Article

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

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.

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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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    • "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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    • "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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