analysis were used to examine relationships between neural and behavioral data. In first fMRI experiment, analysis of variance (ANOVA) revealed an interaction of OXT and nicotine addiction on subjective stress. In smokers, OXT failed to suppress the elevation of subjective stress and craving ratings after psychosocial stress. A voxel-wise ANOVA of fMRI data identified an interaction between OXT and nicotine addiction in anterior rSTG, and its functional connectivity with right middle frontal gyrus. Correlations between this functional connectivity and subjective psychosocial stress were also found abnormal in smokers. In second tDCS experiment, we found that under tDCS, OXT successfully suppressed the elevation of subjective stress and craving ratings after stress. In summary, we found that nicotine addiction blocked OXT’s anxiolytic on psychosocial stress, which was related to abnormalities in anterior rSTG. By applying anodal tDCS on anterior rSTG, OXT’s anxiolytic effect was restored in smokers. These findings will support further development on oxytocin’s intervention of psychosocial stress in nicotine addiction, and provides essential information for indicating OXT’s effectiveness.

Dynamics of Stress Biomarker in Cliff Divers during Official Competition

Stress is defined as a reaction of the body to any given stressor, external or internal. These stressors are common among participants in sports. Therefore, this study aimed to determine the dynamics of two stress biomarkers during an official cliff diving competition. The sample of participants included six professional cliff divers (three females and three males). Their salivary cortisol (C) and alpha-amylase (AA) samples were collected during a 3-day competition (four samples on day 1 and six samples on days 2 and 3). The analysis of the results showed a non-significant increase in AA from day one to day three. On the other hand, C has an increase in the first two days (0.58 ± 0.16 µg/mL–0.61 ± 0.23 µg/mL) and then a decrease in the last competition day (0.53 ± 0.23 µg/mL). Analysis of samples collected during each day demonstrates a fluctuation of the biomarkers. For AA, the sample after the training dive on the 2nd day has the highest value (326.34 ± 280.73 U/mL), whereas on day 3, the samples after training and before the competition dive are the highest (364.50 ± 287.13 U/mL; 466.49 ± 218.39 U/mL). Regarding C levels, the sample after the competition dive tends to show the highest values (0.66 ± 0.17 µg/mL; 0.89 ± 0.29 µg/mL; 0.76 ± 0.32 µg/mL, respectively). Furthermore, the correlation between the results of competition and biomarkers is not significant. These results demonstrate how cliff diving competition tends to have a high impact on the sympathetic nervous system, as observed mainly in AA dynamics. One might contend that even though there is no significant physical strain, cliff divers demonstrate heightened stress biomarker levels that could affect their performance and focus while diving.

How is momentary well-being and stress associated in persons with spinal cord injury and their romantic partners? A study protocol for a dyadic everyday life study

IntroductionVery little is known about daily life dynamics and mutual influences that tie together well-being and psychobiological stress responses in persons with spinal cord injury (SCI) and their romantic partners...

Cortisol Synchrony in Psychotherapy for Major Depressive Disorder.

Accumulating research emphasizes the role of interpersonal coordination in arousal levels, which may manifest as cortisol synchrony, in interpersonal interactions. While the role of cortisol has been investigated in psychotherapy, cortisol synchrony and its characteristics and effect on treatment progress remain a relatively unexplored area. This study aims to explore the existence of distinct patterns of cortisol coordination throughout psychotherapy and test the associations of different coordination patterns with patients' pre-treatment characteristics and treatment progress measures. Fifty patient-therapist dyads participated in 16 weeks of psychodynamic treatment for major depressive disorder. Salivary cortisol samples were collected before and after each session at four time points. Self-report questionnaires and treatment session video-coding were used to characterize and differentiate between patterns of cortisol coordination. Three patterns of cortisol coordination were identified: synchronized, unsynchronized and stable-therapist. These patterns differed in patient characteristics and treatment progress measures in that patients exhibiting a synchronized pattern tended to be more anxious and dominant in their relationships and were more prone to withdrawal ruptures. Results provide novel evidence regarding variability in patient-therapist cortisol patterns and its putative associations with treatment progress.

Parents' work demands on next day's cortisol awakening response - the moderating role of family-to-work conflict

BackgroundConstant availability, overtime and feeling overwhelmed by work can impact employees' wellbeing and their biological stress responses. Especially working parents often struggle to balance the demands of their work and family life and were found to be distracted from their work due to family responsibilities. The Family-to-Work Conflict (FWC) indicates the extent to which participating in work is made difficult by family demands. Recent studies have found associations between FWC and biological outcomes such as the Cortisol Awakening Response (CAR), a measure of an individual's Hypothalamic-Pituitary-Adrenal (HPA)-axis activity. This diary study investigates the effect of parental work demands on next day's cortisol response as well as the moderating role of FWC and the mediating role of fatigue. MethodsOver the course of five consecutive days (from Monday to Friday), 168 observations were made on a total of 42 parents. Participants had at least one child and worked a minimum of 20 hours per week. Salivary cortisol samples were obtained immediately, 15 and 30 minutes after awakening each day. Work demands, FWC and fatigue were assessed using standardized questionnaires. Within-person effects were examined using multilevel modeling and mediation analyses. ResultsOur results indicate that there are no main effects of work demands on next day's cortisol response. The multilevel analysis revealed that FWC predicts lower wakening cortisol levels and confirmed FWC as an increasing moderator between work demands and next day's HPA-axis activity. Further, work overload was found to increase fatigue, which in turn leads to higher CAR on the following day. This indicates that fatigue mediates the relationship between work demands and CAR. Our findings add to a growing body of research demonstrating further predictors for HPA-axis activity and emphasise the importance of considering family related demands when investigating biological outcomes for working parents.

Infants’ cortisol reactivity and infant–mother cortisol synchrony in urban Chinese families: The role of maternal control strategy

Maternal control strategy refers to a mother’s practices used to impel, inhibit, guide, or shape their children’s behaviors during mother-child interaction. The present study examined control strategies used by Chinese urban mothers and how they associated with infants’ cortisol trajectory and infant-mother cortisol synchrony during a separation task. Participants were 115 infant-mother dyads. Maternal control strategy was assessed during mother-infant free-play when the infants were 6 months (T1) and 1 year (T2) old. Salivary cortisol samples were collected from both infants and mothers during a stress-inducing task at T2. The results indicated that mothers most frequently adopted the moderate power control strategy, at both T1 and T2. T1 maternal low control strategy significantly predicted infants’ cortisol response curve, namely infants of mothers who predominantly adopted a low power control strategy had a more dynamic reactivity and recovery in their cortisol response to the separation task. Positive cortisol synchrony was observed between mothers and infants during the separation stress condition. In addition, T2 maternal high power control strategy accounted for inter-individual variations in infant-mother cortisol synchrony, such that mothers who predominantly adopted a high power control strategy exhibited a heightened level of cortisol synchrony with their infants. Our findings suggest that targeted training in maternal control strategies could help mothers calibrate their infants’ adrenocortical regulation.

Unique and interactive effects of threat and deprivation on latent trait cortisol among emerging adults.

Though considerable work supports the Dimensional Model of Adversity and Psychopathology, prior research has not tested whether the dimensions-threat (e.g., abuse) and deprivation (e.g., neglect)-are uniquely related to salivary trait indicators of hypothalamic pituitary adrenal (HPA) axis activity. We examined the unique and interactive effects of threat and deprivation on latent trait cortisol (LTC)-and whether these effects were modified by co-occurring adversities. Emerging adults (n=90; Mage=19.36 years; 99.88% cisgender women) provided salivary cortisol samples four times a day (waking, 30 min and 45 min postwaking, bedtime) over three 3-day measurement waves over 13 weeks. Contextual life stress interviews assessed early adversity. Though the effects varied according to the conceptualization of early adversity, overall, threat-but not deprivation, nor other co-occurring adversities-was uniquely associated with the across-wave LTC. Specifically, the incidence and frequency of threat were each negatively related to the across-wave LTC. Threat severity was also associated with the across-wave LTC, but only among those with no deprivation. Finally, the effects of threat were modified by other co-occurring adversities. Findings suggest that threat has unique implications for individual differences in HPA axis activity among emerging adults, and that co-occurring adversities modify such effects.

The predictive value of cortisol in psychodynamic psychotherapy for social anxiety disorder: Extended results of the SOPHONET-Study

Psychotherapy is an effective treatment for anxiety disorders (AD), yet a vast majority of patients do not respond to therapy, necessitating the identification of predictors to enhance outcomes. Several studies have explored the relationship between stress response and treatment outcome, as a potential treatment mechanism. However, the latter remains under-researched in patients with social anxiety disorder (SAD). We studied N = 29 patients undergoing psychodynamic psychotherapy (PDT) within the SOPHONET-Study. Stress reactivity (i.e., area under the curve with respect to the increase; AUCi) was induced by a standardized psychosocial stressor (Trier Social Stress Test; TSST) and assessed by means of adrenocorticotropic hormone (ACTH), blood and salivary cortisol samples before (t1) treatment. Samples of these biomarkers were taken −1 min prior stress exposure and six more blood samples were collected post-TSST ( + 1, + 10, + 20, + 30, + 45, + 60 min.). The participants were diagnosed with SAD based on the Structured Clinical Interview for DSM-IV (SCID) and completed the Liebowitz Social Anxiety Scale as well as the Beck Depression Inventory before (t1) and after psychotherapy (t2). Pre-treatment stress reactivity significantly predicted changes in depression (salivary p < 0.001 and blood cortisol p = 0.001), as well as in avoidance behavior (blood cortisol p = 0.001). None of the biomarkers revealed significant results in fear or in the total LSAS-scores, except for ACTH with a trend finding (p = 0.06). Regarding therapy success, symptoms of social anxiety (p = 0.005) and depression (p < 0.001) were significantly reduced from pre (t1) to post-treatment (t2). Our study showed that stress reactivity pre-treatment may serve as a predictor of psychotherapy outcome. In this regard, alterations in stress response relate to changes in symptoms of social anxiety and depression after PDT. This implies that patients with chronic stress might benefit from a targeted interventions during psychotherapy, especially to manage fear in social contexts.

Serial Diurnal Salivary Cortisol Profiles in 667 Pregnant Women-Association With Cardiometabolic Complications.

Maternal obesity, hypertensive pregnancy disorders, and gestational diabetes (GDM) are linked to an increased risk of negative offspring health outcomes. This association may be mediated by maternal hypothalamic-pituitary-adrenal axis (HPA axis) activity, resulting in elevated maternal cortisol levels and fetal exposure, but evidence remains scarce. We (1) examined maternal diurnal cortisol profiles longitudinally across gestation, and (2) explored associations with maternal cardiometabolic complications. Women in the InTraUterine sampling in early pregnancy (ITU) study (n = 667) provided 7 salivary cortisol samples from awakening to bedtime up to 3 times during pregnancy (median gestational week 19.3, 25.7, and 38.1; n = 9356 samples). Changes in cortisol awakening response (CAR) and diurnal slope (indicative of HPA axis activity) and their associations with maternal body mass index (BMI), hypertensive pregnancy disorders and GDM were examined using linear mixed models. The CAR declined in 60% to 67% of women, and the diurnal slope attenuated from early to late pregnancy (b = 0.006; P = .001). Higher BMI was associated with less decline in CAR (b = 0.031; P = .0004) and less attenuation in diurnal slope from early to late pregnancy (b = -0.001; P = .006). Hypertensive pregnancy disorders and GDM were not significantly associated with diurnal cortisol profiles. The attenuation in CAR and diurnal slope support HPA axis hyporesponsivity during pregnancy. Less attenuation of both markers in women with a higher BMI may indicate reduced adaption of the HPA axis to pregnancy, presenting a mechanistic link to offspring health outcomes.

The effect of bubble nasal continuous positive airway pressure application on saliva cortisol levels in full-term neonates

Background Neonates with respiratory distress are commonly treated with bubble nasal continuous positive airway pressure (nCPAP) and undergo many procedures that cause stress-induced pain. Salivary cortisol is a biomarker of alteration in the hypothalamic-pituitary-adrenal axis caused by repeated and long-term exposure to stress.&#x0D; Objective To analyze the effect of bubble nCPAP use on salivary cortisol levels in full-term infants.&#x0D; Methods This study used a one-group pre-test­–post-test design to compare salivary cortisol levels before and 30 minutes after bubble nCPAP application. Salivary cortisol was measured using an ELISA method. Pain was also assessed at the same time points using the Neonatal Infant Pain Scale (NIPS) score. We included infants of 37 0/7 to 42 6/7 weeks’ gestational age with respiratory distress necessitating bubble nCPAP application. Infants with birth weight of &lt;2,500 grams, major congenital anomalies, an APGAR score of &lt;5 at 5 minutes, shock, and infants who had undergone surgery were excluded.&#x0D; Results A total of 38 subjects participated in this study. Prior to bubble nCPAP application, median cortisol levels were significantly lower (1.65 ng/mL) than after bubble nCPAP application (6.8 ng/mL) (p value?). There were no significant differences in cortisol increase based on gender, type of birth, or salivary cortisol sampling time. There were significant differences in pain level after the 30-minute nCPAP application.&#x0D; Conclusion An increase in cortisol levels and pain scale scores during administration of bubble nCPAP indicates a pain response in full-term neonates; therefore, this procedure should be accompanied by pain or stress management.