Kudielka BM, Hellhammer DH, W??st S. Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge. Psychoneuroendocrinology 34: 2-18

Article · Literature Review · December 2008with1,453 Reads
DOI: 10.1016/j.psyneuen.2008.10.004 · Source: PubMed
Abstract
Stress and stress-related health impairments are major problems in human life and elucidating the biological pathways linking stress and disease is of substantial importance. However, the identification of mechanisms underlying a dysregulation of major components of the stress response system is, particularly in humans, a very challenging task. Salivary cortisol responses to diverse acute challenge paradigms show large intra- and interindividual variability. In order to uncover mechanisms mediating stress-related disorders and to potentially develop new therapeutic strategies, an extensive phenotyping of HPA axis stress responses is essential. Such a research agenda depends on substantial knowledge of moderating and intervening variables that affect cortisol responses to different stressors and stimuli. The aim of this report is, therefore, to provide a comprehensive summary of important determinants of, in particular, human salivary cortisol responses to different kinds of laboratory stimuli including acute psychosocial stress as well as pharmacological provocation procedures. This overview demonstrates the role of age and gender, endogenous and exogenous sex steroid levels, pregnancy, lactation and breast-feeding, smoking, coffee and alcohol consumption as well as dietary energy supply in salivary cortisol responses to acute stress. Furthermore, it briefly summarizes current knowledge of the role of genetic factors and methodological issues in terms of habituation to repeated psychosocial stress exposures and time of testing as well as psychological factors, that have been shown to be associated with salivary cortisol responses like early life experiences, social factors, psychological interventions, personality as well as acute subjective-psychological stress responses and finally states of chronic stress and psychopathology.
  • ...The study by Seeman et al. [20] aimed to examine stress response by gender, and found that women experienced more prolonged elevation in cortisol. Previous studies indicated that human salivary cortisol responses might differ by sex [26]. As there is currently little research on differential stress response to driving by driver characteristics or driving situations, future studies should fill this gap by investigating how driving affects individuals differently. ...
  • ...The spike in cortisol concentration related to waking is called the cortisol awakening response (CAR). This has been shown to be increased in response to an acute stressor in healthy populations, though with individual variability ( Pruessner et al. 1997;Chida & Steptoe, 2009;Kudielka et al. 2009). Most studies investigating the relationship between the CAR and examination stress in students indicate an increase in cortisol output during examination periods (van Dulmen et al. 2007;Hewig et al. 2008;GonzálezCabrera et al. 2014). ...
  • ...These differences include the use of different biological matrices to assess cortisol levels (i.e., urine, saliva, blood), as well as variation in the number of specimens and the frequency with which they were collected, all of which can affect a study's results. Specifically, HPAA activity varies dramatically within individuals as a result of various confounding factors, such as circadian rhythms, food consumption and physical activity[32,33]. We have previously argued that the use of first morning urinary cortisol allows for a tighter control of these confounders than cortisol quantification in other matrices such as saliva and blood[34]. ...
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