Clemens Kirschbaum

• Technische Universität Dresden

Previous studies have reported weak associations between questionnaire-based stress measurements and hair steroids. A stronger relationship may exist in highly stressed subpopulations or with stress brought up by novel or unpredictable situations. In the Ulm SPATZ Health Study, conducted in Ulm, Germany, baseline recruitment 04/2012 to 05/2013, we...

Background and purpose: The role of stress-related endocrine dysregulation in the development of cognitive changes following a stroke needs further elucidation. We explored this issue in a longitudinal study on stroke survivors using hair cortisol concentrations (HCC), a measure of integrated long-term cortisol levels. Methods: Participants were...

Currently, the quantitative analysis of moderators affecting the function of the hypothalamus-pituitary-adrenal (HPA)-axis in health and sickness is still unreliable. This is, in particular, due to physiological factors such as pulsatile ultradian and circadian glucocorticoid secretion as well as to methodological limitations of the current techniq...

Hair cortisol concentration (HCC) provides a retrospective measure of long-term (i.e. over a period of months) cortisol secretion and has been shown to be elevated in relation to chronic stress conditions. However associations in healthy participants with subjective ill-being are less clear and associations with well-being have not been explored. T...

The serotonin transporter gene-linked polymorphic region (5-HTTLPR) has been implicated in moderating vulnerability to stress-related psychopathology upon exposure to environmental adversity. A recent meta-analysis suggests a potential biological pathway conveying genotype-dependent stress sensitivity by demonstrating a small, but significant assoc...

The serotonin transporter (SERT) gene-linked polymorphic region (5-HTTLPR) has been implicated in moderating the link between life stress and depression. However, respective molecular pathways of gene-environment (GxE) interaction are largely unknown. Sustained alterations in SERT gene expression profiles, possibly mediated by epigenetic modificati...

Little is known about the frequency of traumatic event exposure and the development of post-traumatic stress disorder (PTSD) among German soldiers serving in Afghanistan. We studied a random sample consisting of 1599 soldiers who had served in the 2009/2010 ISAF mission in Afghanistan, stratified by deployment location and unit. Twelve months after...

Chronic stress has been linked with detrimental health effects. The present study aimed to investigate consequences of repeated strong stress system activation without habituation on stress system and inflammatory status in highly experienced competitive ballroom dancers. Ballroom dancing served as a model for repeated, non-habituating social-evalu...

Introduction: We recently reported that 5-minute work breaks every 25 minutes during long lasting laparoscopy in children (intermittent pneumoperitoneum [IPP] scheme) decrease the surgeon's stress markers such as saliva cortisol and heart rate and improve time-concentration scores significantly. Data on the impact of breaks on the patient and on t...

Evidence has supported the association between psychological factors and cancer biology; however, findings are equivocal on the role of psychosocial factors in cancer progression. This study generates a hypothesis of mechanistic variables by examining the clinical effects of psychosocial factors and cortisol dysregulation in patients with metastati...

Investigation of the prevalence, incidence, and determinants of post‐traumatic stress disorders (PTSD) and other mental disorders associated with military deployment in international missions poses several methodological and procedural challenges. This paper describes the design and sampling strategies, instruments, and experimental procedures appl...

To inform the future use of hair cortisol measurement, we have investigated influences of potential confounding variables (natural hair colour, frequency of hair washes, age, sex, oral contraceptive (OC) use and smoking status) on hair cortisol levels. The main study sample comprised 360 participants (172 women) covering a wide range of ages (1-91...

Intermittent work breaks are common in fields with high workload but not yet for surgeons during operations. We evaluated the effects of intraoperative breaks during complex laparoscopic surgery (5 min every half hour) on the surgeon. Fifty-one operations were randomized to a scheme with intraoperative breaks and release of the pneumoperitoneum (in...

In den meisten Lehrbüchern zur Klinischen Psychologie und Psychotherapie wird auf ein gesondertes Kapitel zu den biopsychologischen Grundlagen verzichtet. Das hat in vielen Fällen sicher mit dem Selbstverständnis von Klinischer Psychologie und Psychotherapie zu tun. Warum sollen wir uns mit biologischen Grundlagen herumschlagen, wenn unsere Methode...

Unemployment and financial strain are chronic stressors that have been shown to be associated with an increase in mean salivary and serum cortisol levels. Hair analysis for cortisol content is a new promising tool by which hair segmental analysis may provide a retrospective calendar of cumulative cortisol exposure over time rather than momentary as...

Analysis of salivary cortisol concentrations and derived indices is increasingly used in clinical and scientific medicine. However, comprehensive data on these parameters in the general population are scarce. The aim of this study was to evaluate the concentrations of salivary cortisol in a large middle-aged community sample and to identify major f...

BACKGROUND:Multiple alterations in circadian rhythms have been observed in cancer patients, including the diurnal rhythm of the adrenal hormone cortisol. Diurnal cortisol alterations have been associated with cancer-related physiological processes as well as psychological stress. Here we investigate alterations in diurnal cortisol rhythm in ovarian...

Previous findings on planning abilities in individuals with high-functioning autism spectrum disorder (HFA) are inconsistent. Exploring possible reasons for these mixed findings, the current study investigated the involvement of memory in planning performance in 15 children with HFA and 17 typically developing controls. In addition to planning abil...

The hypothalamic-pituitary-adrenal (HPA) axis responds rapidly and rather specifically to a wide range of environmental and internal demands often referred to as stress. It is thought that the HPA response to stress plays a pivotal role in the organism's attempt to maintain function through change, as expressed in the allostasis model. Although the...

Genetic variation of the serotonin transporter (SCL6A4, 5-HTT) has been associated with fear- and anxiety-related behaviors, while a polymorphism in exon III of the D4 dopamine receptor gene (DRD4) has been linked to novelty seeking. The dopaminergic and the serotonergic neurotransmitter system have been found to modulate the amygdala-connected cir...

Dysregulation of diurnal cortisol secretion patterns may explain the link between adversities early in life and later mental health problems. However, few studies have investigated the influence of social disadvantage and family adversity on the hypothalamic-pituitary-adrenal (HPA) axis early in life. In 366 infants aged 12-20 months from the Gener...

Simulator training is well established to improve technical and non-technical skills in critical situations. Few data exist about stress experienced during simulator training. This study aims to evaluate performance and stress in intensivists before and after two different simulator-based training approaches. Thirty-two intensivists took part in on...

The "Trier Social Stress Test" (TSST) is one of the most prominent laboratory stress paradigms. It is often used to investigate the effects of stress on cognitive or affective parameters. Such studies need a non-stress control condition. However, control conditions currently employed are often rather ill defined and do not parallel important modula...

Dysregulation of the hypothalamic-pituitary-adrenal axis has been suggested as an independent risk factor for ischemic heart disease. The aim of our study was to evaluate whether two markers of the hypothalamic-pituitary-adrenal axis activity, the level of salivary cortisol and the diurnal salivary cortisol pattern, are associated with atherosclero...

Background: Unemployment and financial strain are chronic stressors that have been shown to be associated with an increase in mean salivary and serum cortisol levels. The impact of chronic stress on cortisol excretion is best measured using a summary index of cortisol excretion over longer periods of time rather than momentary assessments. Hair ana...

Background: Hair has long been used as a biological specimen for the detection of environmental agents, drugs, or toxins. Recent evidence suggests that also hormones are incorporated and trapped inside the growing hair. Therefore, hair segmental analysis could provide a retrospective calendar of cortisol production for the individual. Methods: In t...

More than 10 years ago, the Trier Social Stress Test (TSST) was introduced as a standardized protocol for the induction of moderate psychosocial stress in laboratory settings. This article provides an up-to-date description of the TSST protocol and a brief review of a decade of research with the TSST.

Anxiety-related behaviors are closely linked to neural circuits relaying fear-specific information to the amygdala. Many of these circuits, like those underlying processing of innate fear, are remarkably well understood. Recent imaging studies have contributed to this knowledge by discriminating more detailed corticoamygdalar associations mediating...

Tryptophan depletion (TD) has been shown to induce a transient mood-lowering effect in psychiatric patients and susceptible healthy subjects. We investigated the effects of TD on cortisol secretion in psychiatric patients and healthy subjects based on the hypothesis that the potential mood-lowering effects may be associated with increased activity...

An age associated increase in basal activity of the hypothalamus pituitary adrenal (HPA) axis has been reported repeatedly in humans even though the interindividual variance appears to substantial. Some studies have suggested that these alterations are more pronounced in older women. Similarly pharmacological challenge studies often observed a stro...

Glucocorticoids secreted in response to stress modulate memory in animals and humans. Studies in rodents suggest that glucocorticoids enhance memory consolidation but impair delayed retrieval. Similar negative effects on memory retrieval have been reported in humans. The human studies so far have not addressed the issue of emotional valence, which...

One night of sleep deprivation induces a transient improvement in about 60% of depressed patients. Since depression is associated with abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis, the authors measured cortisol secretion before, during, and after therapeutic sleep deprivation for 1 night. Fifteen unmedicated depressed inpatients p...

Sex differences in pain sensitivity and stress reactivity have been well documented. Little is known about the role of the endogenous opioid system in these differences. This study was conducted to compare adrenocortical, pain sensitivity, and blood pressure responses to opioid blockade using naltrexone in men and women. Twenty-six participants com...

Data from five independent studies were reanalyzed in order to investigate the impact of age and gender on HPA axis responses to an acute psychosocial laboratory stress task. The total sample consisted of 102 healthy subjects with 30 older adults (mean age: 67.3 y), 41 young adults (mean age: 23.5 y), and 31 children (mean age: 12.1 y). All partici...

Early life stress, including during fetal development, has been hypothesized to predispose individuals to several illnesses and psychiatric disorders later in adulthood. To determine whether prenatal stress alters neural, hormonal, and behavioral processes in nonhuman primates, pregnant rhesus monkeys were acutely stressed on a daily basis for 25%...

Intraindividual variation in recent stress exposure and its impact upon cortisol and testosterone was investigated. Over 1 year, 72 young male firefighters completed the Daily Stress Inventories, for 2 shift cycles (16 days), every 3 months. At the end of each 16-day period each participant attended a 1-hr morning assessment session. Saliva samples...

Levels of the gonadal steroids estradiol and progesterone fluctuate during the menstrual cycle in young women and in response to hormone replacement therapy in postmenopausal women. Measuring the performance of women over the menstrual cycle with cognitive tests, it has been reported that gonadal steroids modulate cognitive skills with known sex di...

Animal studies have revealed that the gonadal hormones estradiol and progesterone can exert multiple effects in the central nervous system (CNS). The possible relevance of these effects for cognition in postmenopausal women is still debated. Studies in relatively young subjects, which became menopausal due to surgery or pharmacological treatment ha...

Activity of the hypothalamus pituitary adrenal (HPA) axis increases in response to stress leading to elevated cortisol levels. Experimental studies from our laboratory have observed that cortisol acutely influences memory performance in healthy humans. The cortisol increase in response to psychosocial stress was negatively associated with memory pe...

We previously reported that women using oral contraceptives (OC) show blunted free cortisol responses to psychosocial stress compared to medication-free women. Low cortisol responses to stress have been shown to be associated with increased susceptibilities to chronic inflammatory and autoimmune processes in animal models and certain human diseases...

Recent evidence suggested that the free cortisol response to awakening is influenced by awakening time in healthy younger adults (Edwards et al., 2001). In order to investigate this association further, 179 community-dwelling subjects of a large age range (4–75 yrs) participated in the present study. The sample consisted of 99 women, 67 men and 13...

This study investigated whether exposing the fetal primate to repeated episodes of maternal stress would have long-lasting effects on the endotoxin-induced cytokine response and corticosteroid sensitivity of peripheral blood cells in juvenile animals. Pregnant rhesus monkeys were acutely aroused on a daily basis for 6 wk using an acoustical startle...

Störungsspezifische Konzepte und Behandlung in der Psychosmatik

Stress is a common condition of human life and is significantly involved in the maintenance of health or development of disease. This article starts with a brief description of the origin of the term stress. Then the comprehensive definition of stress proposed by Levine and Ursin (1991) is presented. Stress leads to numerous responses of the endocr...

Men and women show marked differences in susceptibility to disorders related to the immune system. These gender differences have been proposed to be mediated by functional interactions of the hypothalamus-pituitary-adrenal (HPA) and hypothalamus-pituitary-gonadal (HPG) axes. A potential mechanism involved in this interaction is the glucocorticoid (...

Epidemiological as well as experimental studies in elderly subjects have suggested that postmenopausal women are more susceptible to the memory impairing effects of elevated cortisol levels than elderly men. Little is known however about gender differences in the susceptibility to acute stress in young subjects. In the present study a total of 58 h...

In several studies lactation has been shown to be associated with a hypothalamic-pituitary-adrenal axis hyporesponsiveness to physical and psychological stressors. As it is not known whether the marked blunting of endocrine stress reactivity in women can be ascribed to suckling as a short-term effect or to lactation in general, the acute effects of...

The relationship of free salivary cortisol stress recovery and basal cortisol with psychological, cardiovascular and metabolic factors was investigated in 82 healthy young men. Blood pressure, heart rate, cortisol and mood were assessed during a single laboratory session involving mental arithmetic and speech tasks, and lipid profiles were analysed...

Free cortisol measured in saliva has been shown to have the same diurnal rhythm as serum cortisol, one that typically declines rapidly throughout the waking day. A recent study showed that over 15% of a sample of community individuals who were monitored over two days did not show the typical diurnal rhythm. The present study specifically tested the...

Recent studies have demonstrated that the free cortisol response to awakening can serve as a useful index of hypothalamus-pituitary-adrenal axis (HPA) activity. This endocrine marker is rather consistent, shows good intraindividual stability across time and appears to be able to uncover subtle changes in HPA regulation. The present twin study inves...

Contradicting data exist as to whether interindividual patterns in glucocorticoid (GC) sensitivity vary between different target tissues in humans. This study therefore measured GC sensitivity in 36 healthy subjects in three target tissues: the immune system; the cardiovascular system, and the hypothalamus-pituitary-adrenal axis. For this purpose,...

We investigated the impact of chronic psychosocial stress and long-term cortisol treatment on hippocampus-mediated memory processes and hippocampal volume in male tree shrews. By combining cognitive tests on a hole board, magnetic resonance imaging (MRI), and saliva cortisol analysis, we were able to follow in individual animals the stress- and cor...

In order to investigate if HPA functioning is altered with age, the present study was conducted. Fifteen healthy elderly men (60-76 years; mean age 66.5 +/- 1.48 yrs.) and 12 younger adults (20-29 years; mean age 25.6 +/- 0.77 yrs.) collected salivary free cortisol profiles after awakening for basal HPA activity. Then, all subjects were exposed to...

The relevance of the age-associated decline in testosterone for cognition in elderly men is still poorly understood. One hypothesis is that testosterone enhances spatial abilities, while it might impair verbal skills. Thirty elderly men received a single testosterone (250 mg testosterone enanthate) or placebo injection. Cognitive performance was te...

To compare cortisol levels, diurnal cycles of cortisol, and reactivity of cortisol to psychological stress in fibromyalgia (FM) and rheumatoid arthritis (RA) patients in their natural environment, and to examine the effect on results of accounting for differences among the groups in psychological stress and other lifestyle and psychosocial variable...

The objectives of this study were to test the hypothesis that high job demands and low job control (job strain) are associated with elevated free cortisol levels early in the working day and with reduced variability across the day and to evaluate the contribution of anger expression to this pattern. One hundred five school teachers (41 men and 64 w...

Objective. To compare cortisol levels, diurnal cycles of cortisol, and reactivity of cortisol to psychological stress in fibromyalgia (FM) and rheumatoid arthritis (RA) patients in their natural environment, and to examine the effect on results of accounting for differences among the groups in psychological stress and other lifestyle and psychosoci...

In this placebo-controlled double-blind study, psychological and endocrine stress responses were investigated in healthy postmenopausal placebo-treated women (n = 15; 60–75 years; placebo via transdermal patches), healthy postmenopausal estradiol-treated women (n = 13; 60–79 years; 0.1 mg 17β-estradiol daily via transdermal patches) and young contr...

Dehydroepiandrosterone (DHEA) and its sulfate ester, DHEAS, exert multiple effects in the rodent central nervous system (CNS). Most of them seem to be mediated through their non-genomic action on several neurotransmitter receptors. DHEA(S) increases neuronal excitability, enhances neuronal plasticity and also has neuroprotective properties. In line...

The present randomized double blind study investigated the effects of a 2 week transdermal estradiol treatment on memory performance in 38 healthy elderly women. Cognitive performance was tested at baseline and after 2 weeks of estradiol or placebo treatment using verbal, semantic, and spatial memory tests as well as a mental rotation task and the...

Saliva sampling is frequently used in humans for adrenal glucocorticoid hormone analysis because of advantages such as non-invasiveness, the ease of collection, and storing of the samples. To transfer this advantageous method to laboratory mammals, potentially confounding factors such as stressful handling procedures have to be excluded. In the pre...

Personality traits measured with the Eysenck Personality Questionnaire-Revised did not show associations with basal or stimulated concentrations of cortisol in a sample of 81 subjects. Cortisol responses to a single exposure to psychosocial stress as well as circadian salivary-free cortisol patterns did not distinguish between subjects with high or...

The present study focused on health status, mood, cognition, saliva cortisol, and social activities in homesick (N=80), homesick-prone (N=152), recovered (N=48) and non-homesick adult women (N=45). Self-reported health and mood were decreased and cognitive functions were poorer in homesick and homesick-prone subjects compared with non-homesick and...

Results from animal and human studies suggest that disregulations of the hypothalamus-pituitary-adrenal (HPA) axis are involved in several behavioral, circulatory, endocrine, and immune disorders with clear-cut gender differences in disease prevalence. The aim of the present study was to investigate sex-specific HPA response patterns with a focus o...

The effects of burnout and perceived stress on early morning free cortisol levels after awakening were investigated in a group of teachers. Previous studies revealed that cortisol levels show a significant increase after awakening, with high intraindividual stability. Sixty-six teachers from local public schools (42 women and 24 men, mean age 42+/-...

Recent studies have shown that cortisol levels rapidly increase within the first 30 minutes after awakening. This response is rather robust over weeks or months and is altered by chronic stress and burnout. The present study investigated to what extent the cortisol response to awakening relates to responses following hCRH, ACTH(1-24), or psychosoci...