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Study of the stress response: Role of anxiety, cortisol and DHEAs
Abstract
Aim of the study:
Several studies have exhibited the psychological processes that are implied in the stress response and have shown, according to Selye's research, the participation of the hypothalamic-pituitary-adrenal axis and the major role of cortisol. The possible action of another adrenal steroïd, dehydroepiandrosterone (DHEA), is increasingly documented. The beneficial effect of the latter and his antistress role would be related to an antagonistic action to that of cortisol. The aim of our study was, first to assess biological and psychological aspects of the stress response, then to define the relationships that exist between these two processes.
Population and methodology:
40 subjects (21 women) aged 42 +/- 12 years, who consulted within a clinic of stress (CITES Prevert, Liege, Belgium) were studied. They all felt stressed but, according to DSM IV, were without mental disorders and drug free when examined. Subjects were asked to accomplish simple cognitive tasks: 1 - to distinguish two different auditory stimulations. The first one was a high-pitched sound of 1 470 Hz, which was presented unfrequently (20%). The second one, a low frequency tone of 800 Hz, was presented more frequently (80%). The interval between both stimuli was 1 s. The subject had to press a button when the rare stimulus was recognized. 2 - to extinguish a light after a warning tone of 64 dB, 50 ms and 1 000 Hz. The light, which followed one second later the tone, consisted of a series of flashes of 18 c/s that the subject had to stop by pressing a button. The purpose of this second procedure was that the subject was warned and had to prepare and anticipate the most rapid response. After that, subjects were submitted to self-evaluation psychological tests. The impact of psychosocial factors was assessed by Amiel-Lebigre life events questionnaire. Personality features and emotional response (state anxiety, related to experimental situation) were assessed by Spielberger inventory (STAI: State and Trait Anxiety Inventory). Psychological tests are practised immediately after experimental situation. Cortisol and DHEAs (dehydroepiandrosterone sulfate) were measured in blood samples taken before (t1) and after (t2) the experimental test. Cortisol was measured by radio-immunology and expressed as ng/ml of plasma. DHEAs was measured by radio-immunoassay and expressed as g/liter of plasma.
Results and discussion:
The majority of subjects displayed high scores of trait anxiety (37 subjects had a score>42) and life events impact (35 subjects had a score>200). These data confirmed that the subjects were fragile and were obviously stressed. In response to the cognitive tasks, that constituted for each subject a new event with which it was necessary to cope, 25 subjects exhibited high level of state anxiety (score>42) and an increase of cortisol plasmatic concentrations occurred solely in 11 persons. Ten among them were in the group of subjects which displayed a score of state anxiety>42 (p=0,0223, Chi square). Base on these data three types of stress response were identified: 1 - the experimental situation was experienced without anxiety ( psychological silence ) and without any increase in cortisol level ( biological silence ). There was no stress and these subjects were, despite their vulnerability, close to a normal health state . 2 - high emotional reaction (high level of state anxiety) was observed. This response reveals a psychological vulnerability that can be considered as the expression of a consecutive psychological distress induced by a threatening experimental situation. There were no biological manifestations ( biological silence ). 3 - high state anxiety and increased plasma cortisol levels were observed. The corresponding subjects were obviously more vulnerable.
Conclusion:
These results allow us to propose that the emergence of state anxiety is the first stress response and the primary protest . Up to a certain level, a plateau level, anxiety remains stable. Then, nature of the stress response changes and takes a biological aspect. Increased of cortisol plasma levels, the secondary protest , is observed and gives evidence of an intensified and sustained stress response. Such a gradual phenomenon is particularly reported in elevated psychological distress which is associated with loss of control. It is important to note that identical scores of state anxiety (Mann Whitney test) were observed in anxious subjects with or without rise of plasma cortisol levels. DHEAs was also implied in the stress response. The enhancement of plasma levels of DHEAs were dependent on cortisol, as shown by the close correlation between both hormones (r=0,433, p=0,0033, Spearman test). The hypothesis of an antagonism between these two hormones is based on the fact that DHEAs opposes the action of cortisol and exerts a true anticortisol effect. This antagonism might be related to a competition in their synthesis and release by the adrenal gland. In the present case, high level of anxiety (state and trait) was associated with an increase of cortisol, while low level (of anxiety) was related to an exclusive rise of DHEAs. Intermediate anxious score was observed in subjects who showed increases of both cortisol and DHEAs (p=0,0225, Kruskall Wallis test). Furthermore, a close relationship (negative correlation: Spearman test), was observed between increases in DHEAS and scores of state anxiety (r=- 0,382, p=0,06) and trait anxiety (r=- 0,0097, p=0,527). This means that the worriness and the underlying anxious ruminations and negative anticipations, which characterize trait anxiety, were less important in subjects who increased plasma DHEAs levels. In addition, emotional tension and uneasiness, which accompanies state anxiety, were also less marked. There are no studies reporting a relation between DHEA(s) and state or trait anxiety. Nevertheless, many authors have proposed a beneficial action of DHEA on the feeling of well-being. This beneficial role could be related to a double action of DHEA: a direct effect provided by its transformation into sexual hormones, an indirect one mediated by its competition with cortisol, of which the synthesis and consequently the activity decrease.
... Although this led to indications that MDD patients had greater cortisol/DHEA ratios, which correlate with existing literature, the behavior of salivary cortisol and DHEA and its fluctuations did not corroborate with the hormonal patterns expected from MDD patients. Comparatively, Boudarene et al. (2002) study on the roles of cortisol and DHEA during the stress response showcased high levels of anxiety and stress were linked with higher cortisol levels and close correlations between DHEA and cortisol (Boudarene et al., 2002). As this study was conducted on healthy participants, it brings forward the question of whether the cortisol fluctuations in the Assies et al.'s study were a result of blunted cortisol responses, commonly observed in MDD patients (Assies et al., 2004;Mcewen, 2005;McEwen, 2000;Tsigos & Chrousos, 2002). ...
... Although this led to indications that MDD patients had greater cortisol/DHEA ratios, which correlate with existing literature, the behavior of salivary cortisol and DHEA and its fluctuations did not corroborate with the hormonal patterns expected from MDD patients. Comparatively, Boudarene et al. (2002) study on the roles of cortisol and DHEA during the stress response showcased high levels of anxiety and stress were linked with higher cortisol levels and close correlations between DHEA and cortisol (Boudarene et al., 2002). As this study was conducted on healthy participants, it brings forward the question of whether the cortisol fluctuations in the Assies et al.'s study were a result of blunted cortisol responses, commonly observed in MDD patients (Assies et al., 2004;Mcewen, 2005;McEwen, 2000;Tsigos & Chrousos, 2002). ...
Psychological stress and its inevitable trajectory toward mental health deteriorations such as clinical and major depression has become an unprecedented global burden. The diagnostic procedures involved in the characterization of mental illnesses commonly follow qualitative and subjective measures of stress, often leading to greater socioeconomic burdens due to misdiagnosis and poor understanding of the severity of such illnesses, further fueled by the stigmatization surrounding mental health. In recent years, the application of cortisol and stress hormone measurements has given rise to an alternative, quantifiable approach for the psychological evaluation of stress and depression. This review comprehensively evaluates the current state-of-the-art technology for measuring cortisol and dehydroepiandrosterone (DHEA) and their applications within stress monitoring in humans. Recent advancements in these fields have shown the importance of measuring stress hormones for the characterization of stress manifestation within the human body, and its relevance in mental health decline. Preliminary results from studies considering multimodal approaches toward stress monitoring have showcased promising developments, emphasizing the need for further technological advancement in this field, which consider both neurochemical and physiological biomarkers of stress, for global benefit.
... Dehydroepiandrosterone (DHEA) and its more abundant form dehydroepiandrosterone sulfate (DHEAS) are precursors of sex steroids secreted by the adrenal gland (Burger 2002;Labrie 2010;Labrie et al. 2005;Neunzig and Bernhardt 2014). Both DHEA and DHEAS have been the focus of studies of human aging (Baulieu 1996;Laughlin and Barrett-Connor 2000;Mobbs 1998;Sorwell and Urbanski 2010), stress (Boudarene et al. 2002;Hu et al. 2000), and cognition and memory (Flood and Roberts 1988;Kalmijn et al. 1998;Vallee et al. 2001). During gestation, DHEA and DHEAS are produced by the fetal zone, a transient layer of the fetal adrenal, to provide estrogens to the mother that are necessary for parturition (Mesiano and Jaffe 1997;Rainey et al. 2004;Walsh et al. 1984), and probably pregnancy maintenance (Takeshita et al. 2016). ...
... In our study, the amount of ACTH and the route of administration (intramuscular instead of intravenous) may have been insufficient to stimulate DHEAS production, but further studies are needed to test this hypothesis. DHEAS also increases during acute and chronic stress as an antagonist of the cortisol response (Boudarene et al. 2002;Hechter et al. 1997;Majewska 1995;Spivak et al. 2000). The time lag between ACTH challenge and cortisol metabolites response in Japanese macaque feces is 24 h (Takeshita et al. 2018). ...
Measuring hormonal profiles is important in monitoring stress, physical fitness, and reproductive status in primates. Noninvasive methods have been used to measure several steroid hormones in primates without causing them stress. However, few studies have used feces or urine to measure dehydroepiandrosterone sulfate (DHEAS), an important precursor of sex steroids that has been studied as a biomarker of aging, pregnancy, and stress in humans and nonhuman primates. We developed an enzyme immunoassay to detect DHEAS in the feces of Japanese macaques (Macaca fuscata). Our subjects included eight singly housed Japanese macaques. To validate the assay, we administrated oral DHEA to one male and one female macaque, collected their feces, and measured DHEAS levels over time. Given that DHEAS is related to gonadal steroids and the stress response, we also measured DHEAS concentrations in response to adrenal (adrenocorticotropic hormone [ACTH]) and gonadal (human chorionic gonadotropin [hCG]) stimulation. Our assay successfully detected DHEAS in Japanese macaque feces, and levels of DHEAS were associated with the amount of DHEA ingested. Parallelism and accuracy tests revealed that fecal extracts were reliable measures of DHEAS. Neither ACTH nor hCG challenge appeared to affect DHEAS levels. The method we describe is less expensive than that using the commercially available kits and is applicable to investigations involving aging, stress, and reproduction in Japanese macaques.
... Although CRH stimulates corticotrophin secretion and in turn corticotrophin is a stimulus for cortisol and DHEA secretion (do Vale, Martins, Fagundes, & Carmo, 2011;Nieschlag et al., 1973), thus explaining the direct relation between cortisol and DHEA levels (both baseline and responses to stimuli), results suggest that DHEA is not just a stress hormone and that some differential regulation of DHEA and cortisol exists (do Vale et al., 2015). Multiple results even suggest that DHEA may be an antistress hormone, and Boudarene, Legros, and Timsit-Berthier (2002) observed that highanxiety individuals have a preferential cortisol response, whereas lowanxiety trait individuals show a preferential DHEA(S) response to stress. These authors hypothesize that the antagonism in DHEAS and cortisol might be related to a competition in their synthesis and release by the adrenal gland (Boudarene et al., 2002). ...
... Multiple results even suggest that DHEA may be an antistress hormone, and Boudarene, Legros, and Timsit-Berthier (2002) observed that highanxiety individuals have a preferential cortisol response, whereas lowanxiety trait individuals show a preferential DHEA(S) response to stress. These authors hypothesize that the antagonism in DHEAS and cortisol might be related to a competition in their synthesis and release by the adrenal gland (Boudarene et al., 2002). We also observed that patients with higher baseline DHEAS levels had lower peak/baseline cortisol response to CRH infusion (do Vale et al., 2011). ...
Steroid hormones are important regulators of brain development, physiological function, and behavior. Among them, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone-sulfate (DHEAS) also do modulate emotional processing and may have mood enhancement effects. This chapter reviews the studies that bear relation to DHEA and DHEAS [DHEA(S)] and brain emotional processing and behavior. A brief introduction to the mechanisms of action and variations of DHEA(S) levels throughout life has also been forward in this chapter. Higher DHEA(S) levels may reduce activity in brain regions involved in the generation of negative emotions and modulate activity in regions involved in regulatory processes. At the electrophysiological level, higher DHEA-to-cortisol and DHEAS-to-DHEA ratios were related to shorter P300 latencies and shorter P300 amplitudes during the processing of negative stimuli, suggesting less interference of negative stimuli with the task and less processing of the negative information, which in turn may suggest a protective mechanism against negative information overload. Present knowledge indicates that DHEA(S) may play a role in cortical development and plasticity, protecting against negative affect and depression, and at the same time enhancing attention and overall working memory, possibly at the cost of a reduction in emotional processing, emotional memory, and social understanding.
... The results of the baseline biomarker levels showed that compared to the AF personnel, the firefighters had significantly lower DHEAS levels and DHEAS/Cortisol ratios. Low DHEAS/Cortisol rations have been found to be related to anxiety and chronic stress [12]. Firefighters also had significantly higher levels of Orexin and Serotonin at baseline. ...
... These biomarkers are related to chronic stress and are better indicators of long term stress exposure. Occupations of high stress should monitor these biomarkers as low DHEAS:cortisol can signal the development of anxiety disorders [12]. In fact, one finding not discussed in this paper was that Firefighters who reported greater chronic stress also exhibited lower DHEAS:cortisol ratios post stress during the simulated Firefighter combat challenge. ...
Firefighters are three times more likely to die on the job than any other occupation with half of these deaths due to heart attacks, stroke, or heat exhaustion from stress and over exertion [1]. Most protection of firefighters is focused on gear and equipment. Our objective is to test biomarkers and biometrics of high physical exertion in the laboratory and the field to discover irregular patterns of physiological or biological responses in order to save lives. Twenty firefighters between the ages of 22-57 participated in 5 sessions of testing. Session 1 provided baseline fitness levels with a VO2 Maximal Treadmill test and DEXA body composition scan. Session 2 utilized a Modified Astrand Treadmill protocol with participants wearing full firefighter gear minus the mask. Session 3 was the Firefighter Combat Challenge simulation. Session 4 was a live fire evolution in their training building. Finally, Session 5 repeated session 2 with the addition of a cooling vest worn under the gear. Results showed for biomarker indices of physical exhaustion that lactate and serotonin significantly increased immediately following physical exhaustion while cortisol and DHEAS significantly increased 10minutes following the exhaustion. Some biophysiological patterns were also found. We also found some biological recovery patterns. Serotonin and orexin-A have opposing trends from post physical exhaustion to 10minutes post physical exhaustion. Cortisol and DHEAS have opposing trends between the two blood draws as well. These results can help drive the innovation for real-time biosensors to diagnose and analyze physiological and cognitive health for firefighters.
... The heterogeneous group of symptoms that characterize CP/CPPS is the reason for the still unknown and unclear etiopathogenesis, although numerous risk factors are identified, including intraprostatic urinary reflux, endocrine disbalance, inflammation through the CNS, psychological and hereditary factors, immunological disbalance and muscle-skeletal dysfunctions (27). Statistically significant changes in serum cortisol levels have been found in patients with CP/CPPS (28), while the hypothalamic-pituitary-adrenal (HPA) axis dysfunction is hypothesized to be one of the main mechanisms that links CP/CPPS with anxiety (29). We also previously found that elevated levels of corticosterone in the rat's serum have a positive correlation with lipid peroxidation and oxidative stress in the cortex, thalamus and hippocampus (20). ...
Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) is a inflammatory syndrome, manifested by pain, voiding symptoms, sexual dysfunction, and mental health issues including anxiety. Beneficial effects of exercise are known, but its influence on CP/CPPS has not been investigated. This study aimed to determine the effects of chronic aerobic physical activity on anxiety-related behavior and pain in rats with experimental CP/CPPS. Material and Methods: Adult male Wistar albino rats (n=32) were randomly assigned to 4 groups (n=8 in each): Sham-SED (30-days sedentary-SED protocol on treadmill and intraprostatic injection of 0.9% NaCl); Sham-PA (30-days physically active-PA protocol on treadmill and intraprostatic injection of 0.9% NaCl); CP/CPPS-SED (30-days SED protocol on treadmill and intraprostatic injection of 3% l-carrageenan); CP/CPPSPA (30-days PA protocol on treadmill and intraprostatic injection of 3% l-carrageenan). To establish pain dynamics, scrotal skin pain thresholds were measured by electronic von Frey aesthesiometer (evF) preoperatively: 2 and 1 day, and also postoperatively: 2nd, 3rd, and 7th day. Anxiety-like behavior was estimated by subjectiong the animals to the open field (OF), elevated plus maze (EPM) and light/dark (L/D) tests at the same postoperative days as evF. Results: Rats that developed experimental CP/CPPS showed decreased mechanical pain threshold in the scrotal skin in all postoperative time points, in comparison to the Sham group. Also, in rats with prostatitis increased anxiety-like behavior was observed in OF, EMP and L/D test, compared to corresponding controls. Protocol of 30-day long exercise in rats with CP/CPPS led to reversion of anxiety-like behavior and increased scrotal pain threshold. Conclusion: Results of the present study showed that exercise pretreatment on the treadmill for 30 consecutive days led to the amelioration of anxiety-related and pain-related behavior in rats with CP/CPPS.
... Stress is a physiological response to a demand or challenge and it carries feelings of physical and emotional tension (Aneshensel., 1992). When stress response is prolonged in time, it leads to the apparition of anxiety disorders (Boudarene et al., 2002;Patriquin & Mathew., 2017). ...
Memory formation is modulated by anxiety, depression and sleep quality, and it is altered as a consequence of normal aging. During the COVID-19 pandemic, anxiety and depression values increased and sleep quality decreased, being young adults the more affected. It has been proposed that older adults had better coping mechanisms that could have diminished the negative effects of isolation. Furthermore, we have previously shown that this mental health deterioration, directly affected encoding of aversive episodic memories. Thus, we aimed to study the differential effects of the lockdown on memory processes in young and older adults. We hypothesized that as mental health was more impaired in young adults, their higher performance in episodic memory tasks over older adults would be lost during the pandemic. Participants completed a set of anxiety, depression and sleep quality tests, watched an aversive video and gave a free recall (day 1). On day 2, they performed a recognition and a free recall task, and carried out an episodic order task. We observed that anxiety and depression values were higher for both young and older adults compared to their respective population mean values before pandemic. In addition, younger adults had significantly higher values of anxiety as well as depression than older ones. Interestingly, older adults performed significantly better in the free recall task and both groups ordered the episodic events to an equal extent. However, young adults recognized faces better than older adults. As expected, the pandemic situation altered episodic memory processes markedly in young adults.
... 92 Biomarkers of stress include cortisol and dehydroepiandrosterone sulfate (DHEA-S) from the HPA axis. 93 The fat to lean mass ratio will be obtained using an impedance balance. Body mass index (BMI) will also be calculated at each testing time. ...
Introduction
There has been a growing interest towards cognitive-training programmes to improve cognition and prevent cognitive impairment despite discrepant findings. Physical activity has been recognised in maintaining or improving cognitive ability. Based on a psychoneurophysiological approach, physiological indexes should partly determine neuronal dynamics and influence cognition as any effects of cognitive training. This study’s primary aim was to examine if improved physiological indexes predict improved cognitive variables in the context of a clinical intervention programme for type 2 diabetes (T2D).
Method and analysis
PhyCog will be a 22-week randomised controlled trial comparing cognitive performance between three arms: (1) physical activity (1 month), a 15-day wash-out, then cognitive training (1 month), (2) cognitive training (1 month), a 15-day wash-out and physical activity (1 month), and (3) an active breathing condition (psychoeducation and resonance frequency breathing for 1 month), then a 15-day wash-out, and combined physical activity and cognitive training (1 month), allowing to determine the most effective intervention to prevent cognitive impairment associated with T2D. All participants will be observed for 3 months following the intervention. The study will include a total of 81 patients with T2D.
Cognitive performance and physiological variables will be assessed at baseline (week 0—W0), during the washout (W5, 72–96 hours after week 4), at the end of the intervention (W10), and at the end of the follow-up (W22). The main variables of interest will be executive function, memory and attention. Physiological testing will involve allostatic load such as heart rate variability, microcirculation, cortisol and dehydroepiandrosterone sulfate levels. Sociodemographic and body composition will also be a consideration. Assessors will all be blinded to outcomes. To test the primary hypothesis, the relationship between improvement in physiological variables and improvement in cognitive variables (executive, memory and attention) will be collected.
Ethics and dissemination
This protocol was approved by the Est III French Ethics Committee (2020-A03228-31). Results will be published in peer-reviewed journals.
Trial registration number
NCT04915339 .
... The results of our study showed that the level of serum corticosterone in the HFD group was higher than the control group, whereas in the HFD + extract group was signi cantly lower than the HFD group. Numerous studies have shown a relationship between corticosteroids levels and the levels of anxiety (72)(73)(74)(75). In this regard, the role of corticosterone in anxiety-and depressive-like behavior and HPA regulation following prenatal alcohol exposure has been reported (76). ...
Today, a high-fat diet (HFD) is widely used in most communities. This diet causes anxiety by oxidative stress and inflammation. On the other hand, the Rosa damascena mill has potent antioxidant properties and can eliminate free radicals. In this study, the effect of hydroalcoholic extract of R. damascena on anxiety was investigated in male rats fed with a HFD. In this experiment, forty male Wistar rats (200–250 g) were used. The extract was administrated through gavage for one month. The HFD was consumed freely by the animals for three months. The elevated plus-maze (EPM) was used to assess anxiety. At the end of the experiment, the activity of glutathione peroxidase (GPX) and superoxide dismutase (SOD) enzymes and the levels of corticosterone also were measured. In the EPM test, the number of entries into the open arms and time spent in the open arms in the HFD + extract group significantly increased compared with the HFD group. The activity of GPX and SOD enzymes was lower in the HFD group than in the control group. The level of serum corticosterone in the HFD group was higher than in the control group, whereas the HFD + extract group was found with significantly lower corticosterone levels than the HFD group. In the EPM, a HFD caused anxiety and the extract decreased it. These effects of extract probably are due to its antioxidant properties. The extract increased the GPX and SOD activities, which is representative of its antioxidant activity.
... It can be measured in several ways, but cortisol is one of the most established biomarkers for stress (Hellhammer et al., 2018;Bozovic et al., 2013). This is because Cortisol is a corticosteroid that increases metabolism and is one of the ending products of the hormone cascade in the Hypo-Pituitary Adrenal Axis (HPAA), helping to create the "fight or flight" response (Boudarene et al., 2002). Previous research has also demonstrated an increase in cortisol levels due to perceived emotional stress (Do Yup Lee et al., 2015). ...
Background: Exercise has amassed much evidence as a significant buffer for stress,
... As such, the increased levels of blood leptin (Fig. 6) and its receptor in MG (Fig. 5I) might be induced due to the impairment of energy generation by DEHP. More important, two increased metabolites in MG that were closely related to stress-induced substances were cortisol and tetrahydrocortisone (Boudarene et al., 2002), highly supporting the DEHP-induced severe stress responses (Fig. 5H). The overall changes of the above hormones and their receptors in blood and MG indicate DEHP-disrupted hormone homeostasis, thus impairing lactation capacity. ...
Increasing evidence shows that di-2-ethylhexyl phthalate (DEHP), mostly commonly used phthalate for the production of flexible polyvinyl chloride (PVC), has the potential to induce serious health risks in humans. However, the understanding of DEHP-induced lactation performance remains largely unknown. We sought to investigate the adverse effects of DEHP on lactation and examine the underlying mechanism linking DEHP exposure with the lactation alterations. We successfully adapted a maternal DEHP exposure model in female pregnant/lactating mice. Then we determined effects of DEHP exposure on food intake, body weight and milk production as well as the alterations in endocrine factors in lactating mice. The integrated metabonomic and transcriptomic analyses of the mammary gland were performed to measure the changed metabolites and genes related to DEHP exposure-induced lactation alterations. We observed the reduced food intake with elevated blood leptin and the decreased milk yield as well as the reduced levels of serum prolactin, growth hormone, insulin-like growth factor 1 and insulin after exposed to DEHP. Furthermore, 208 metabolites and 3452 genes were separately identified as differentially expressed features associated with DEHP exposure. Integrated metabonomic and transcriptomic analyses demonstrated that DEHP caused lactation depression mainly through impairing energy generation, inducing stress responses along with the hypoactivation of inflammation, reducing the production of antioxidants, disrupting hormone homeostasis and repressing the synthesis of milk constituents (the lower glucose availability for lactose synthesis; the disruption of milk fat globule membrane for lipid droplet formation; the ribosomal dysfunction and disruption of post-modifications for milk protein synthesis). We demonstrated that DEHP disrupted several lactation-related hormone homeostasis and multiple processes like energy insufficiency, inflammation activation, oxidative stress aggravation and disturbance of milk production in the mammary gland of female lactating mice. Our results provide valuable information for the health risk of plastic additive (DEHP) on female lactation dysfunction.
... Anxiety is a psychological and physiological state that can be a normal response to a stressful moment (Stein & Steckler, 2010), but when that stressful exposure is prolonged, the perceived stress levels can lead to appearance of anxiety disorders, as has been observed during the COVID-19 pandemic (Salari Nelson & Bergeman, 2020). Studies have found that stress significantly correlates with anxiety levels (Racic et al., 2017), and an onset of state anxiety has even been proposed as the first psychological response to stress (Boudarene et al., 2002). Moreover, the relationship between stress and anxiety has been shown to be mediated by age, the quality of sleep and loneliness during the Covid-19 pandemic in young adults (Varma et al., 2021;Rossell et al., 2021). ...
The threatening context of the COVID-19 pandemic provided a unique setting to study the effects of negative psychological symptoms on memory processes. Episodic memory is an essential function of the human being related to the ability to store and remember experiences and anticipate possible events in the future. Studying this function in this context is crucial to understand what effects the pandemic will have on the formation of episodic memories. To study this, the formation of episodic memories was evaluated by free recall, recognition, and episode order tasks for an aversive and neutral content. The results indicated that aversive episodic memory is impaired both in the free recall task and in the recognition task. Even the beneficial effect that emotional memory usually has for the episodic order was undermined as there were no differences between the neutral and aversive condition. The present work adds to the evidence that indicates that the level of activation does not modify memory processes in a linear way, which also depends on the type of recall and the characteristics of the content to be encoded.
... Together, they tightly coordinate short-term and long-term endocrine stress responses, while also empowering the physiological and behavioural adjustments that are necessary for maintaining homeostasis [17]. Cortisol and DHEA with testosterone have an inverse relationship: while cortisol stimulates, testosterone and its precursor, DHEA, tend to limit the stress response [18,19]. DHEA also facilitates the metabolism of cortisol to the inactive metabolite cortisone [20]. ...
This study aimed to analyse the association between endogenous hair steroid hormones as reliable biological indicators of an individual’s stress level and the social environmental factors experienced during military training that are manifested at the beginning of compulsory military service. Hair steroid hormone concentrations—cortisol, cortisone, dehydroepiandrosterone (DHEA), and testosterone—in a group of 185 conscripts were measured using the ultra-high performance liquid chromatography-tandem mass spectrometry method. Six subjective social environmental factors in the military—attitude towards the military and military service, adaptation to the military environment, team, task, and norm cohesion, as well as psychological (un)safety in the group—were evaluated using military-specific research questionnaires. Weak but significant negative correlations were identified between cortisol and adaptation (r = −0.176, p < 0.05), attitude (r = −0.147, p < 0.05) as well as between testosterone and task cohesion (r = −0.230, p < 0.01) levels. Additionally, a multiple forward stepwise regression analysis highlighted that cortisone variation might be partially explained by task cohesion; the DHEA—determined by psychological (un)safety in the group, attitude towards the military and military service, and norm cohesion; and the testosterone—determined by task cohesion and adaptation to the new military environment. The results of this study suggest that subjective measures of social factors can be used to predict hair steroid hormone levels as objective measures of the chronic stress perceived by conscripts during their basic military training.
... As early as 1972, Skylab mission reported a significant increase in 24 -h urinary cortisol and aldosterone levels during the mission for all the nine crew members, though not much change was reported in plasma cortisol levels (Michel et al., 1976;Stowe et al., 2001). Cortisol and dehydroepiandrosterone (DHEA) are glucocorticoids released by the adrenals in response to stress (Boudarene et al., 2002;Mouthaan et al., 2014). Furthermore, the ratio of cortisol/DHEA can act as an indicator of immune regulation (Araghi-Niknam et al., 1998;Christeff et al., 1997;Danenberg et al., 1995;Mouthaan et al., 2014;Zhang et al., 1999). ...
As human space exploration advances to establish a permanent presence beyond the Low Earth Orbit (LEO) with NASA’s Artemis mission, researchers are striving to understand and address the health challenges of living and working in the spaceflight environment. Exposure to ionizing radiation, microgravity, isolation and other spaceflight hazards pose significant risks to astronauts. Determining neurobiological and neurobehavioral responses, understanding physiological responses under Central Nervous System (CNS) control, and identifying putative mechanisms to inform countermeasure development are critically important to ensuring brain and behavioral health of crew on long duration missions. Here we provide a detailed and comprehensive review of the effects of spaceflight and of ground-based spaceflight analogs, including simulated weightlessness, social isolation, and ionizing radiation on humans and animals. Further, we discuss dietary and non-dietary countermeasures including artificial gravity and antioxidants, among others. Significant future work is needed to ensure that neural, sensorimotor, cognitive and other physiological functions are maintained during extended deep space missions to avoid potentially catastrophic health and safety outcomes.
... Taking into account physiological responses, Boudarene et al. [22] identified three types of stress responses: (a) situations with no anxiety (psychological silence) and no increase in cortisol levels (biological silence), (b) high levels of anxiety (high emotional reaction) with no biological manifestations (biological silence), and (c) high levels of anxiety as well as plasma cortisol. In a recent review [23], it was concluded that young resident physicians receive a progressively increasing workload parallel to increasing levels of stress, reporting that 20-30% of resident physicians may experience relevant levels of anxiety. ...
Hospital healthcare workers of emergency departments (EDs) face a variety of occupational stressors on a daily basis. We have recently published that emergency professionals display increased salivary levels of α-amylase and dehydroepiandrosterone during the working day. The pattern of these markers may suggest a counteracting mechanism of dehydroepiandrosterone against the stress reflected by amylase increases. In order to verify this hypothesis, we have analysed different psychological aspects in the same group of healthcare professionals through different tests related to behaviours resulting from stress. These include the state-trait anxiety inventory, the self-efficacy test and the sleeping quality questionnaire. The tests were provided at the beginning of the working day and collected at the end. STAI scores (trait and state) were indicative of no anxiety. Self-efficacy scores were considered optimal, as well as those from the sleeping quality questionnaire. This is supported by the modest correlation between STAI scores and salivary levels of α-amylase and dehydroepiandrosterone. In conclusion, the emergency professionals of the studied hospitals seem to have adequate work management. Altogether it means that the stress generated during work performance is controlled, allowing a correct adaptation to the demanding situations undergone in emergency departments.
... based on the usual Student's t test, which assumes homoscedasticity. This result is fairly consistent with one reported in [1] where r s = .43, p = .003. ...
Psychological studies in general, and psychobiological studies in particular, routinely use a collection of classic statistical techniques aimed at comparing groups or studying associations. A funda- mental issue is whether violating the basic assumptions underlying these methods, namely normality and homoscedasticity, can result in relatively poor power or miss important features of the data that have practical significance. In the statistics literature, hundreds of papers make it clear that under general conditions the answer is yes and that routinely used strategies for dealing with violations of assumptions can be unsatis- factory. Moreover, a vast array of new and improved techniques is now available for dealing with violations of assumptions, including more flexible methods for dealing with curvature. The paper reviews the major insights regarding standard methods, explains why some seemingly reasonable methods for dealing with violations of assumptions are technically unsound, and then outlines methods that are technically correct. It then illustrates the practical importance of modern methods using data from the Well Elderly II study.
... In particular, it is the slow return to baseline of catecholamine stress responses which reflect depressive behaviour [21]. Similarly, high and extended cortisol responses to acute stressors observed in vulnerable individuals are examples of inability of the HPA axis to adapt (e.g., high-anxiety participants exposed to a mental discrimination task [22]). However, repeated continuous high responses are supposed to develop into blunted or non-response to stressors due to the development of insensitivity of the corticotropin-releasing hormone (CRH) receptors in the hypothalamus. ...
Background:
This paper tries to demonstrate that the questionnaire-based continuum between temperament traits and psychopathology can also be shown on the biochemical level. A common feature is the incapacity to adapt to external demands, as demonstrated by examples of disturbed hormone cycles as well as neurotransmitter (TM) responses related to affective and impulse control disorders.
Methods:
Pharmacological challenge tests performed in placebo-controlled balanced crossover experiments with consecutive challenges by serotonin (5-HT), noradrenaline (NA), and dopamine (DA) agonistic drugs were applied to healthy subjects, and individual responsivities of each TM system assessed by respective cortisol and prolactin responses were related to questionnaire-based facets of depressiveness and impulsivity, respectively.
Results:
The depression-related traits "Fatigue" and "Physical Anhedonia" were characterized by low and late responses to DA stimulation as opposed to "Social Anhedonia," which rather mirrored the pattern of schizophrenia. Reward-related and premature responding-related impulsivity represented by high scores on "Disinhibition" and "Motor Impulsivity," respectively, as well as the questionnaire-based components of attention deficit hyperactivity disorder, "Cognitive" and "Motor Impulsivity," could be discriminated by their patterns of DA/NA responses. 5-HT responses suggested that instead of the expected low availability of 5-HT claimed to be associated with impulse control disorders, low NA responses indicated lack of inhibition in impulsivity and high NA responses in depression-related "Anhedonia" indicated suppression of approach motivation.
Conclusions:
In spite of the flaws of pharmacological challenge tests, they may be suitable for demonstrating similarities in TM affinities between psychopathological disturbances and respective temperament traits and for separating sub-entities of larger disease spectra.
... Despite the fact that there is no any scientific evidence about its impact on physicians, the daily management of the "Zeigarnik effect" appears to be crucial in terms of their efficacy, efficiency, productivity, mental and physical health as well as the well-being of their professional and familial surroundings [9]. ...
... These cultural differences in aggressive social behaviours and violence present a direct effect on stress related factors as the autonomic modulation, showing that Latin America university students have higher sympathetic modulation during their clinical stay than European students [13]. Other authors consider socio-cultural Latin American conditions as stimuli that would produce higher levels of stress due to the eliciting social environment and violent context [37][38][39][40]. ...
With the aim to explore cultural differences in stress-related psychological, nutrition, physical activity, and oral health factors between Spanish and Latin American professors, we analysed stress-related factors in 598 professors (39.9% male, 60.1% female, 41.3 ± 9.8 years) by a collection of questionnaires, which involved psychological, nutritional, physical activity and oral health items. Results showed how Spanish professors presented significantly (p ≤ 0.05) higher scores than Latin American professors in perceived stress (Spanish: 21.40 ± 4.32 vs. Latin American: 20.36 ± 4.31), teaching stress (Spanish: 6.59 ± 2.28 vs. Latin American: 6.00 ± 2.99) and neuroticism (Spanish: 5.40 ± 2.10 vs. Latin American: 4.58 ± 1.72). Spanish professors also showed healthier nutritional and physical activity habits than their Latin American counterparts, presenting higher consumption of milk products and a higher numbers of meals per day, greater weekly meat and fish consumption and higher weekly resistance training, as well as less eating between hours and snacking consumption. Nevertheless, Spanish professors brushed their teeth less and showed a higher smoking habit than Latin American professors. We concluded that there were cultural differences between Spanish and Latin American professors. In the present research, Spanish professors showed significantly higher burnout levels, teaching stress, perceived stress, and neuroticism than Latin American professors, and several differences were also found around health behaviours. These differences in perceived stress, teaching stress and burnout syndrome may be due to the habituation process of Latin American professors, and probably are associated with a higher stressful and demanding socio-cultural context.
... This in turn is reflected in the deterioration of task-specific behavior including the areas of cognition, emotion and psychosocial functioning. Controversy exists about the use of DHEA-S in the pharmacotherapy of schizophrenia [11,12] . Before the development of chlorpromazine, DHEA-S was used in young schizophrenics with modest success in improving deficit symptoms. ...
Objective: To investigate the levels of serum cortisol, dehydroepiandrosterone sulfate (DHEA-S), nitric oxide (NO) and adrenomedullin (AM) in schizophrenic patients. Subjects and Methods: Sixty-six male patients with chronic schizophrenia and 28 normal male subjects participated in this study. The duration of disease was 145 ± 120 (mean ± SD) months. Serum levels of cortisol and DHEA-S were measured by electrochemiluminescence; plasma nitrite levels as an index of NO were measured with the Griess reaction, while plasma AM concentration was measured by using high-performance liquid chromatography. Results: Patients (12.48 ± 3.2 µg/dl), as compared to controls (10.31 ± 3.1 µg/dl), had higher levels of baseline cortisol (p < 0.05). DHEA-S levels were lower in patients though this did not reach statistical significance (302 ± 156 µg/dl compared to control, 322 ± 96 µg/dl, p > 0.05). The mean levels of plasma AM and NO in the schizophrenic group (44.33 ± 5.07 pmol/l and 36.27 ± 17.6 µmol/l) were significantly higher than the levels in the control group (14.56 ± 4.03 pmol/l and 32.54 ± 7.14 µmol/l; p < 0.001, p < 0.03, respectively). There was a positive association between duration of disease and cortisol/DHEA-S ratio and cortisol level. Conclusion: The data show that schizophrenia is associated with abnormal levels of cortisol, DHEA-S, NO and AM.
... Likewise, PTs reported that they felt less anxious at Time 2. However, the boosted activity of miR-34c was negatively, strongly related to the task performance of PTs in the high incremental mindset experimental group. This can be explained based on the fact that biological (e.g., miRNA activity) and psychological (e.g., felt anxiety) aspects of emotions do not always linearly resonate with each other due to the complexity of the biological processes involved (Boudarene, Legros, & Timsit-Berthier, 2002). Also, there is evidence that resilience to stressful events could be induced by lack of miR-34c, suggesting that miR-34c activity may prevent coping with stress/anxiety (e.g., and that this may in turn negatively affect individuals' task performance. ...
This experimental study examined whether the language mindset of English as a Foreign Language (EFL) pre-service teachers significantly relates to their task-oriented state-anxiety, changes in epigenetic activity, and task performance on a translation task. A total of 52 EFL pre-service teachers were randomly assigned to either experimental groups (i.e., high incremental mindset-experimental group/low incremental mindset-experimental group) or control groups (i.e., high incremental mindset-control group/low incremental mindset-control group). The results revealed that pre-service teachers’ state-anxiety, microRNA activity (i.e., miR-34c, miR-22, and miR-204), and task performance were significantly, selectively related to each other in terms of language mindset, regardless of the effects of the demographic variables (e.g., gender). The results also showed that the interactions between state-anxiety, miR-22 activity, and task performance were only considerable for the pre-service teachers in the low incremental mindset-experimental group. The results suggest that teacher educators and policymakers should be aware of the fact that the English as a foreign language learning environment, which boosts pre-service teachers’ task-oriented state-anxiety, may have significant consequences in terms of stimulating changes in epigenetic activity, which, in turn, may significantly affect their task performance.
... These findings were similar to previous studies that describe stress in the form of continuous mental tasks. 4,5 In the present study it was observed that students facing examination stress with increasing serum cortisol showed better performance. It was observed that higher anxiety scores (STAI>40) were associated with higher cortisol levels when baseline readings were considered. ...
... As such, a comprehensive biopsychosocial model of cLBP [4], wherein psychological and social factors such as depression and employment status are included, considers the influence of such factors on the pain experience. For example, anxiety activates a stress response in the body, causing muscle tension [14,15], generating a cascade of chemical alterations that lead to further muscle tension and/or spasm [16,17]. The degree of muscle tension is positively correlated with the severity of depression, suggesting a physiological course whereby psychological factors affect the persistence of musculoskeletal conditions [18]. ...
Objective:
This study preliminarily characterizes and compares the impact of lower limb loss and development of chronic low back pain (cLBP) on psychosocial factors, as well as the relationship between these factors and low back pain-related functional disability.
Design:
Cross-sectional study.
Methods:
Participants were adults, active duty or retired military, with traumatic lower limb loss with and without chronic low back pain. Psychosocial factors and low back pain-related functional disability were measured using common clinical self-report questionnaires. The presence of psychosocial factors was compared between those with and without cLBP using multivariate analysis of covariance (P < 0.05), and correlations determined relationships between psychosocial factors and cLBP-related functional disability.
Results:
There were no statistically significant differences among psychosocial factors between those with vs without cLBP (F(4, 13) = 0.81, P = 0.54, η2= 0.19). Employment status (ρ = 0.43, P = 0.02), anxiety (ρ = 0.45, P = 0.04), and kinesiophobia (ρ = 0.47, P = 0.04) were moderately associated with low back pain-related disability.
Conclusions:
Psychological (i.e., anxiety) and social (i.e., employment status) factors may influence how persons with traumatic lower limb loss respond to self-reported measures of low back pain-related disability. The findings suggest that the Modified Oswestry Disability Index identifies cLBP-related functional disability in the context of lower limb loss. These results support the interdependence among biological, psychological, and social factors, which should be collectively considered during the development of rehabilitative strategies to treat secondary musculoskeletal conditions within this population.
... Notably, recent studies demonstrated that certain psychological factors might also contribute to the development and severity of type 2 diabetes mellitus. As the association between high blood glucose levels and emotional stress, anxiety, and depressive symptoms is well-documented [4][5][6], personal psychological tendencies that influence the ability to cope with stressors and emotionally charged circumstances seem particularly important with respect to susceptibility to high blood glucose levels and type 2 diabetes mellitus. In particular, differentiation of self, a family systems construct shaped by family-of-origin patterns [7], appears to be an important regulating factor of anxiety and psychological distress [8][9][10][11][12]. ...
Background
Differentiation of self is a family systems construct defined as the ability to balance intimacy and autonomy and to separate instinctually driven emotional reactions and thoughtfully considered goal-directed functioning. In theory, low differentiation of self is reflected by four components: a low tendency to take an I-position in relationships (i.e., to own one’s thoughts and feelings); emotional cutoff from others; a greater tendency to fuse with others; and a tendency towards emotional reactivity. Low differentiation of self is associated with anxiety and depression, which are risk factors for type 2 diabetes mellitus. The current study examines the relationship between differentiation of self and type 2 diabetes mellitus.
Method
Individuals with type 2 diabetes mellitus (N = 107) and healthy individuals (N = 145) completed the Differentiation of Self Inventory-Revised (DSI-R), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI-II).
Results
Compared with healthy individuals, participants with type 2 diabetes had more severe depressive symptoms, higher levels of emotional cutoff, and a lower tendency to take an I-position, but had similar levels of trait anxiety, emotional reactivity, and fusion with others (factor analysis revealed these factors were not separable in the current sample and thus were merged into a single construct). Importantly, the severity of depressive symptoms mediated the relationship between emotional cutoff and being in the type 2 diabetes study group rather than the healthy group.
Conclusion
These findings suggest a new perspective on the role of psychological patterns in type 2 diabetes mellitus development and progression.
... The term bruxism is defined as an involuntary rhythmic or spasmodic, non functional grinding, gnashing or clenching of teeth. 1 Voluntary clenching of the teeth is a common maneuver used to facilitate peripheral monosynaptic reflexes and motor system excitability as a reaction to stress. 2 It has also been indicated that an aggressive biting is associated with a significant attenuation of the stress-induced increase of nor-adrenaline turnover in the brain. 3 Therefore, occlusion of the masticatory organ contributes significantly to an individual's reaction to stress. Pathological tooth wear is often associated with bruxism, which appears in turn to be influenced by psychosocial factors. ...
... Exercise increases the concentration of stress hormones, including cortisol (2,3,20). Concentration of plasma cortisol is known to be elevated during (7,9,10,28) and before (32) sport competition because of physical exertion or anticipatory response. ...
The purpose of this study was to investigate the stress and immune responses to a competition in elite male and female junior golfers. Six male (16.2 +/- 1.4 years) and 6 female junior golfers (16.4 +/- 1.1 years) completed salivary collections during competition vs. practice rounds on 2 different days. Salivary samples were collected on 4 occasions (rest, before, during, and after rounds). Salivary cortisol and IgA were measured for stress and immune responses, respectively. Our results were as follows: (a) Salivary cortisol level was higher in competition than practice in male golfers (p = 0.009) but it was similar in female golfers. In male golfers, salivary cortisol level was higher before a round than at rest (p = 0.029), but it was higher after rounds than at rest (p = 0.016) in female golfers. (b) Salivary IgA was elevated during competition than during practice rounds in male golfers (p = 0.019), but not in females (p = 0.152). Salivary IgA was not significantly different among salivary collection times although it tended to be elevated during and after rounds for both male and female golfers. In conclusion, salivary cortisol and IgA were elevated during golf competition compared with practice in male junior golfers, but they were not in female golfers. Furthermore, salivary cortisol was higher before a round than rest in men, but it was higher after a round than rest in women. Both male and female junior golfers, however, showed similar salivary IgA responses during golf. Our results suggest that sex might play a role on stress and immune responses during a game of golf in elite junior golfers.
... Thus, in recent years, an increasing number of studies have documented the effectiveness of qigong to improve psychological well-being, including anxiety and depression symptoms (Abbott & Lavretsky, 2013;Chan et al., 2013Chan et al., , 2014 gland under the influence of ACTH, like cortisol, has been associated with an improvement in psychological well-being and mood (Binder, Weber, Ehrismann et al., 2009;Brooke, Kalingag, Miraki-Moud et al., 2006;Ceballos, France & al'Absi, 2007;Gurnell, Hunt, Curran et al., 2008;Hunt, Gurnell, Huppert et al., 2000;Kasala, Bodduluru, Maneti & Thipparaboina, 2014;Morales, Nolan, Nelson & Yen, 1994), among other effects. As a matter of fact, the beneficial role of DHEA on the feeling of well-being has been suggested to be related, at least in part, with DHEA opposing action of cortisol through its competition in their synthesis and release by the adrenal gland (Boudarene, Legros & Timsit-Berthier, 2002). Regarding the positive effects of DHEA on psychological wellbeing, recent meta-analyses have revealed, however, conflicting results (Rutkowski, Sowa, Rutkowska-Talipska, Kuryliszyn-Moskal & Rutkowski, 2014). ...
... DHEA can broadly infl uence physiology through its conversion to other sex steroids and metabolites, indicating the potential for a diverse pattern of peripheral downstream effects. DHEA has been associated with externalizing disorders such as disruptive behavior disorder (Brown et al., 2008;van Goozen et al., 2000 ) as well as internalizing disorders such as anxiety ( Boudarene, Legros, & Timsit-Berthier, 2002 ) and depression ( Shirtcliff, Zahn-Waxler, Klimes-Dougan, & Slattery, 2007 ;Wolkowitz et al., 1995 ), marking this as a particularly important emerging biomarker in the study of social neuroendocrinology. It is worth noting that many of the behaviors that are implicated as an outcome of the HPG are also correlates of the HPA. ...
... Redukcja stresu, a tym samym lęku daje możliwości niwelowania bólu po zabiegu chirurgicznym, i co się z tym ściśle wiąże, zmniejszenia konieczności stosowania narkotycznych leków przeciwbólowych po operacji, pozwala również na krótszy czas hospitalizacji. W związku z tym tak ważna jest odpowiednia edukacja i rozmowa przeprowadzona w okresie okołooperacyjnym z pacjentem [18][19][20]. Wnioski 1. Pacjenci po zabiegach ortopedycznych ocenili stres związany z własną trudną sytuacją życiową na poziomie wyników przeciętnych. Osób, u których zanotowano wysokie nasilenie stresu, było 21, średnie nasilenie stresu występowało u 22 osób, natomiast niskie u 7 osób. ...
Cel pracy: Ocena natężenia stresu i bólu pooperacyjnego
oraz określenie związku stresu z bólem u pacjentów po zabiegach
ortopedycznych.
Materiał i metody: Grupę badaną stanowiło 50 osób
w wieku 30–60 lat. Byli to pacjenci poddani zabiegowi chirurgicznemu
z powodu choroby zwyrodnieniowej stawu biodrowego
lub kolanowego, przebywający na Oddziale Urazowo-
Ortopedycznym dla Dzieci i Dorosłych w Wojewódzkim
Szpitalu Dziecięcym z Toruniu.
Do pomiaru stresu i bólu zastosowano: Skalę odczuwanego
stresu PPS 10, Skalę natężenia bólu NRS, Skalę natężenia
stresu 0–10.
Wyniki: Pacjenci poddani zabiegowi ortopedycznemu
oceniali poziom doświadczanego stresu na poziomie wyników
przeciętnych. Ważnym moderatorem doświadczania poziomu
stresu był czas trwania choroby. Największe nasilenie
stresu występowało u pacjentów chorujących powyżej 5 lat,
najmniejsze zaś u pacjentów chorujących do roku. Wykazano
również, że im dłuższy czas trwania choroby, tym silniej
odczuwane natężenie bólu w 1. i 3. dobie po operacji. Wraz
ze wzrostem natężenia poziomu stresu wzrastało natężenia
poziomu bólu w poszczególnych dobach pooperacyjnych.
Wnioski: Otrzymane wyniki badań dostarczają dowodów
na to, że istnieje związek odczuwanego stresu z subiektywną
oceną bólu pooperacyjnego. Dlatego też ocena stanu klinicznego
powinna być równie ważna, jak ocena stanu psychicznego.
Właściwie przeprowadzona rozmowa przedoperacyjna
może się okazać skutecznym sposobem obniżania stresu
i tym samym redukcji bólu. W związku z tym, że uzyskane
wyniki wskazują, że natężenie stresu i bólu wzrasta wraz
z czasem trwania choroby, warto by rozważyć realizację programów
wsparcia psychologicznego dla tych pacjentów.
Słowa kluczowe: ból, stres, zabiegi ortopedyczne.
... As such, a comprehensive biopsychosocial model of cLBP [4], wherein psychological and social factors such as depression and employment status are included, considers the influence of such factors on the pain experience. For example, anxiety activates a stress response in the body, causing muscle tension [14,15], generating a cascade of chemical alterations that lead to further muscle tension and/or spasm [16,17]. The degree of muscle tension is positively correlated with the severity of depression, suggesting a physiological course whereby psychological factors affect the persistence of musculoskeletal conditions [18]. ...
Altered trunk-pelvic motions and inter-segmental coordination in persons with unilateral lower limb amputation (ULLA) have been associated with increased risk for secondary health conditions (e.g., low back pain) [1-3]. Kinematic adaptations within these proximal segments may be a result of adopted neuromuscular strategies to account for absent sensory information and/or altered musculoskeletal tissues within the lower extremity due to trauma. In contrast, these adaptations may also indicate impaired trunk neuromuscular control, in that the neuro-musculoskeletal system cannot successfully govern kinematic variability (i.e., mechanical disturbances) and control errors in order to maintain stability. Non-linear analyses quantify the structure of variability over time using stochastic dynamics and may posit how the neuromuscular system controls the trunk in persons with varying levels of limb loss while walking. Thus, the objectives of this study are to: (1) characterize trunk local stability (as an indication of neuromuscular control) in persons with varying levels of ULLA during gait (vs. controls), and (2) evaluate the influences of concurrent cognitive challenges, as the ability to control the trunk during gait requires attentional resources, potentially further influencing trunk stability [4]. We hypothesize that persons with transfemoral ULLA will demonstrate decreased trunk local stability (greater lyapunov exponent) compared to persons with transtibial ULLA and able-bodied controls. Secondarily, persons with transfemoral ULLA will demonstrate larger decreases in local stability with increased cognitive challenge compared to transtibial ULLA and able-bodied controls.
Sixteen males with traumatic ULLA [8 transfemoral (TFA; mean age: 35.4 yrs) and 8 transtibial (TTA; mean age: 33.5 yrs)] and eight controls (CTR; mean age: 27.1 yrs) provided written informed consent, and all study procedures were approved by the local IRB. Participants completed a repeated measures design with three distinct conditions (in random order). For each, participants walked for 8 minutes within the Computer Assisted Rehabilitation Environment (CAREN; Motek Medical BV, Netherlands) at their self-selected speed (mean=1.1±0.2 m/s) while performing a secondary cognitive task (“easy” and “hard”) – each involving distinct attentional demands – or no (“none”) secondary task. For the “easy” task, a single object was displayed on a screen within direct line-of-sight with changing shapes. Participants were asked to press a button whenever a square appeared. For the “hard” task, two objects were displayed simultaneously, with individually changing shapes and colors. Participants were asked to press a button when both objects were either the same shape or same color.
Three-dimensional trunk positions were tracked (120Hz) using a 12-camera motion capture system (Vicon; Oxford, UK). Accelerations were derived using model-based computations in Visual3D (C-motion; Germantown, MD). Local stability of trunk movements was quantified from trunk accelerations using short-term maximum lyapunov exponents (λ) [5]. Trunk ranges of motion (ROM) were also calculated in each plane as the angular deviation relative to the global coordinate system. A two-way ANOVA compared group (CTR, TTA, TFA) and task (none, easy, hard) for each plane of movement (p<0.05). Eta squared for main effects of group are presented as an index of the power of the effect.
There were no significant interactions between the effects of levels of ULLA and task condition on trunk local stability; however, there were significant main effects of group in the mediolateral, F (2,62) = 20.58, p < 0.001, η2 = 0.39, and axial, F (2,62) = 28.30, p < 0.001, η2 = 0.47 planes. In general, CTR demonstrated less trunk local stability (p<0.001) and smaller trunk ROM (p<0.001) compared to persons with ULLA (Figure 1). However, there were no group differences in anteroposterior plane stability (p=0.34). In the mediolateral and axial planes, TFA demonstrated more trunk local stability, with no differences between cognitive tasks. While the latter is contrary to prior work [6], here we used a different secondary task and a more homogenous sample with respect to age, time since amputation, and walking speed. The concomitant increases in trunk motion and local stability in the TFA group suggest these individuals may employ larger global movements proximally to account for disrupted proprioception and motor function distally. Within these increased global movements, however, this subset of TFA appear to have developed a trunk neuromuscular control strategy that is better able to accommodate increased kinematic variability within the system. This is potentially a compensatory mechanism to prevent balance impairments that can accompany trunk movements outside the base of support. Clinically, rehabilitation goals should aim to increase trunk neuromuscular control via targeted trunk rehabilitation incorporating both anticipatory feed-forward (e.g., active muscle stiffness) and reactive feed-back (e.g., postural adjustments through proprioceptive mechanisms), resulting in increased local stability and effective control of local mechanical disturbances.
... Saliva samples were collected and analyzed for levels of three hormones: cortisol, cortisone, and dehydroepiandrosterone (DHEA). Cortisol and cortisone are both glucocorticoids released in response to emotional distress (including both stress and anxiety) ( Vedhara et al., 2003), while DHEA is a steroid hormone thought to oppose the action of cortisol ( Boudarene, Legros, & Timsit-Berthier, 2002). Samples were collected via the passive drool method into 2 mL polypropylene cryovials. ...
Among mammals who invest in the production of a relatively small number of offspring, bonding is a critical strategy for survival. Mother–infant bonding among humans is not only linked with the infant’s survival but also with a range of protective psychological, biological, and behavioral responses in both mothers and infants in the post-birth period and across the life span. Anthropological theories suggest that one behavior that may have evolved with the aim of enhancing mother–infant bonding is infant-directed singing. However, to date, despite mother–infant singing being practiced across cultures, there remains little quantitative demonstration of any effects on mothers or their perceived closeness to their infants. This within-subjects study, comparing the effects of mother–infant singing with other mother–infant interactions among 43 mothers and their infants, shows that singing is associated with greater increases in maternal perceptions of emotional closeness in comparison to social interactions. Mother–infant singing is also associated with greater increases in positive affect and greater decreases in negative affect as well as greater decreases in both psychological and biological markers of anxiety. This supports previous findings about the effects of singing on closeness and social bonding in other populations. Furthermore, associations between changes in closeness and both affect and anxiety support previous research suggesting associations between closeness, bonding, and wider mental health.
... A cycle of physiological pain and psychological stress ensues leading to biochemical responses. Firstly, due to initial low level pain and active stress, beta-endorphin is released [65e67], followed by cortisol release as the cycle continues into the chronic phase [68,69]. Meanwhile HR and BP become elevated due to the effects of stress [70]. ...
Reflexology is used for various pregnancy related complaints. A three-armed, pilot randomised controlled trial was conducted to test changes in physiological and biochemical stress parameters. Ninety primiparous volunteers experiencing low back and/or pelvic girdle pain (LBPGP) were recruited to receive either six reflexology or footbath treatments or usual care. Primary outcome data included pain intensity and frequency measured on a visual analog scale (VAS), and salivary beta-endorphin and cortisol levels. 61 (68%) women completed the intervention. A clinically important reduction of 1.63 cm occurred for VAS pain frequency following reflexology. Beta-endorphin levels increased by 8.8% and 10.10% in the footbath and usual care groups respectively and decreased by 15.18% for the reflexology group. Cortisol increased by 31.78% for footbath participants, 31.42% in usual care and 18.82% in the reflexology group. Reflexology during pregnancy may help reduce LBPGP, and associated stress. However, antenatal reflexology is under researched and requires further investigation.
... 5 In the present study the second important factor to be seen in student is change in appetite which was 30% which is due to deprivation of sleep because it can exacerbate appetite by increasing ghrelin and decreasing leptin 6 whereas the loss of appetite can occur due to CRH release after acute stress. 7 In the present study 36% of students feel pain because the increased level of stress among students causes physical changes in body i.e. painful muscle tension due to repeated excitatory neural stimulation results in tension headaches, back ache and neck aches and stiffness [8] In our present study 60% of students complain about fatigue that may be due to chronic stress causes adrenal burnout which causes the diminish release of DHEA and cortisol. This adrenal insufficiency causes fatigue, dizziness and low blood sugar. ...
Objective: To assess the level of stress among university students. Materials and Methods: a cross-sectional questionnaire-based study constituting approximately 200 randomly selected university students. For convenience confidentiality is maintained. Stress is measured by using stress scale of 24 closed ended questions. The questionnaire is filled by university students under the supervision of pharmacist. Results: The study shows that approximately 82 percent student showing a great trait and characteristics of stress that are creating unhealthy behaviors. 17% of students have low self-esteemand13% of students were always preoccupied with thoughts and 11% of students keeps on thinking even if relaxing and 50% of the students face problem regarding their sleep pattern which is badly influencing the behavior of the students. This suggest that they are more prone to experience stress related illnesses like diabetes, irritable bowel, migraine, back and neck pain, high blood pressure, heart disease/strokes, mental ill health (depression, anxiety & stress). The extent of stress level observed among university student is certainly alarming and thus. Approaches are needed that reduce the negative aspects of stress (distress). Conclusion: The prevalence of stress among university students is alarming. The study suggests that there is a need for primary and secondary preventive measures, with the development of adequate and appropriate support services for this group.
... These blunted physiological stress responses may result from malfunctioning of biological stress systems. In the short-term, anxiety may heighten psychophysiological stress reactivity (e.g., increased cortisol) as shown by Boudarene, Legros, &Timsit-Berthier(2002). However, chronic anxiety may induce a prolonged physiological activation that may lead to systemic allostatic load, resulting in maladaptive physiological stress response patterns (McEwen, 1998(McEwen, , 2007. ...
Background and objectives:
Both chronic smoking and trait anxiety have been associated with dysregulations in psychobiological stress response systems. However, these factors have not been studied in conjunction. We expected trait anxiety and smoking status to attenuate stress reactivity. Furthermore, we expected an allostatic load effect resulting in particularly attenuated stress reactivity in high-anxious smokers. In addition, high-anxious smokers were expected to exhibit increased urges to smoke in response to stress.
Methods:
115 smokers and 37 nonsmokers, aged 18-64 years, completed a laboratory session including mental stressors such as evaluated public speaking and mental arithmetic. Trait anxiety was assessed using Spielberger's State-Trait Anxiety Inventory. Cardiovascular autonomic indices, salivary cortisol, and the desire to smoke were measured at baseline, during stressors, and at recovery.
Results:
Regression analyses showed that smokers exhibited attenuated cardiovascular stress responses in comparison to nonsmokers. Higher trait anxiety predicted attenuated systolic blood pressure responses to stress. No interaction effect of smoking status and trait anxiety was found in stress response measures. Higher trait anxiety predicted an increased desire to smoke in response to stress among smokers.
Conclusion:
Results indicate that both smoking status and trait anxiety are associated with blunted sympatho-adrenal cardiovascular stress reactivity. Elevated urges to smoke in response to stress found among smokers with high trait anxiety suggest an important role of anxiety in smoking propensity and relapse.
... DHEA is the most abundant steroid hormone found in human body and its highest concentration is around age 20-30. Decreased in DHEA(S) level occurred during stress conditions (Boudarene et al. 2002). A previous study showed that DHEA-S level increased significantly towards acute stress in healthy participants (Lennartsson et al. 2012). ...
Stress is a common problem among university students and studies showed that involvement in exercise could help in reducing stress. However, information regarding the effect of high intensity progressive resistance training (PRT) using a resistant tube on stress among inactive and moderate active young male university students is limited. Hence, the aim of this study is to examine the effect of high intensity PRT using a resistant tube on psychological stress level, cortisol, DHEA and physical fitness in this population. A total of 30 male university students were participated in this quasi-experiment study. Intervention group (n = 14, age: 21.50 ± 1.37 yr) was participaned to carry out high intensity PRT by using resistant tube 3 times per week for 10 weeks; control group (n = 16, age: 21.29 ± 1.86 yr) was asked to continue their current lifestyle as usual. Before and after 10 weeks of intervention, psychological stress was measured by using PSS and SLSI questionnaires; cortisol and DHEA level were measured by using ELISA method. Timed up-and-go (TUG) used to examine dynamic balance and handgrip strength test used to measure muscle strength. Findings showed that the increased of DHEA level after 10 weeks of intervention was significantly difference between control and intervention groups (p < 0.05). There was no significant group difference in changes over time in anthropometric and body composition measurements, stress scores, cortisol level and physical fitness. High intensity PRT using resistant tube may be beneficial in increasing DHEA level among young male adults, which can act as a stress biochemical indicator. DOI : http://dx.doi.org/10.17576/JSKM-2015-1302-06
... DHEA is the most abundant steroid hormone found in human body and its highest concentration is around age 20-30. Decreased in DHEA(S) level occurred during stress conditions (Boudarene et al. 2002). A previous study showed that DHEA-S level increased significantly towards acute stress in healthy participants (Lennartsson et al. 2012). ...
... 6,37,38 The elevated DHEA and cortisol lev- Whether the increase in DHEA levels in patients is the cause or result of anxiety is not fully understood. DHEA is believed to have an antiglucocorticoid effect, 39,40 and levels are thought to increase to reduce the destructive effect of cortisol 41 produced under stressful conditions. The increase in DHEA can therefore be interpreted as a compensatory mechanism developed to reduce anxiogenic activity. ...
Objective:
Changes in serum neurosteroid levels have been reported in stress-related disorders such as anxiety and depression, but not in patients with obsessive-compulsive disorder (OCD). We thus investigated such changes in patients with OCD.
Methods:
We compared the serum levels of progesterone, pregnanolone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S), cortisol and testosterone in 30 patients with OCD and 30 healthy controls.
Results:
When male and female patients were evaluated together, DHEA and cortisol levels were significantly higher in patients with OCD than the control group. When the genders were evaluated separately, DHEA and cortisol levels were higher in female patients than the female controls. The increase in DHEA levels in female patients is likely an effect of the hypothalamic-pituitary-adrenal (HPA) axis. In contrast, cortisol levels in male patients were higher than the control group, while testosterone levels were lower. The increased cortisol and decreased testosterone levels in male patients likely involves the hypothalamic-pituitary-gonadal (HPG) axis.
Conclusion:
These findings suggest that neurosteroid levels in patients with OCD should be investigated together with the HPA and HPG axes in future studies.
... over, it suggests that DHEA is not just a stress hormone and that some differential regulation of DHEA and cortisol exists. In fact CRH stimulates corticotrophin secretion and in turn corticotrophin is a stimulus for cortisol and DHEA secretion (Nieschlag et al., 1973). This may explain the direct relation we found between cortisol and DHEA levels. Boudarene et al. (2002) studied subjects without mental disorders and varying levels of anxiety, and found that the level of anxiety was related to the profile of endocrine response after the performance of cognitive tasks: subjects with high anxiety levels in the STAI test had increased cortisol reactivity and subjects with low anxiety levels showed an exclus ...
... This may explain the direct relation we found between cortisol and DHEA levels. Boudarene et al. (2002) studied subjects without mental disorders and varying levels of anxiety, and found that the level of anxiety was related to the profile of endocrine response after the performance of cognitive tasks: subjects with high anxiety levels in the STAI test had increased cortisol reactivity and subjects with low anxiety levels showed an exclusive increase in DHEAS levels. The authors suggested that the antagonism in DHEAS and cortisol might be related to competition in their synthesis and its release by the adrenal gland. ...
Background: Childhood adversity might impair corticolimbic brain regions, which play a crucial role in emotion processing and the acute stress response. The dimensional model of childhood adversity proposed that deprivation and threat dimensions might associated with individuals' development through different mechanisms. However, few studies have explored the relationship between different dimensions of childhood stress, emotion processing, and acute stress reactivity despite the overlapping brain regions of the last two. With the aid of event-related potentials technique, we explore whether negative emotion processing, which might be particularly relevant for adaptive stress responding among individuals with adverse childhood experience, mediates the relationship between dimensional childhood stress and acute stress response. Method: Fifty-one young adults completed a free-viewing task to evaluate neural response to negative stimuli measured by late positive potential (LPP) of ERPs (Event-related potentials). On a separate day, heart rate and salivary cortisol were collected during a social-evaluative stress challenge (i.e., TSST, Trier Social Stress Test). After the TSST, childhood trauma questionnaire was measured to indicate the level of abuse (as a proxy of threat) and neglect (as a proxy of deprivation) dimensions. Multiple linear regression and mediation analysis were used to explore the relationship among the childhood stress, emotion processing and acute stress response. Results: Higher level of childhood abuse (but not neglect) was distinctly related to smaller LPP amplitudes to negative stimuli, as well as smaller heart rate reactivity to acute stress. For these participants, smaller LPP amplitudes were linked with smaller heart rate reactivity to acute stress. Furthermore, decreased LPP amplitudes to negative stimuli mediated the relationship between higher level of childhood abuse and blunted heart rate reactivity to stress. Conclusions: Consistent with the dimensional model of childhood stress, our study showed that childhood abuse is distinctly associated with neural as well as physiological response to threat. Furthermore, the blunted neural response to negative stimuli might be the underlying mechanism in which childhood abuse leads to the blunted acute stress response. Considering that all the participants are healthy in the present study, the blunted processing of negative stimuli might rather reflect adaptation instead of vulnerability, in order to prevent stress overshooting in the face of early-life threatening experiences.
The purpose of this study was to analyze the psychophysiological responses (anxiety, cortisol, heart rate, skin conductance) to acute psychological stress during a visualization of competition, under the influence of pressure for perfection exerted by parents, and pressure for perfection exercised by the coach. Artistic gymnasts (3 men and 3 women) with an age range of 13 to 15 years participated, who were present in four sessions for data collection that included salivary cortisol, heart rate and skin conductance. The first session was the baseline, where we apply a booklet of questionnaires that inquire about competitive anxiety and pressure for perfection. The remaining three sessions included guided viewing; session two to create mental images and live the gymnastic competition; the third highlights the pressure for perfection created by the coach (PPE); and the fourth highlights the pressure for perfection created by parents (PPP). The results showed that the visualization of competitive situation causes stress and anxiety, although the increase in salivary cortisol was within the normal daytime level. The physiological changes were greater in those gymnasts who perceived high PPE and PPP. However, for some gymnasts the situation was considered threatening (decrease in skin conductance, and small increases in heart rate), and for others was challenging (increase in skin conductance and heart rate). In conclusion, the pressure for perfection integrates a link for the different physiological responses in competition.
Weight-associated stigmatization and discrimination may induce chronic stress in individuals with obesity. As a consequence, this stressor may cause an imbalance of HPA stress axis leading to increased eating behavior, and ultimately, weight gain. However, the direct link between internalized weight bias and stress response to acute stressors via cortisol secretion has not been investigated so far. Therefore, the purpose of this study was to investigate the interaction between internalized weight stigma as a stressor and cortisol reactivity in an acute psychosocial stress situation induced by the Trier Socials Stress Test for groups (TSST-G). Participants with BMI >30 kg/m² (n = 79) were included in the study. Results reveal that while individuals with low internalized stigma reacted as predicted with an increase in cortisol secretion to acute psychosocial stress, individuals with medium or high internalized stigma did not show a typical cortisol response. However, these findings depend on the several factors, for instance on gender. In sum, acute stress in individuals with internalized weight bias seems to blunt HPA axis reactions to acute psychosocial stress. The study contributes to the understanding of the psychological and endocrinological consequences of internalized weight bias and underlines the importance of interventions to reduce stigmatization.
Introduction:
Nurses play critical roles in disaster response, often preparing through simulated exercises. According to The NLN Jeffries Simulation Theory, simulations can lead to anxiety in participants that affects learning. The objective of this research was to measure and describe anxiety and stress levels of participants in a live disaster-training exercise.
Methods:
A quasiexperimental/descriptive design using quantitative methods (amylase, cortisol levels) and qualitative methods (survey, focus groups) was used with a convenience sample of senior nursing students taking part in a disaster exercise. Participants completed self-reports of anxiety before and after the exercise using the State-Trait Anxiety Inventory (pre/post). Following the training, participants provided saliva samples for analysis of cortisol and amylase levels to measure physiological stress levels. Participants were also invited to take part in a focus group after exercise participation.
Results:
A total of 22 participants were recruited. Significant elevation of self-reported anxiety levels was found on the State-Anxiety Inventory comparing pre- with post-training, but no Trait-Anxiety changes were noted. Amylase and cortisol levels were within normal ranges. Themes emerging from qualitative analysis include preparation, uncertainty, teamwork, realism, and decision making.
Discussion:
Disaster training may be anxiety provoking and stressful. ED nurses should consider how to include best practice approaches for simulation in design of exercises to prepare for the increasing number of multicasualty events.
La coronarographie est l’examen de référence dans l’investigation des cardiomyopathies ischémiques. Si c’est un examen courant, avec peu de risque, il reste source d’anxiété à cause de la gêne occasionnée par le geste mais également en raison du diagnostic éventuellement retenu et de ses conséquences. Si l’hypnose a une légitimité historique, elle dispose maintenant d’un étayage scientifique de plus en plus important. C’est pourquoi le recours à cette prise en charge, notamment en chirurgie et médecine interventionnelle, est de plus en plus fréquent. A partir d’un échantillon de 126 patients, nous avons mesuré l’anxiété avant la réalisation d’une primo coronarographie. Les patients du groupe H ayant bénéficié d’une séance d’hypnose et de suggestions post-hypnotiques, alors que les patients du groupe contrôle bénéficiaient d’une prise en charge classique. Les scores d’anxiété furent mesurés à l’aide de l’Inventaire d’Anxiété Etat-Trait (STAI-Y). L’analyse multivariée montre une diminution de l’anxiété chez les patients du groupe hypnose. Cette diminution est associée à une médication moindre durant l’intervention. Cette étude tend à montrer que l’hypnose a une influence sur l’anxiété pré-interventionnelle. Des études ultérieures, incluant un troisième bras permettrait de renforcer ces résultats.
Mental and physical stress is common in physicians during night shifts. Neurocognitive effects of sleep deprivation as well as alterations in hormonal and metabolic parameters have previously been described. The aim of this crossover study was to evaluate the effects of night-shift work with partial sleep deprivation on steroid hormone excretion and possible associations with mood, sleep characteristics and cognitive functions in physicians.
In total, 34 physicians (mean age 42 ± 8.5 years, 76.5% male) from different departments of the General Hospital of Vienna, Austria, were randomly assigned to two conditions: a regular day shift (8 h on duty, condition 1) and a continuous day-night shift (24 h on duty, condition 2). In both conditions, physicians collected a 24 h urine sample for steroid hormone concentration analysis and further completed psychological tests, including the sleep questionnaire (SF-A), the questionnaire for mental state (MDBF) and the computer-assisted visual memory test (FVW) before and at the end of their shifts, respectively.
Although mean sleep deprivation during night shift was relatively small (~1.5 h) the impairment in participants’ mental state was high in all three dimensions (mood, vigilance and agitation, p ≤ 0.001). Sleep quality (SQ), feeling of being recovered after sleep and mental balance decreased (p ≤ 0.001), whereas mental exhaustion increased (p < 0.05). Moreover, we could show a nearly linear relationship between most of these self-rating items. Testing visual memory participants made significantly more mistakes after night shift (p = 0.011), however, mostly in incorrectly identified items and not in correctly identified ones (FVW). SQ and false identified items were negatively correlated, whereas SQ and time of reaction were positively associated. It is assumed that after night shift, a tendency exists to make faster wrong decisions. SQ did not influence correctly identified items in FVW. In contrast to previous investigations, we found that only excretion rates for pregnanetriol and androsterone/etiocholanolone ratios (p < 0.05, respectively) were slightly reduced in 24-h urine samples after night shift. A considerable stimulation of the adrenocortical axis could not be affirmed. In general, dehydroepiandrosteron (DHEA) was negatively associated with the sense of recreation after sleep and with the time of reaction and positively correlated with correctly identified items in the FVW test.
These results, on the one hand, are in line with previous findings indicating that stress and sleep deprivation suppress gonadal steroids, but, on the other hand, do not imply significant adrenocortical-axis stimulation (e.g. an increase of cortisol) during the day-night shift.
Objective: The objective of the present study was to investigate the correlation between various levels of anxiety and cortisol levels in pre-competition bodybuilding athletes.
Methods: Twelve athletes aged between 20 and 35 years participated in the study. The Multidimensional Inventory of Anxiety Inventory Questionnaire-II (CSAI-2) was used, and it was applied during weighing for the Paraense Championship of Bodybuilding and Fitness of 2015. The concentration of cortisol was collected and analyzed through the Coat- A-Count (DPCMedlab®, Brazil). Cortisol collection used venous blood, which remained at rest for 30 minutes at room temperature for coagulation. Then, the blood sample was centrifuged for 10 minutes at 800 rcf (relative centrifugal force) for serum separation. Biochemical measurements were performed using the Vitros® 5600 film system (Ortho-Clinical Diagnostics, Johnson & Johnson Co., Rochester, NY, USA).
Results: The levels of cognitive anxiety were (21.7 ± 9.1), the somatic anxiety levels were medium (22.7 ± 6.3), and the self-confidence levels were high (30.2 ± 8.4). There were no significant differences between cognitive anxiety, somatic anxiety, and self-confidence (P = 0.542). However, the results revealed significant differences (P = 0.012) between cognitive anxiety and self-confidence. Significant differences were also observed between somatic anxiety and self-confidence (P = 0.007). The cortisol evaluation showed a median inverse correlation with cognitive anxiety, a median correlation with the emotional anxieties, and a high negative correlation with self-confidence.
Conclusion: It was concluded that the correlation of cortisol and anxiety tends to help in the control of the emotional state favorable to the athlete's performance.
Stress and anxiety have a negative impact on working memory systems by competing for executive resources and attention. Broad memory deficits, anxiety, and elevated stress have been reported in individuals with chromosome 22q11.2 deletion syndrome (22q11.2DS). We investigated anxiety and physiological stress reactivity in relation to visuospatial working memory impairments in 20 children with 22q11.2DS and 32 typically developing (TD) children ages 7 to 16. Children with 22q11.2DS demonstrated poorer working memory, reduced post-stress respiratory sinus arrhythmia recovery, and overall increased levels of cortisol in comparison to TD children. Anxiety, but not physiological stress responsivity, mediated the relationship between 22q11.2DS diagnosis and visuospatial working memory impairment. Findings indicate that anxiety exacerbates impaired working memory in children with 22q11.2DS.
Link to paper: http://rdcu.be/ouO3
Introduction and Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common painful oral ulcerative conditions. Stress is said to have a role in occurrence of RAS. Medical students are under immense stress due to their hectic schedule and curriculum. Cortisol is the primary hormone that is secreted in response to stress. Psychological stress can be evaluated using State Trait Anxiety Inventory (STAI) questionnaire. The purpose of this study was to evaluate the role of stress in the causation of RAS. Materials and Methods: Two groups of medical students, one with RAS (21) and other without RAS (30) were included in the study. Examination of the ulcers was done. STAI score and the serum cortisol were measured and compared using Student t test. Correlation analysis was done between the parameters. Results: There was no significant difference in the serum cortisol and STAI score between both the groups. However, a negative correlation was found between stress and STAI score between the groups. Conclusion: Stress could be an initiating factor in the occurrence of RAS. Diet and other factors may play a role in the pathogenesis of ulcers.
Bereavement, the loss of someone close, is frequently followed by grief and can have serious implications for physical and mental health, from the increased symptoms of depression and anxiety, sleep disturbances and indigestion, and more serious physical health consequences such as cardiovascular and immune related illness. Another key factor associated with a deterioration of the body's defence mechanisms, such as the immune system, is ageing. This review has as its focus the combined effects of bereavement and ageing on immune function. First, the relationship between bereavement and increased mortality is examined, followed by its link to various physical and mental health morbidities. Second, the effects of ageing per se on immune functions are considered. Finally, the joint impact of both ageing and bereavement are discussed, focussing on recent studies of immune function after bereavement in young and older adults.
Introduction: Many studies confirm the health benefits of exercise during pregnancy both for mother and fetus. Given the possibility of poor pregnancy outcomes as well as adverse economic, physical and psychological consequences, the main purpose of the present study was to investigate the relationship between physical activity levels, maternal weight (before delivery) and serum cortisol levels (during labor) in nulliparous women. Methods: The participants of this cross-sectional study were women admitted to Imam Hussein hospital for delivery in Shahrood, Iran, 2013. Overall, 76 women were chosen randomly as the sample. The physical activity level was determined via PPAQ questionnaire and maternal weight and serum cortisol level were measured using a scale and ELISA kit, respectively. The validity of all the data gathering tools was approved by a number of experts in the field and the reliability of the questionnaire was measured (α=0.81). The data was analyzed using SPSS software version 18. Kolmogorov-Smironov, Pearson correlation and Spearman correlation were performed (P-value less than 0.05 was considered significant). Results: Our findings proposed that there is a significant inverse relationship between physical activity Level of pregnant women and maternal weight before delivery (p<0.05); however, no significant relationship was found between physical activity level of pregnant women and maternal serum cortisol level while in labor (p>0.05). Conclusion: Delivery, considered as the most physically and mentally stressful event for pregnant women, is completely independent of pregnancy. Therefore, serum cortisol levels during labor is not affected by physical activity during pregnancy, however, the weight gain during pregnancy can be controlled through physical activity. © 2014, Mashhad University of Medical Sciences. All rights reserved.
This article defines stress and related concepts and reviews their historical development. The notion of a stress system as the effector of the stress syndrome is suggested, and its physiologic and pathophysiologic manifestations are described. A new perspective on human disease states associated with dysregulation of the stress system is provided.
Published original articles from human and animal studies and selected reviews. Literature was surveyed utilizing MEDLINE and the Index Medicus.
Original articles from the basic science and human literature consisted entirely of controlled studies based on verified methodologies and, with the exception of the most recent studies, replicated by more than one laboratory. Many of the basic science and clinical studies had been conducted in our own laboratories and clinical research units. Reviews cited were written by acknowledged leaders in the fields of neurobiology, endocrinology, and behavior.
Independent extraction and cross-referencing by the authors.
Stress and related concepts can be traced as far back as written science and medicine. The stress system coordinates the generalized stress response, which takes place when a stressor of any kind exceeds a threshold. The main components of the stress system are the corticotropin-releasing hormone and locus ceruleus-norepinephrine/autonomic systems and their peripheral effectors, the pituitary-adrenal axis, and the limbs of the autonomic system. Activation of the stress system leads to behavioral and peripheral changes that improve the ability of the organism to adjust homeostasis and increase its chances for survival. There has been an exponential increase in knowledge regarding the interactions among the components of the stress system and between the stress system and other brain elements involved in the regulation of emotion, cognitive function, and behavior, as well as with the axes responsible for reproduction, growth, and immunity. This new knowledge has allowed association of stress system dysfunction, characterized by sustained hyperactivity and/or hypoactivity, to various pathophysiologic states that cut across the traditional boundaries of medical disciplines. These include a range of psychiatric, endocrine, and inflammatory disorders and/or susceptibility to such disorders.
We hope that knowledge from apparently disparate fields of science and medicine integrated into a working theoretical framework will allow generation and testing of new hypotheses on the pathophysiology and diagnosis of, and therapy for, a variety of human illnesses reflecting systematic alterations in the principal effectors of the generalized stress response. We predict that pharmacologic agents capable of altering the central apparatus that governs the stress response will be useful in the treatment of many of these illnesses.
A critical analysis of the applicability of corticosterone, cortisone and cortisol radioimmunoassays in human plasma is presented. Rabbits immunized with corticosteroid-3-CMO-BSA conjugates yielded specific antisera. Yet, their specificity may become insufficient when the concentrations of weakly cross-reacting steroids are much higher than that of the steroid to be assayed. In these particular instances, appropriate and simple purification steps, such as hexane extraction or celite chromatography, must be added. Normal values for pregnant women at delivery and their babies are presented.
The present study assessed the relation of cortisol response to anxiogenic reactivity during intravenous lactate infusion and oral fenfluramine in 12 panic disorder (PD) patients who responded positively to both challenges and in eight non-reactive control subjects. There was no significant cortisol response difference between the PD patients and the controls during lactate infusion, but there was s significant difference at 120 min during the fenfluramine challenge. These findings are consistent with the possibility that these challenges stimulate different neurobiologic mechanisms and that fenfluramine-precipitated anxiety is more akin to anticipatory or generalized anxiety than to true panic anxiety.
Feedback inhibition of the adrenocortical axis by circulating glucocorticoids occurs at the pituitary and CNS sites. In the CNS, both hypothalamic and suprahypothalamic sites have been implicated as mediators of glucocorticoid feedback activity. In the present experiments, we have attempted to identify specific CNS regions mediating the feedback and to characterize which hypothalamic adrenocorticotropic hormone secretagogues are under glucocorticoid inhibitory control. Adrenalectomized rats were presented with a delayed feedback signal in the form of systemic infusion with corticosterone or dexamethasone. Hypophysialportal concentrations of corticotropin-releasing factor (CRF), arginine vasopressin (AVP), and oxytocin (OT) were determined before and during a hypotensive stressor in the face of varying levels of feedback. The rats were then killed, and the extent of total, type I, and type II corticosteroid receptor occupancy in hippocampus, hypothalamus, and amygdala was determined. The following observations were made: (1) increased hippocampal corticosteroid receptor occupancy was associated with suppressed adrenocorticotropic hormone secretagogue concentrations; (2) the major, significant predictor of initial (prehypotensive) concentrations of CRF, AVP, and OT was the extent of occupancy of hippocampal type II receptors, often in combination with occupancy of hippocampal type I or hypothalamic receptors; (3) secretion of CRF induced by hypotension was best predicted by hippocampal type I and type II receptor occupancy (stress-induced OT secretion was best predicted by hippocampal type II and hypothalamic receptor occupancy), and (4) the 'shape' of the hippocampal type II receptor occupancy versus initial AVP concentration curve suggested a nonlinear, threshold type of relationship, implying tight hippocampal regulation of AVP secretion.
Stress stimulates several adaptive hormonal responses. Prominent among these responses are the secretion of catecholamines from the adrenal medulla, corticosteroids from the adrenal cortex, and adrenocorticotropin from the anterior pituitary. A number of complex interactions are involved in the regulation of these hormones. Glucocorticoids regulate catecholamine biosynthesis in the adrenal medulla and catecholamines stimulate adrenocorticotropin release from the anterior pituitary. In addition, other hormones, including corticotropin-releasing factor, vasoactive intestinal peptide, and arginine vasopressin stimulate while the corticosteroids and somatostatin inhibit adrenocorticotropin secretion. Together these agents appear to determine the complex physiologic responses to a variety of stressors.
Human immunodeficiency virus (HIV) is a major cause of immunoincompetence. Whether the virus, itself, accounts for all the deficiency remains in question. Steroids can also influence immune function; glucocorticoids cause immunoincompetence while dehydroepiandrosterone (DHEA) enhances immune function. Changes in the levels of such hormones during the course of HIV illness might result in significant changes in immune competence. The purpose of this study is to investigate whether dehydroepiandrosterone-sulphate (DHEA-S) or cortisol levels correlate with absolute CD4 lymphocyte levels. Plasma for cortisol and DHEA-S was drawn from 98 adults with HIV. Of these, 67 had simultaneous CD4 levels. Cortisol levels were 12.4 +/- 4.6 micrograms/dl, DHEA-S 262 +/- 142 micrograms/dl, and CD4 levels were 308 +/- 217/mm3 (mean +/- SD). Correlational analysis revealed a significant relationship between DHEA-S and CD4 levels (r = 0.30; p = 0.01) but not between CD4 levels and cortisol (r = 0.11; p = 0.36) or cortisol/DHEA-S ratios (r = 0.17; p = 0.16). When analyzed by clinical subgroups, significant differences were also found with a decrease in DHEA-S levels seen in persons with more advanced illness. The data exhibit a positive relationship between the immune status of patients with HIV-related illness and DHEA, leading to the hypothesis that DHEA deficiency may worsen immune status.
Squirrel monkeys show unusually prolonged elevations in plasma cortisol when separated from like-sex social companions. To determine whether this hypersecretion of cortisol reflects a deficiency in feedback mechanisms that normally inhibit the prolonged activation of the pituitary-adrenal axis, we simultaneously measured plasma cortisol and corticotropin (ACTH) in 30 juvenile monkeys housed in established groups, individual cages, and newly formed groups. As found in recent longitudinal studies of adults, when juveniles were living without companions, mean cortisol titers were consistently higher than those observed when the same juveniles were living in like-sex social groups. When cortisol was elevated, however, ACTH titers were significantly and chronically reduced. These results suggest that elevated cortisol does inhibit ACTH synthesis or release, and that hypercortisolism in squirrel monkeys living without companions is not a consequence of chronic elevations in ACTH. Similar peculiarities in pituitary-adrenal activity are evident in a number of affective disorders in human beings.
The authors studied differences in cortisol response to controllable and uncontrollable stress and its relationship to Seligman's theory of learned helplessness in hospitalized unipolar depressed patients (11 nontreated, acutely depressed; 11 treated patients) and 11 age and sex matched controls hospitalized for traumatic surgery. Control and lack of control were achieved by induction of success and failure in a simple number addition test and applied in balanced order on 2 consecutive days. Saliva cortisol samples were collected before and after the test. No group differences in baseline cortisol levels were observed. Cortisol increased after uncontrollable and decreased after controllable stress in control patients, whereas cortisol decreased after both conditions in the acutely depressed group and less so in the treated group, although they were as emotionally upset after failure as controls. Thus, the normally observed ability of the neuroendocrine system to discriminate between controllable and uncontrollable stress deteriorates with increasing severity of depression.
Serum cortisol concentrations are increased in fasted or malnourished human subjects. The dynamic mechanisms underlying this adaptive response have been investigated in eight normal men by analyzing serum cortisol concentrations measured in blood obtained at 5-min intervals over 24 h on a control (fed) day and on the fifth day of a fast (water only) assigned in randomized order. A multiple parameter deconvolution method was used to simultaneously resolve endogenous cortisol secretion and half-life. Five days of fasting induced a 1.8-fold increase in the 24-h endogenous cortisol production rate (fed, 2504 +/- 308; fasted, 4528 +/- 488 nmol/L distribution volume; P < 0.006). This enhanced cortisol production rate was accounted for by a 1.6-fold increase in the mass of cortisol secreted per burst (fed, 115 +/- 12.1; fasted, 183 +/- 17.3 nmol/L; P < 0.02). Cortisol secretory event amplitudes (maximal rates of cortisol release attained within a burst) increased in seven of eight men, and mean secretory burst durations remained unchanged by fasting. Moreover, the number of computer-resolved cortisol secretory bursts per 24 h (fed, 22 +/- 1.4; fasted, 25 +/- 2.0; P = NS) and the interburst interval (fed, 65 +/- 4.0; fasted, 57 +/- 4.4 min) did not change significantly during a 5-day fast. The calculated half-life of endogenous cortisol was not significantly altered by fasting (fed, 108 +/- 9.7; fasted, 129 +/- 11 min). There was no significant change in the nyctohemeral pattern of varying adrenocortical secretory burst frequency in response to fasting. However, the mean (mesor) mass of glucocorticoid secreted per burst over 24 h rose significantly in response to fasting. In addition, by cosinor analysis, maximal serum cortisol concentrations occurred (95% confidence intervals) between 0930-1334 h in the fed state and between 1116-1612 h in the fasted state (P < 0.04). Fasting augmented the mesor (average value about which the diurnal rhythm oscillates; P < 0.0008 compared with fed state) and the amplitude (P < 0.04) of the 24-h serum cortisol concentration profile. Linear regression analysis disclosed a significant inverse relationship between mean serum cortisol and GH concentrations in fasted men (r = -0.76; P < 0.02). In conclusion, the present data indicate that starvation-induced enhancement of cortisol secretion in young healthy men is mediated by an increased glucocorticoid secretory burst mass, rather than changes in secretory burst frequency or duration or in cortisol half-life. In addition, fasting modifies the diurnal secretory pattern of cortisol by delaying maximal serum concentrations to the early afternoon. The inverse relationship between serum cortisol and GH responses to fasting suggests differential regulation of the corticotropic and somatotropic axis by the metabolic stress of fasting and/or feedback interactions between these two axes when they are both activated.
Dehydroepiandrosterone (DHEA) and its sulfate, DHEA-S, are plentiful adrenal steroid hormones that decrease with aging and may have significant neuropsychiatric effects. In this study, six middle-aged and elderly patients with major depression and low basal plasma DHEA f1p4or DHEA-S levels were openly administered DHEA (30-90 mg/d x 4 weeks) in doses sufficient to achieve circulating plasma levels observed in younger healthy individuals. Depression ratings, as well as aspects of memory performance significantly improved. One treatment-resistant patient received extended treatment with DHEA for 6 months: her depression ratings improved 48-72% and her semantic memory performance improved 63%. These measures returned to baseline after treatment ended. In both studies, improvements in depression ratings and memory performance were directly related to increases in plasma levels of DHEA and DHEA-S and to increases in their ratios with plasma cortisol levels. These preliminary data suggest DHEA may have antidepressant and promemory effects and should encourage double-blind trials in depressed patients.
Two classes of steroid hormones are successively produced following a microbial infection stress in rat and man. First there are those of attenuation and acceptation, the glucocorticoids and progestins, which correspond to the temporization phase of reaction to stress. Secondly, there are those of rejection or creative reinforcement, namely the adrenal androgens converted in certain circumstances to estrogens by aromatization, which are necessary to fight against or accept the stressor. We suggest that these two classes of signal carrier molecules function as agonistic-antagonistic couples which work to prevent the organism from going too far in the direction of attenuation-acceptation or, on the contrary, in the direction of rejection-reinforcement. The presence of agonistic-antagonistic couples can be identified as regulating numerous other steps in the signal networks. Dysfunctions of such couples result in pathological situations, characterized by an imbalance in the concentration and correspondingly in the biological activity of one of the partners due to a change in the 'equilibrium constant' of the ago-antagonistic couple, changes in the level of synthesis or catabolism of one of the partners, the presence in adequate time and location of the partners, or the deficiency of the receptor of at least one of the partners. Different 'paradoxical' therapeutical strategies are envisaged to reequilibrate the imbalance.
Representing a challenge for current concepts of stress research, a number of studies have now provided convincing evidence that the adrenal gland is hypoactive in some stress-related states. The phenomenon of hypocortisolism has mainly been described for patients, who experienced a traumatic event and subsequently developed post-traumatic stress disorder (PTSD). However, as presented in this review, hypocortisolism does not merely represent a specific correlate of PTSD, since similar findings have been reported for healthy individuals living under conditions of chronic stress as well as for patients with several bodily disorders. These include chronic fatigue syndrome, fibromyalgia, other somatoform disorders, rheumatoid arthritis, and asthma, and many of these disorders have been related to stress. Although hypocortisolism appears to be a frequent and widespread phenomenon, the nature of the underlying mechanisms and the homology of these mechanisms within and across clinical groups remain speculative. Potential mechanisms include dysregulations on several levels of the hypothalamic-pituitary adrenal axis. In addition, factors such as genetic vulnerability, previous stress experience, coping and personality styles may determine the manifestation of this neuroendocrine abnormality. Several authors proposed theoretical concepts on the development or physiological meaning of hypocortisolism. Based on the reviewed findings, we propose that a persistent lack of cortisol availability in traumatized or chronically stressed individuals may promote an increased vulnerability for the development of stress-related bodily disorders. This pathophysiological model may have important implications for the prevention, diagnosis and treatment of the classical psychosomatic disorders.
Stressful experiences may influence neuroendocrine, immune and cytokine functioning, as well as physical and psychological well being. The present prospective investigation assessed physiological and behavioral variations in anticipation of a critical oral academic examination among graduate students (i.e. related to a dissertation or comprehensive defense). Relative to matched control subjects, plasma cortisol levels were elevated among graduate students, especially females, 1 h prior to the oral examination, but not 6-8 weeks earlier (at about the time of the submission of the written document). In contrast, mitogen-stimulated (Con-A) lymphocyte proliferation was only reduced 6-8 weeks before the examination. Neither adrenocorticotrophic hormone (ACTH), prolactin, serum interleukin-1beta (IL-1beta) nor mitogen stimulated IL-1beta production was influenced at any time. Although, graduate students did not differ from controls with respect to perceived stress and feelings of mastery, they reported more frequent malaise (e.g. headaches, sore throat, fatigue) than did controls. The present findings suggest that during the course of lengthy anticipatory periods preceding a scheduled stressor, different stress-sensitive, situation-dependent biological processes may be engendered. It is further suggested that cortisol release is most closely aligned with immediate threats, while the immune alterations are sensitive to more distal events, or are subject to adaptation in response to a protracted stressor.