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

Jacobs Center on Lifelong Learning and Institutional Development, Jacobs University Bremen, Campus Ring 1, 28759 Bremen, Germany.
Psychoneuroendocrinology (Impact Factor: 4.94). 12/2008; 34(1):2-18. DOI: 10.1016/j.psyneuen.2008.10.004
Source: PubMed


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.

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    • "The HPA axis is thought to respond to these high levels by reducing cortisol output over time, resulting in a more flattened profile (Miller et al. 2007; Fries et al. 2009; Kudielka et al. 2009). That is, hyperactive HPA functioning results in hypoactive functioning when a severe state of fatigue or exhaustion is reached and the individual is no longer able to cope with an ongoing stressor (Kudielka et al. 2009). Hence, the direction and magnitude of the response appears to be a function of the chronicity of the stressor. "
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    ABSTRACT: Objectives: It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. Design: Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid-liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. Results: Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. Conclusions: Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.
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    • "Several individual difference variables have been suggested to moderate a person's cortisol response to psychosocial stress and thus explain null effects [6]. For children and adolescents, however, only few of these moderating variables like participants' physical activity levels [13], "
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    ABSTRACT: In the present study we examined the moderating effect of the power motive on salivary cortisol responses to acute psychosocial stress and exercise in adolescents. Fifty-seven high school students aged M = 14.8 years participated in the study. The Operant Motive Test (OMT) was applied to measure the implicit power motive and the Personality Research Form (PRF) was used to measure the explicit power motive. Salivary cortisol levels were assessed before and after the stress stimuli. Participants were randomly assigned to three experimental groups. An exercise group ran 15 minutes at a defined heart rate of 65-75% HRmax. A psychosocial stress group worked on a standard intelligence test for the same amount of time under the assumption, that their test scores will be made public in class after the test. The control group participated in a regular class session. The implicit power motive was significantly associated with increased cortisol levels in the psychosocial stress group. The explicit power motive was not associated with cortisol responses. Findings suggest that the implicit power motive moderates the cortisol responses to acute stress in an adolescent age group with higher responses to psychosocial stress in comparison to exercise or control conditions.
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    • "Human cortisol levels are most commonly assessed via saliva, urine or serum but are difficult to accurately ascertain. Indeed, inconsistent findings in the literature are likely due to methodological differences in the timing, number and type of measures taken, as well as the large number of other potential confounds (see Kudielka et al., 2009; Vreeburg et al., 2009b). Hair, a relatively new medium for the assay of cortisol, has been proposed as a reliable index of long term function (Koren et al., 2002; Raul et al., 2004; Stalder and Kirschbaum, 2012). "
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    ABSTRACT: Adversity early in life can disrupt the functioning of the hypothalamic-pituitary-adrenal axis (HPAA) and increase risk for negative health outcomes. Recent research suggests that cortisol in scalp hair represents a promising measure of HPAA function. However, little is known about the relationship between early exposure to traumatic events and hair cortisol concentrations (HCC) in childhood, a critical period of HPAA development. The current study measured HCC in scalp hair samples collected from 70 community-based children (14 males, mean age=9.50) participating in the Imaging Brain Development in the Childhood to Adolescence Transition Study (iCATS). Data were also collected on lifetime exposure to traumatic events and current depressive symptoms. Lifetime exposure to trauma was associated with elevated HCC; however, HCC was not associated with current depressive symptoms. Consistent with some prior work, males were found to have higher HCC than females, although results should be treated with caution due to the small number of males who took part. Our findings suggest that hair cortisol may represent a biomarker of exposure to trauma in this age group; however, further study is necessary with a particular focus on the characterization of trauma and other forms of adversity.
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