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Qin XM, Xu MQ, Qin YQ, Shao FZ, Ma MH, Ou WW, Lv GY, Zhang QQ, Chen WT, Zhao XT, Deng AQ, Xiong JT, Zeng LS, Peng YL, Huang M, Xu SY, Liao M, Zhang L, Li LJ, Ju YM, Liu J, Liu BS, Zhang Y. Cumulative effects of stress-sensitivity factors on depressive symptoms and suicide risk: A prospective study. World J Psychiatry 2025; 15:99996. [PMID: 39974481 PMCID: PMC11758051 DOI: 10.5498/wjp.v15.i2.99996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 12/04/2024] [Accepted: 12/25/2024] [Indexed: 01/14/2025] Open
Abstract
BACKGROUND Sensitivity to stress is essential in the onset, clinical symptoms, course, and prognosis of major depressive disorder (MDD). Meanwhile, it was unclear how variously classified but connected stress-sensitivity variables affect MDD. We hypothesize that high-level trait- and state-related stress-sensitivity factors may have different cumulative effects on the clinical symptoms and follow-up outcomes of MDD. AIM To investigate how stress-sensitivity factors added up and affected MDD clinical symptoms and follow-up results. METHODS In this prospective study, 281 MDD patients were enrolled from a tertiary care setting. High-level stress-sensitivity factors were classified as trait anxiety, state anxiety, perceived stress, and neuroticism, with a total score in the top quartile of the research cohort. The cumulative effects of stress-sensitivity factors on cognitive dysfunction, disability and functional impairment, suicide risk, and depressive and anxiety symptoms were examined using an analysis of variance with linear trend analysis. Correlations were investigated further using multiple regression analysis. RESULTS Regarding high-level stress-sensitivity factors, 53.40% of patients had at least one at baseline, and 29.61% had two or more. Four high-level stress-sensitivity components had significant cumulative impacts on MDD symptoms at baseline (all P < 0.001). Perceived stress predicted the greatest effect sizes of state-related factors on depressive symptoms (partial η 2 = 0.153; standardized β = 0.195; P < 0.05). The follow-up outcomes were significantly impacted only by the high-level trait-related components, mainly when it came to depressive symptoms and suicide risk, which were predicted by trait anxiety and neuroticism, respectively (partial η 2 = 0.204 and 0.156; standardized β = 0.247 and 0.392; P < 0.05). CONCLUSION To enhance outcomes of MDD and lower the suicide risk, screening for stress-sensitivity factors and considering multifaceted measures, mainly focusing on trait-related ones, should be addressed clinically.
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Affiliation(s)
- Xue-Mei Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Meng-Qi Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ya-Qi Qin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Fang-Zhou Shao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Mo-Han Ma
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wen-Wen Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Guan-Yi Lv
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Qian-Qian Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wen-Tao Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Xiao-Tian Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ao-Qian Deng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jin-Tao Xiong
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ling-Si Zeng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yi-Lin Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Mei Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Shu-Yin Xu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Mei Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Li Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Ling-Jiang Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yu-Meng Ju
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jin Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Bang-Shan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Yan Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
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Szabo A, Ábel K. Anxiety and heart rate in a real-life class test in undergraduates choosing real-time or prerecorded oral presentations. Biol Futur 2024; 75:17-28. [PMID: 37542019 DOI: 10.1007/s42977-023-00175-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/17/2023] [Indexed: 08/06/2023]
Abstract
Most studies on acute stress stem from works conducted under artificial laboratory conditions. Inducing stress for experimental scrutiny is problematic and can be unethical. In this study, a 'research methods' course's curriculum included a demonstration study testing anxiety and heart rate responses to the midterm test. Fifty-four university students (35 males and 19 females) presented a research topic in-person (n = 14) or prerecorded while being present (n = 40). Students selected a test format they could change until the week before the midterm test. The measures were trait anxiety, test anxiety, state anxiety, heart rate (HR), the last two being measured before and after examination, and grades. All students manifested decreased state anxiety and increased HR from before to after the test. Females exhibited higher HR and state anxiety than males. Real-time presentations were associated with higher HRs but not higher state anxiety. Those who changed their planned presentation mode from in-person to prerecorded exhibited higher test anxiety but not trait anxiety than those who presented as planned. Students who presented in-person obtained lower grades than those who prerecorded their presentations. Grades were negatively correlated with state anxiety after the test, but test anxiety did not significantly mediate the grades. Pre-test state anxiety was positively associated with both trait anxiety and test anxiety. The findings suggest that test anxiety is unlikely to affect grades, but test-anxious students need more control over academic evaluation. A choice in test format could be helpful in this regard.
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Affiliation(s)
- Attila Szabo
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Krisztina Ábel
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Doctoral School of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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3
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Garces-Arilla S, Mendez-Lopez M, Fidalgo C, Salvador A, Hidalgo V. Examination-related anticipatory levels of dehydroepiandrosterone and cortisol predict positive affect, examination marks and support-seeking in college students. Stress 2024; 27:2330009. [PMID: 38952223 DOI: 10.1080/10253890.2024.2330009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/08/2024] [Indexed: 07/03/2024] Open
Abstract
Dehydroepiandrosterone (DHEA) and cortisol release appear to have contrasting effects on stress perception during stressful tasks. This study aimed to investigate anticipatory examination stress in college students by considering DHEA, cortisol, psycho-emotional aspects and examination performance. Seventy-six students (66 females, 10 males; age range 18-25 years) provided saliva samples and completed questionnaires in two sessions 48 hours apart. During the second session, the students performed the examination. The questionnaires used were the State-Trait Anxiety Inventory, the Positive and Negative Affect Scale, and the Brief-Coping Orientation to Problems Experienced Inventory. DHEA, cortisol, anxiety and negative affect showed an anticipatory rise before the examination (all ps < 0.001). This rise of DHEA and cortisol was associated with lower positive affect (p = 0.001 and p = 0.043, respectively). However, only the DHEA anticipatory levels were linked to poorer examination marks (p = 0.020). Higher levels of the DHEA/cortisol ratio in anticipation of the examination were related to lower scores on the support-seeking strategy (p = 0.022). There was no association between DHEA and cortisol levels and anxiety, negative affect, active and avoidant coping strategies, or academic record. These results suggest that how DHEA and cortisol respond in anticipation of examination stress significantly impacts students' emotional well-being during examination periods and how they cope with stress. They also suggest that levels of DHEA in anticipation of an academic stressor have detrimental effects on stress management.
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Affiliation(s)
- Sara Garces-Arilla
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Magdalena Mendez-Lopez
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Camino Fidalgo
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, University of Valencia, Valencia, Spain
- Spanish National Network for Research in Mental Health CIBERSAM, Madrid, Spain
| | - Vanesa Hidalgo
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, IIS Aragón, Teruel, Spain
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, University of Valencia, Valencia, Spain
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4
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Torbaghan ME, Moghimi A, Kobravi HR, Fereidoni M, Bigdeli I. Effect of stress on spatial working memory and EEG signal dynamics in the follicular and luteal phases of the menstrual cycle in young single girls. Brain Behav 2023; 13:e3166. [PMID: 37488720 PMCID: PMC10498068 DOI: 10.1002/brb3.3166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/26/2023] Open
Abstract
AIM Women undergo behavioral changes during the menstrual cycle. This study aimed to investigate the effect of estradiol (Es) on stress and effect of stress on spatial working memory (WM) and also to investigate electroencephalogram (EEG) signal's dynamics in the early and late follicular (EF and LF) and luteal (LU) phases of unmarried girls' menstrual cycle. METHODS Stress was induced by presentation of a short (3 min) movie clip. Simultaneous with a memory test and stress induction, EEG, serum Es levels, and galvanic skin response (GSR) were assessed. RESULTS Serum Es concentrations were decreased in LF, LU, and EF phases. The mean GSR score decreased after stress induction in all three phases, but it increased in the LF and LU phases versus the EF phase. Spatial WM diminished after stress induction in all three phases, but it increased in the LF phase versus the two phases before and after stress induction. Average power spectrum density in all frequency bands increased after stress induction in the frontal and prefrontal channels in the spatial WM test. CONCLUSION The results showed that stress led to spatial WM dysfunction; however, Es improved spatial WM performance in the LF phase versus the other two phases.
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Affiliation(s)
| | - Ali Moghimi
- Rayan Research Center for Neuroscience & Behavior, Department of Biology, Faculty of ScienceFerdowsi University of MashhadMashhadIran
| | - Hamid Reza Kobravi
- Research Center of Biomedical Engineering, Mashhad BranchIslamic Azad UniversityMashhadIran
| | - Masoud Fereidoni
- Rayan Research Center for Neuroscience & Behavior, Department of Biology, Faculty of ScienceFerdowsi University of MashhadMashhadIran
| | - Imanollah Bigdeli
- Department of Psychology, Faculty of Educational Sciences and PsychologyFerdowsi University of MashhadMashhadIran
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5
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Jeppesen E, Backer V, Jespersen KV, Borresen SW, Vuust P, Wallentin M. Sex, anxiety and the interplay with physiological variables of stress: a clinical study of patients about to undergo bronchoscopy. PSYCHOL HEALTH MED 2023; 28:2548-2561. [PMID: 36951640 DOI: 10.1080/13548506.2023.2193418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 03/01/2023] [Indexed: 03/24/2023]
Abstract
Women often report more anxiety than men, but there are divergent results regarding the putative correlation between physiological variables, such as cortisol, blood pressure and heart rate and the experienced emotional states. The aim of the present study was to evaluate sex differences in anxiety, and the relation to serum cortisol, blood pressure and heart rate. We used data from two pooled studies with participants from the same population (N = 405) facing a real-life stressor, bronchoscopy, as part of examination for lung cancer. At admission, blood pressure and heart rate were recorded, and a blood sample was taken for analysis of serum cortisol. Participants then completed Spielberger's State Trait Anxiety Inventory (STAI). Patients had elevated anxiety measured with STAI state compared to relevant age and sex stratified norm scores. Women had significantly higher STAI state score than men (M = 44.9, SD = 13.2 vs M = 36.2, SD = 10.7; t(403) = 7.25, p < 0.001). Mean serum cortisol, systolic blood pressure and heart rate showed no significant sex difference. There was a weak but significant correlation between state anxiety and heart rate and cortisol but none between blood pressure and anxiety. This study adds an important confirmation of sex differences in anxiety in a real-life setting, where women report significantly more anxiety than men do. However, the physiological markers only show a weak link with experienced anxiety, and exhibit no sex differences.
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Affiliation(s)
- Elisabeth Jeppesen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Vibeke Backer
- Centre for Physical Activity Research, CFAS, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of ENT, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kira Vibe Jespersen
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stina Willemoes Borresen
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Royal Academy of Music, Aarhus, Denmark
| | - Mikkel Wallentin
- Department of Linguistics, Cognitive Science and Semiotics, Aarhus University, Aarhus, Denmark
- Centre of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
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6
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Geva N, Golan S, Pinchas L, Defrin R. Sex effects in the interaction of acute stress and pain perception. Pain 2023; 164:587-597. [PMID: 35947086 DOI: 10.1097/j.pain.0000000000002743] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT A reciprocity between the stress and the pain system is recognized; however, the manner by which sex affects this reciprocity is unclear. Understanding the interactions of stress, pain, and sex may shed light on the apparent women's vulnerability to chronic pain, which often coexists with increased distress, and to affective disorders, which often coexist with chronic pain. The study's aim was to examine the effect of acute, validated, psychosocial stress on pain perception and modulation of women and men in a controlled manner. Participants were 82 women and 66 men. Heat-pain threshold, heat-pain tolerance, and pain modulation by temporal summation of pain (TSP), and pain adaptation were measured before and after exposure to the Montreal Imaging Stress Task (MIST) or to a sham task. The stress response was verified by perceived ratings of stress and anxiety, autonomic variables, and salivary cortisol. A significant stress response was obtained by the MIST among both sexes; however, women displayed a greater increase in perceived distress, and men displayed a greater increase in cortisol. Among women, TSP decreased and pain adaptation increased following the MIST, responses that were predicted by perceived distress levels. Among men, TSP increased following the MIST but was not predicted by the stress variables. In conclusion, acute stress manipulation seems to differentially affect both stress and pain responses of women and men: women exhibited stress-induced antinociception and men exhibited stress-induced pronociception. Higher perceived stress levels among women may trigger a temporary increase in pain inhibition mechanisms to serve evolutionary purposes.
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Affiliation(s)
- Nirit Geva
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sari Golan
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Pinchas
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Defrin
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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7
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Performance during Presentations:A Question of Challenge and Threat Responses? CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2023. [DOI: 10.1016/j.cedpsych.2023.102168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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8
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Vorster-De Wet R, Gerber AM, Raubenheimer JE. Effect of receiving mobile text messages on cortisol concentrations in students at the University of the Free State. Health SA 2023; 28:2064. [PMID: 36873777 PMCID: PMC9982505 DOI: 10.4102/hsag.v28i0.2064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background Texting has become central to social life, with adverse effects on physiological functioning. Research into the impact of texting on cortisol secretion is limited. Aim Thus study aimed to determine how receiving mobile text messages affected salivary cortisol concentrations and investigate the moderating effects of stress, anxiety and depression on cortisol secretion. Setting Undergraduate physiology students attending physiology lectures at the Faculty of Health Sciences, University of the Free State, 2016. Methods An experimental, crossover, quantitative design was used. Participants were involved over two consecutive days, receiving mobile text messages (intervention) on one day and acting as their own control on the other. Self-reported data on stress, anxiety, depression and subjective experience of the study, and saliva samples were collected. Text frequency and wording (neutral, positive, negative) were varied among participants. Results Forty-eight students participated in the study. Salivary cortisol concentrations did not differ significantly between the intervention and control days. High anxiety levels were associated with increased cortisol concentrations. No associations with cortisol concentrations were documented in low to moderate anxiety, stress, depression or how participants experienced the intervention. There were no significant differences between text frequency, text emotion and change in cortisol concentrations on the intervention day. Conclusion Receiving mobile text messages did not elicit a significant cortisol response in participants. Contribution Findings added to the body of knowledge about the effect of texting on student learning by measuring salivary cortisol concentrations in a lecture setting, with investigation into the moderating effects of stress, anxiety, depression and participants' subjective experience.
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Affiliation(s)
- Roné Vorster-De Wet
- Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Anthonie M Gerber
- Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Jacques E Raubenheimer
- Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.,Department of Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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9
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Man ISC, Shao R, Hou WK, Xin Li S, Liu FY, Lee M, Wing YK, Yau SY, Lee TMC. Multi-systemic evaluation of biological and emotional responses to the Trier Social Stress Test: A meta-analysis and systematic review. Front Neuroendocrinol 2023; 68:101050. [PMID: 36410619 DOI: 10.1016/j.yfrne.2022.101050] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/28/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
Humans experience multiple biological and emotional changes under acute stress. Adopting a multi-systemic approach, we summarized 61 studies on healthy people's endocrinological, physiological, immunological and emotional responses to the Trier Social Stress Test. We found salivary cortisol and negative mood states were the most sensitive markers to acute stress and recovery. Biomarkers such as heart rate and salivary alpha-amylase also showed sensitivity to acute stress, but the numbers of studies were small. Other endocrinological (e.g., dehydroepiandrosterone), inflammatory (C-Reactive Protein, Interleukin-6) and physiological (e.g., skin conductance level) measures received modest support as acute stress markers. Salivary cortisol showed some associations with mood measures (e.g., state anxiety) during acute stress and recovery, and heart rate showed preliminary positive relationship with calmness ratings during response to TSST, but the overall evidence was mixed. While further research is needed, these findings provide updated and comprehensive knowledge on the integrated psychobiological response profiles to TSST.
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Affiliation(s)
- Idy S C Man
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Robin Shao
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China; Department of Affective Disorders, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - W K Hou
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China; Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, China
| | - Shirley Xin Li
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Fiona Yan Liu
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Maggy Lee
- Department of Sociology, The University of Hong Kong, Hong Kong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Suk-Yu Yau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; Mental Health Research Center, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Tatia M C Lee
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China.
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10
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Journault AA, Plante I, Charbonneau S, Sauvageau C, Longpré C, Giguère CÉ, Labonté C, Roger K, Cernik R, Chaffee KE, Dumont L, Labelle R, Lupien SJ. Using latent profile analysis to uncover the combined role of anxiety sensitivity and test anxiety in students' state anxiety. Front Psychol 2022; 13:1035494. [PMID: 36619097 PMCID: PMC9811949 DOI: 10.3389/fpsyg.2022.1035494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies report a growing tendency for students to experience state anxiety in schools. However, the combination of individual susceptibilities likely to trigger students' anxious states remains unclear. Aims This study examined whether distinct profiles of students emerge regarding their susceptibility to anxiety sensitivity and/or test anxiety and evaluated whether students' profile predicted anxious states. We also verified whether susceptibility profiles varied across gender, school level, and school type. Sample and methods In total, 1,404 Canadian students in Grades 5 and 10 (589 boys; M age = 15.2, SD = 2.1) from 13 public and private schools completed self-reported measures of state/trait anxiety, anxiety sensitivity, and test anxiety. Results Latent profile analyses identified four susceptibility profiles: (1) Double-susceptibility: highest anxiety sensitivity and test anxiety scores; (2) Unique-susceptibility to test anxiety: high test anxiety score and low anxiety sensitivity score; (3) Unique-susceptibility to anxiety sensitivity: high anxiety sensitivity score and low test anxiety score; and (4) No-susceptibility: lowest anxiety sensitivity and test anxiety scores. The profiles comprised 12, 9, 6, and 73% of the sample, respectively, and their membership varied across gender and school type, but not across school levels. A linear mixed-effect model showed that state anxiety varied significantly between profiles, where the Double-susceptibility profile predicted the highest state anxiety scores, followed by the two Unique-susceptibility profiles (indifferently), and the No-susceptibility profile. Conclusion Beyond their theoretical contribution to the state-trait anxiety literature, these findings suggest that selective interventions designed more specifically for students with the Double-susceptibility profile may be worthwhile. Results also highlight the high proportion of students with the No-susceptibility profile and shed light on the reassuring portrait regarding students' anxiety.
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Affiliation(s)
- Audrey-Ann Journault
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada,*Correspondence: Audrey-Ann Journault,
| | - Isabelle Plante
- Department of Didactics, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sandrine Charbonneau
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Claudia Sauvageau
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Charlotte Longpré
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | | | | | | | - Rebecca Cernik
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Laurence Dumont
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Réal Labelle
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sonia J. Lupien
- Centre for Studies on Human Stress, Montréal, QC, Canada,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada,Department of Psychology, Université de Montréal, Montréal, QC, Canada,Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
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11
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Wofford N, Ceballos N, Elkins G, Westerberg CE. A brief nap during an acute stressor improves negative affect. J Sleep Res 2022; 31:e13701. [PMID: 35851731 PMCID: PMC9786543 DOI: 10.1111/jsr.13701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/30/2022]
Abstract
Overnight sleep can reduce perceived stress, and improve associated cognitive disruptions and negative affect after an acute stressor. Whether a brief nap can also bestow these benefits in a non-sleep-restricted population is currently unknown. In this study that used a between-subjects design, stress was triggered by administering a modified Trier Social Stress Test to two groups of participants (nap [n = 29], wake [n = 41]). All participants were instructed they would give a speech during the study but the topic would be withheld until later, and then completed a math task. After a 40-min break in which participants watched a neutral video or took a nap monitored with electroencephalography, stress was reinforced by presenting the speech topics and giving participants a 10-min preparation period. Next, instead of giving a speech, the study ended and participants were debriefed. Negative affect, perceived stress and working memory were measured at multiple time points before and after the break. Both groups showed lower perceived stress and improved working memory after the break than before, but a nap did not confer additional benefits for perceived stress or working memory beyond taking a break. However, the nap group exhibited lower negative affect after the break than the wake group, and only the nap group showed a reduction in negative affect compared with initial negative affect levels. These results indicate a nap can improve negative emotions accompanying a stressor to a greater extent than taking a break, and suggest that brief naps may be a useful way to improve mood while experiencing an acute stressor.
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Affiliation(s)
- Nathan Wofford
- Department of PsychologyTexas State UniversitySan MarcosTexasUSA,Department of Psychology and NeuroscienceBaylor UniversityWacoTexasUSA
| | - Natalie Ceballos
- Department of PsychologyTexas State UniversitySan MarcosTexasUSA
| | - Gary Elkins
- Department of Psychology and NeuroscienceBaylor UniversityWacoTexasUSA
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12
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Huber A, Klug SJ, Abraham A, Westenberg E, Schmidt V, Winkler AS. Animal-Assisted Interventions Improve Mental, But Not Cognitive or Physiological Health Outcomes of Higher Education Students: a Systematic Review and Meta-analysis. Int J Ment Health Addict 2022; 22:1-32. [PMID: 36406903 PMCID: PMC9666958 DOI: 10.1007/s11469-022-00945-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Due to the high burden of mental health issues among students at higher education institutions world-wide, animal-assisted interventions (AAIs) are being used to relieve student stress. The objective of this study was to systematically review of the effects of AAIs on the mental, physiological, and cognitive outcomes of higher education students. Randomized controlled trials using any unfamiliar animal as the sole intervention tool were included in this review. Study quality was assessed using the Cochrane Risk-of-Bias tool. Where possible, effect sizes (Hedges' g) were pooled for individual outcomes using random-effects meta-analyses. Albatross plots were used to supplement the data synthesis. Of 2.494 identified studies, 35 were included. Almost all studies used dogs as the intervention animal. The quality of most included studies was rated as moderate. Studies showed an overall reduction of acute anxiety and stress. For other mental outcomes, studies showed smaller, but nonetheless beneficial effects. Studies showed no clear effect on physiological or cognitive outcomes. Strong methodological heterogeneity between studies limited the ability to draw clear conclusions. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-022-00945-4.
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Affiliation(s)
- Annalena Huber
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefanie J. Klug
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Annette Abraham
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erica Westenberg
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Veronika Schmidt
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Andrea S. Winkler
- Department of Neurology, Center for Global Health, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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13
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Tronson NC, Schuh KM. Hormonal contraceptives, stress, and the brain: The critical need for animal models. Front Neuroendocrinol 2022; 67:101035. [PMID: 36075276 DOI: 10.1016/j.yfrne.2022.101035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 01/10/2023]
Abstract
Hormonal contraceptives are among the most important health and economic developments in the 20thCentury, providing unprecedented reproductive control and a range of health benefits including decreased premenstrual symptoms and protections against various cancers. Hormonal contraceptives modulate neural function and stress responsivity. These changes are usually innocuous or even beneficial, including their effects onmood. However, in approximately 4-10% of users, or up to 30 million people at any given time, hormonal contraceptives trigger depression or anxiety symptoms. How hormonal contraceptives contribute to these responses and who is at risk for adverse outcomes remain unknown. In this paper, we discussstudies of hormonal contraceptive use in humans and describe the ways in which laboratory animal models of contraceptive hormone exposure will be an essential tool for expanding findings to understand the precise mechanisms by which hormonal contraceptives influence the brain, stress responses, and depression risk.
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Affiliation(s)
- Natalie C Tronson
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Kristen M Schuh
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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14
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An ecological approach for investigations of the anticipatory cortisol stress response. Biol Psychol 2022; 175:108428. [DOI: 10.1016/j.biopsycho.2022.108428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 11/17/2022]
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15
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Tammayan M, Jantaratnotai N, Pachimsawat P. Differential responses of salivary cortisol, amylase, and chromogranin A to academic stress. PLoS One 2021; 16:e0256172. [PMID: 34383867 PMCID: PMC8360508 DOI: 10.1371/journal.pone.0256172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/30/2021] [Indexed: 12/20/2022] Open
Abstract
Salivary biomarkers have been widely used to help diagnose stress, anxiety, and/or depression. This study aimed to compare the responses of three commonly investigated salivary stress biomarkers that represent the hypothalamic-pituitary-adrenal activity (cortisol; sCort) and the sympathetic activity (alpha-amylase; sAA and chromogranin A; sCgA), using academic oral presentation as a model of stress. Twenty postgraduate dental students attended the seminar class as presenter and audience. The presenters' performances were evaluated by the instructors suggesting more stress than the audience. The saliva was collected two times: before attending class and after an academic presentation (for presenters) or during the class (for audience). The pulse rates (PR) were also recorded. The results showed that the levels of all three biomarkers, as well as PR, were significantly higher in the presenter group compared with the audience group; however, the changes were most prominent with sCort and sAA (99.56 ± 12.76% for sCort, 93.48 ± 41.29% for sAA, 16.86 ± 6.42% for sCgA, and 15.06 ± 3.41% for PR). When compared between pre-post presentation, the levels of sCgA were not different, while those of sCort and sAA were significantly increased. These results suggest more sensitive reactivity to academic stress of sCort and sAA compared with sCgA and that the response of sCgA did not necessarily follow sAA pattern even though both are claimed to reflect the sympathetic activity. More studies are needed to elucidate the roles of sCgA in stress.
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Affiliation(s)
- Manita Tammayan
- Faculty of Dentistry, Department of Advanced General Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Praewpat Pachimsawat
- Faculty of Dentistry, Department of Advanced General Dentistry, Mahidol University, Bangkok, Thailand
- * E-mail:
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16
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Henze GI, Konzok J, Kreuzpointner L, Bärtl C, Giglberger M, Peter H, Streit F, Kudielka BM, Kirsch P, Wüst S. Sex-Specific Interaction Between Cortisol and Striato-Limbic Responses to Psychosocial Stress. Soc Cogn Affect Neurosci 2021; 16:972-984. [PMID: 33961049 PMCID: PMC8421693 DOI: 10.1093/scan/nsab062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/15/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Although women and men differ in psychological and endocrine stress responses as well as in the prevalence rates of stress-related disorders, knowledge on sex differences regarding stress regulation in the brain is scarce. Therefore, we performed an in-depth analysis of data from 67 healthy participants (31 women, taking oral contraceptives), who were exposed to the ScanSTRESS paradigm in a functional magnetic resonance imaging study. Changes in cortisol, affect, heart rate and neural activation in response to psychosocial stress were examined in women and men as well as potential sex-specific interactions between stress response domains. Stress exposure led to significant cortisol increases, with men exhibiting higher levels than women. Depending on sex, cortisol elevations were differently associated with stress-related responses in striato-limbic structures: higher increases were associated with activations in men but with deactivations in women. Regarding affect or heart rate responses, no sex differences emerged. Although women and men differ in their overall stress reactivity, our findings do not support the idea of distinct neural networks as the base of this difference. Instead, we found differential stress reactions for women and men in identical structures. We propose considering quantitative predictors such as sex-specific cortisol increases when exploring neural response differences of women and men.
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Affiliation(s)
| | - Julian Konzok
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | | | - Christoph Bärtl
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Marina Giglberger
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Hannah Peter
- Institute of Psychology, University of Regensburg, Regensburg, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Stefan Wüst
- Institute of Psychology, University of Regensburg, Regensburg, Germany
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17
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Wheelock MD, Goodman AM, Harnett NG, Wood KH, Mrug S, Granger DA, Knight DC. Sex-related Differences in Stress Reactivity and Cingulum White Matter. Neuroscience 2021; 459:118-128. [PMID: 33588003 PMCID: PMC7965343 DOI: 10.1016/j.neuroscience.2021.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 01/24/2023]
Abstract
The prefrontal cortex and limbic system are important components of the neural circuit that underlies stress and anxiety. These brain regions are connected by white matter tracts that support neural communication including the cingulum, uncinate fasciculus, and the fornix/stria-terminalis. Determining the relationship between stress reactivity and these white matter tracts may provide new insight into factors that underlie stress susceptibility and resilience. Therefore, the present study investigated sex differences in the relationship between stress reactivity and generalized fractional anisotropy (GFA) of the white matter tracts that link the prefrontal cortex and limbic system. Diffusion weighted images were collected and deterministic tractography was completed in 104 young adults (55 men, 49 women; mean age = 18.87 SEM = 0.08). Participants also completed self-report questionnaires (e.g., Trait Anxiety) and donated saliva (later assayed for cortisol) before, during, and after the Trier Social Stress Test. Results revealed that stress reactivity (area under the curve increase in cortisol) and GFA of the cingulum bundle varied by sex. Specifically, men demonstrated greater cortisol reactivity and greater GFA within the cingulum than women. Further, an interaction between sex, stress reactivity, and cingulum GFA was observed in which men demonstrated a positive relationship while women demonstrated a negative relationship between GFA and cortisol reactivity. Finally, trait anxiety was positively associated with the GFA of the fornix/stria terminalis - the white matter pathways that connect the hippocampus/amygdala to the hypothalamus. These findings advance our understanding of factors that underlie individual differences in stress reactivity.
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Affiliation(s)
- M D Wheelock
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA
| | - A M Goodman
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA
| | - N G Harnett
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA
| | - K H Wood
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA
| | - S Mrug
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA
| | - D A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA 92697, USA; Johns Hopkins University School of Nursing, Johns Hopkins University Bloomberg School of Public Health, and Johns Hopkins University School of Medicine, 525 N Wolfe St, Baltimore, MD 21205, USA
| | - D C Knight
- Department of Psychology, University of Alabama at Birmingham, 1720 2nd Ave S, Birmingham, AL 35294, USA.
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18
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Høgsted ES, Borgsted C, Dam VH, Nasser A, Rye Jørgensen N, Ozenne B, Stenbæk DS, Frokjaer VG. Stress-Hormone Dynamics and Working Memory in Healthy Women Who Use Oral Contraceptives Versus Non-Users. Front Endocrinol (Lausanne) 2021; 12:731994. [PMID: 34819917 PMCID: PMC8606688 DOI: 10.3389/fendo.2021.731994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women who use oral contraceptives (OCs) may have a higher risk of developing a depression, which is associated with both vulnerability to stress and cognitive dysfunction. OCs disrupt the hypothalamic-pituitary-gonadal (HPG) axis by suppressing endogenous sex steroid production including estradiol. The HPG axis and the hypothalamic-pituitary-adrenal (HPA) axis are known to interact, possibly through modulations driven by estradiol. OCs may affect HPA regulation capacity, i.e., disturb cortisol dynamics such as the cortisol awakening response (CAR), and influence cognition such as working memory (WM). We hypothesize that OC use is associated with blunted cortisol dynamics and impaired WM performance relative to non-users. METHODS Data from 78 healthy women in the reproductive age were available from the CIMBI database. We evaluated if CAR and WM differed between OC users (n=25) and non-users (n=53) and if the level of estradiol modulated the OC use effect on CAR or WM in generalized least square models. RESULTS We found that OC users had a blunted CAR (p= 0.006) corresponding to a 61% reduction relative to non-users; however, no estradiol-BY-OC use interaction effect was observed on CAR. Also, OC users had higher cortisol levels at awakening compared to non-users (p = 0.03). We observed no effect of OC use or an estradiol-BY-OC use interaction effect on WM. Also, within the OC user group, neither CAR nor WM was associated with suppressed estradiol. CAR was not associated with WM. CONCLUSION Healthy women who use OCs have blunted cortisol dynamics relative to non-users. However, we could not detect OC use effects on working memory in our sample size. We speculate that disrupted cortisol dynamics may be important for the emergence of depressive symptoms in OC users.
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Affiliation(s)
- Emma Sofie Høgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Camilla Borgsted
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke H. Dam
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Arafat Nasser
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry Centre of Diagnostic Investigations, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
| | - Brice Ozenne
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibe G. Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Vibe G. Frokjaer,
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19
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Cardozo LT, Azevedo MARD, Carvalho MSM, Costa R, de Lima PO, Marcondes FK. Effect of an active learning methodology combined with formative assessments on performance, test anxiety, and stress of university students. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:744-751. [PMID: 33205996 DOI: 10.1152/advan.00075.2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to evaluate the effect of an active methodology combined with a lecture on undergraduate student learning and levels of stress and anxiety. The active learning methodology consisted of a lecture of 50-min duration, study at home with a textbook, an educational game activity, and three formative assessments on the topic of the cardiac cycle. In a following class, the students provided saliva samples to evaluate their levels of stress, received an anxiety test, and then undertook an exam to assess their understanding of the cardiac cycle. The traditional teaching methodology consisted of two lectures (∼2-h duration) on blood pressure control systems, delivered orally. In the third class, the students provided saliva samples, received an anxiety test, and then undertook an exam to assess their understanding of blood pressure control systems. The level of stress was assessed with the concentrations of the stress biomarkers cortisol and alpha-amylase in saliva. Anxiety was assessed with the State-Trait Anxiety Inventory (STAI) questionnaire. The students achieved significantly higher average scores in exams when the active learning strategy was applied compared with the use of traditional theoretical classes. The active methodology resulted in significantly lower levels of stress and anxiety, as well as improved student performance, compared with the use of traditional lectures.
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Affiliation(s)
- Lais Tono Cardozo
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | | | - Rafaela Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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20
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Vera J, Redondo B, Álvarez-Rodríguez M, Molina R, Jiménez R. The intraocular pressure responses to oral academic examination: The influence of perceived levels of public speaking anxiety. APPLIED ERGONOMICS 2020; 88:103158. [PMID: 32678777 DOI: 10.1016/j.apergo.2020.103158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
We examined the intraocular pressure responsiveness to oral examination stress, as well as the mediating role of the perceived levels of public speaking anxiety on intraocular pressure changes. Thirty-two university students (intervention group) publicly defended their degree final project, and intraocular pressure and perceived levels of stress were measured before and after the oral presentation, and after 10 min of recovery. The control group (n = 32) was not exposed to any stressful situation, and the dependent measures were taken at the same time points. All participants completed the public speaking anxiety scale. The intervention group exhibited higher intraocular pressure values before the oral presentation (corrected p-values<0.001), with these changes being positively associated with the perceived levels of public speaking anxiety (p < 0.001, r = 0.71). Our results reveal a mediating role of public speaking anxiety on the intraocular pressure responsiveness to oral examination stress, and highlight the utility of intraocular pressure as an indicator of stress in applied situations.
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Affiliation(s)
- Jesús Vera
- Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Beatriz Redondo
- Department of Optics, Faculty of Sciences, University of Granada, Spain.
| | | | - Rubén Molina
- Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Raimundo Jiménez
- Department of Optics, Faculty of Sciences, University of Granada, Spain
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21
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Pearman A, Neupert SD, Hughes ML. State Anxiety Is Related to Cortisol Response During Cognitive Testing for Older Adults. Gerontol Geriatr Med 2020; 6:2333721420914776. [PMID: 32284956 PMCID: PMC7139176 DOI: 10.1177/2333721420914776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/03/2020] [Accepted: 02/27/2020] [Indexed: 01/09/2023] Open
Abstract
Cognitive testing situations can be stressful for both younger and older adults,
but threats of cognitive evaluation may be particularly salient among anxious
older individuals as they tend to be more concerned than younger adults about
their cognitive abilities and age-related cognitive decline. We examined
age-related differences in the effect of anxiety on cortisol responses during
cognitive testing in a sample of 27 younger (M = 19.8) and 29
older (M = 71.2) adults. Older adults with higher anxiety also
had higher during-task cortisol (suggesting higher reactivity to testing) than
older adults with lower anxiety and young adults. There was no effect of anxiety
on cortisol for younger adults. Simultaneously examining subjective (state
anxiety) and physiological (cortisol response) indicators of threat during
cognitive testing appears to be especially important for older adults with
higher state anxiety. The results are important for understanding cortisol
reactivity, particularly in older adults. Researchers who administer cognitive
tests to older adults and clinicians who work with older adults with cognitive
concerns and/or anxiety may want to consider how they present their
material.
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Affiliation(s)
- Ann Pearman
- Georgia Institute of Technology, Atlanta, USA
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22
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Wimmer S, Lackner HK, Papousek I, Paechter M. Influences Of Different Dimensions Of Academic Self-Concept On Students' Cardiac Recovery After Giving A Stressful Presentation. Psychol Res Behav Manag 2019; 12:1031-1040. [PMID: 31807097 PMCID: PMC6844235 DOI: 10.2147/prbm.s219784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/16/2019] [Indexed: 02/02/2023] Open
Abstract
Purpose Giving a presentation in a seminar is a strenuous academic situation. To meet such a challenge adequately, individuals not only have to activate their mental and physical resources, but they also have to disengage from the task and recover once the challenge has been met. How students experience these situations depends in part on how they recover from the stress, and this has putative impact on their longer-term academic well-being. Methods In a sample of 68 university students, the present study investigated the impact of four dimensions of students’ academic self-concept on how efficiently students recovered after a challenging presentation in a university seminar. Recovery was assessed using psychophysiological measures; heart rate and heart rate variability were investigated. Higher levels of students’ social self-concept (self-concept depending on social comparison) were linked to poorer recovery from the challenge, whereas higher levels of absolute self-concept (independent of external criteria) were associated with more efficient recovery. Results The findings suggest that a focus on one’s own abilities (ie, internal performance standard) is linked to more adaptive patterns of responses to challenging situations, while the focus on social comparisons seems to hamper adaptive coping with academic stress. Conclusion These findings have consequences not only for learning and instruction but also for students’ health and well-being.
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Affiliation(s)
- Sigrid Wimmer
- Educational Psychology Unit, Department of Psychology, University of Graz, Graz 8010, Austria
| | - Helmut K Lackner
- Otto Loewi Research Center, Division of Physiology, Medical University of Graz, Graz 8010, Austria
| | - Ilona Papousek
- Biological Psychology Unit, Department of Psychology, University of Graz, Graz 8010, Austria
| | - Manuela Paechter
- Educational Psychology Unit, Department of Psychology, University of Graz, Graz 8010, Austria
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23
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Abstract
Laboratory experiments revealed the stress hormone cortisol to decrease memory retrieval of emotional material, but a translation to real-life settings is missing so far. In this study, 51 students encoded a list of neutral, positive, and negative words as well as two neutral, biographical notes one day before attendance at a seminar at the university. In the stress condition, students gave a graded oral presentation, whereas they just attended the same seminar in the control condition immediately before retrieval took place. Measures of state anxiety, salivary cortisol and alpha-amylase confirmed the oral presentation to constitute a potent stressor. Importantly, stress significantly impaired retrieval of negative words, but not retrieval of the biographical notes. These results indicate that a real-life stressor decreases memory retrieval for negative items. In contrast, delayed memory retrieval of neutral information and interrelated details of biographical notes seems to be less prone to stress effects. These results have critical implications for educational settings.
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24
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Marchette RCN, Bicca MA, Santos ECDS, de Lima TCM. Distinctive stress sensitivity and anxiety-like behavior in female mice: Strain differences matter. Neurobiol Stress 2018; 9:55-63. [PMID: 30450373 PMCID: PMC6234269 DOI: 10.1016/j.ynstr.2018.08.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 12/21/2022] Open
Abstract
Epidemiologic studies have shown that the prevalence of stress-related mood disorders is higher in women, which suggests a different response of neuroendocrine circuits involved in the response to stressful events, as well as a genetic background influence. The aim of this study was to investigate the baseline differences in anxiety-like behaviors of females of two commonly used mice strains. Secondly, we have also aimed to study their behavioral and biochemical alterations following stress. Naïve 3-4 months-old Swiss and C57BL/6 female mice were evaluated in the elevated plus maze (EPM) and in the acoustic startle response (ASR) for anxiety-like behaviors. Besides, an independent group of animals from each strain was exposed to cold-restraint stress (30 min/4 °C, daily) for 21 consecutive days and then evaluated in EPM and in the sucrose consumption tests. Twenty-four hours following behavioral experimentation mice were decapitated and their hippocampi (HP) and cortex (CT) dissected for further Western blotting analysis of glucocorticoid receptor (GR) and glial fibrillary acid protein (GFAP). Subsequent to each behavioral protocol, animal blood samples were collected for further plasma corticosterone analysis. C57BL/6 presented a lower anxiety profile than Swiss female mice in both behavioral tests, EPM and ASR. These phenomena could be correlated with the fact that both strains have distinct corticosterone levels and GR expression in the HP at the baseline level. Moreover, C57BL/6 female mice were more vulnerable to the stress protocol, which was able to induce an anhedonic state characterized by lower preference for a sucrose solution. Behavioral anhedonic-like alterations in these animals coincide with reduced plasma corticosterone accompanied with increased GR and GFAP levels, both in the HP. Our data suggest that in C57BL/6 female mice a dysregulation of the hypothalamus-pituitary-adrenal axis (HPA-axis) occurs, in which corticosterone acting on GRs would possibly exert its pro-inflammatory role, ultimately leading to astrocyte activation in response to stress.
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Affiliation(s)
| | | | | | - Thereza Christina Monteiro de Lima
- Department of Pharmacology, Center of Biological Sciences, Universidade Federal de Santa Catarina, 88049-970, Florianópolis, Santa Catarina, Brazil
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25
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Jiménez R, Vera J. Effect of examination stress on intraocular pressure in university students. APPLIED ERGONOMICS 2018; 67:252-258. [PMID: 29122197 DOI: 10.1016/j.apergo.2017.10.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/22/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
Intraocular pressure (IOP) has been investigated as a possible objective index of mental stressors. Here, we assessed the effect of examination stress on IOP in 33 university students. A repeated-measures design was used with two experimental conditions (examination and control) and two points of measurements (pre- and post-sessions). Also, the cardiovascular response, subjective perceived stress, as well as calculated ocular perfusion pressure and blood-pulse pressure were determined. A Bayesian statistical analysis showed higher IOP values in the examination in comparison to the control condition (BF01 < 0.001). A similar pattern was found for the cardiovascular indices (diastolic and systolic blood pressure, and heart rate), and these findings were corroborated by subjective reports (BF01 < 0.001 in all cases). Our data incorporates evidence in relation to the utility of IOP as an objective marker of examination stress, and it may help in the assessment and management of stress in applied scenarios.
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Affiliation(s)
| | - Jesús Vera
- Department of Optics, University of Granada, Spain.
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26
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Contribution of stress and sex hormones to memory encoding. Psychoneuroendocrinology 2017; 82:51-58. [PMID: 28501551 DOI: 10.1016/j.psyneuen.2017.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/03/2017] [Accepted: 05/01/2017] [Indexed: 01/31/2023]
Abstract
Distinct stages of the menstrual cycle and the intake of oral contraceptives (OC) affect sex hormone levels, stress responses, and memory processes critically involved in the pathogenesis of mental disorders. To characterize the interaction of sex and stress hormones on memory encoding, 30 men, 30 women in the early follicular phase of the menstrual cycle (FO), 30 women in the luteal phase (LU), and 30 OC women were exposed to either a stress (socially evaluated cold-pressor test) or a control condition prior to memory encoding and immediate recall of neutral, positive, and negative words. On the next day, delayed free and cued recall was tested. Sex hormone levels verified distinct estradiol, progesterone, and testosterone levels between groups. Stress increased blood pressure, cortisol concentrations, and ratings of stress appraisal in all four groups as well as cued recall performance of negative words in men. Stress exposure in OC women led to a blunted cortisol response and rather enhanced cued recall of neutral words. Thus, pre-encoding stress facilitated emotional cued recall performance in men only, but not women with different sex hormone statuses pointing to the pivotal role of circulating sex hormones in modulation of learning and memory processes.
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27
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Helbig S, Backhaus J. "Sex differences in a real academic stressor, cognitive appraisal and the cortisol response". Physiol Behav 2017; 179:67-74. [PMID: 28546084 DOI: 10.1016/j.physbeh.2017.05.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/19/2017] [Accepted: 05/19/2017] [Indexed: 11/26/2022]
Abstract
Women and men differ in their physiological and psychological stress response but only a few studies have analyzed this sex difference in a naturalistic setting and focused on cognitive stress appraisal. In the present study, the salivary cortisol concentration of 24 female and 22 male subjects was measured before and several times after an oral academic presentation given by themselves (stress condition) or given by a fellow student (control condition). Feelings of subjective stress and nervousness were assessed simultaneously to the saliva samples and a questionnaire for cognitive stress appraisal was conducted right before the oral presentation. In the stress condition, the presentation led to a significantly higher cortisol increase than in the control condition. Sex differences were shown concerning the subjective stress feelings, which were higher in women, whereas there were no sex differences in cortisol release. Women showed a disadvantageous cognitive appraisal compared to men in both conditions. There was an interaction effect of sex and condition: women reported to feel equally challenged in both conditions whereas men felt significantly more challenged by their own presentation than by the presentations of their fellow students. The result that men's cognitive appraisal was more influenced by an academic stressor than women's and that women felt subjectively more stressed whereas there was no difference concerning the cortisol response is discussed in consideration of evolutional and biological aspects.
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Affiliation(s)
- Susanne Helbig
- Department of Clinical Psychology and Psychotherapy, University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
| | - Jutta Backhaus
- Department of Clinical Psychology and Psychotherapy, University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
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28
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Peters EMJ, Müller Y, Snaga W, Fliege H, Reißhauer A, Schmidt-Rose T, Max H, Schweiger D, Rose M, Kruse J. Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLoS One 2017; 12:e0175904. [PMID: 28423056 PMCID: PMC5397031 DOI: 10.1371/journal.pone.0175904] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 04/02/2017] [Indexed: 12/25/2022] Open
Abstract
Mouse models show that experimental stress mimicking prolonged life-stress exposure enhances neurogenic inflammation, induces adaptive immunity cytokine-imbalance characterized by a shift to Type 1 T-helper cell cytokines and increases apoptosis of epithelial cells. This affects hair growth in otherwise healthy animals. In this study, we investigate whether a prolonged naturalistic life-stress exposure affects cytokine balance and hair parameters in healthy humans. 33 (18 exam, 15 comparison) female medical students with comparable sociobiological status were analyzed during a stressful final examination period, at three points in time (T) 12 weeks apart. T1 was before start of the learning period, T2 between the three-day written exam and an oral examination, and T3 after a 12 week rest and recovery from the stress of the examination period. Assessments included: self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ], Trier Inventory for the Assessment of Chronic Stress [TICS]), COPE), cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs), and trichogram (hair cycle and pigmentation analysis). Comparison between students participating in the final medical exam at T2 and non-exam students, revealed significantly higher stress perception in exam students. Time-wise comparison revealed that stress level, TH1/TH2 cytokine balance and hair parameters changed significantly from T1 to T2 in the exam group, but not the control. However, no group differences were found for cytokine balance or hair parameters at T2. The study concludes that in humans, naturalistic stress, as perceived during participation in a major medical exam, has the potential to shift the immune response to TH1 and transiently hamper hair growth, but these changes stay within a physiological range. Findings are instructive for patients suffering from hair loss in times of high stress. Replication in larger and more diverse sample populations is required, to assess suitability of trichogram analysis as biological outcome for stress studies.
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Affiliation(s)
- Eva M. J. Peters
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
- * E-mail:
| | - Yvonne Müller
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
| | - Wenke Snaga
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Herbert Fliege
- Foreign Office, Health Service, Psychosocial Counseling, Auswärtiges Amt, Berlin, Germany
| | - Anett Reißhauer
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for Physical Medicine and Rehabilitation, Berlin, Germany
| | | | | | | | - Matthias Rose
- Universitätsmedizin Charité, Center 12 for Internal Medicine and Dermatology, Division for General Internal Medicine, Psychosomatics and Psychotherapy: Psycho-Neuro-Immunology Skin Research Group, Berlin, Germany
| | - Johannes Kruse
- Justus-Liebig-University, Department of Psychosomatics and Psychotherapy, Psychoneuroimmunology Laboratory, Gießen, Germany
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García-Sesnich JN, Flores MG, Ríos MH, Aravena JG. Longitudinal and Immediate Effect of Kundalini Yoga on Salivary Levels of Cortisol and Activity of Alpha-Amylase and Its Effect on Perceived Stress. Int J Yoga 2017; 10:73-80. [PMID: 28546677 PMCID: PMC5433116 DOI: 10.4103/ijoy.ijoy_45_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Context: Stress is defined as an alteration of an organism's balance in response to a demand perceived from the environment. Diverse methods exist to evaluate physiological response. A noninvasive method is salivary measurement of cortisol and alpha-amylase. A growing body of evidence suggests that the regular practice of Yoga would be an effective treatment for stress. Aims: To determine the Kundalini Yoga (KY) effect, immediate and after 3 months of regular practice, on the perception of psychological stress and the salivary levels of cortisol and alpha-amylase activity. Settings and Design: To determine the psychological perceived stress, levels of cortisol and alpha-amylase activity in saliva, and compare between the participants to KY classes performed for 3 months and a group that does not practice any type of yoga. Subjects and Methods: The total sample consisted of 26 people between 18 and 45-year-old; 13 taking part in KY classes given at the Faculty of Dentistry, University of Chile and 13 controls. Salivary samples were collected, enzyme-linked immunosorbent assay was performed to quantify cortisol and kinetic reaction test was made to determine alpha-amylase activity. Perceived Stress Scale was applied at the beginning and at the end of the intervention. Statistical Analysis Used: Statistical analysis was applied using Stata v11.1 software. Shapiro–Wilk test was used to determine data distribution. The paired analysis was fulfilled by t-test or Wilcoxon signed-rank test. T-test or Mann–Whitney's test was applied to compare longitudinal data. A statistical significance was considered when P < 0.05. Results: KY practice had an immediate effect on salivary cortisol. The activity of alpha-amylase did not show significant changes. A significant decrease of perceived stress in the study group was found. Conclusions: KY practice shows an immediate effect on salivary cortisol levels and on perceived stress after 3 months of practice.
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Affiliation(s)
| | - Mauricio Garrido Flores
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | | | - Jorge Gamonal Aravena
- Laboratory of Periodontal Biology, Faculty of Dentistry, University of Chile, Santiago, Chile
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30
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Merz CJ, Wolf OT. Sex differences in stress effects on emotional learning. J Neurosci Res 2016; 95:93-105. [DOI: 10.1002/jnr.23811] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/24/2016] [Accepted: 06/10/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Christian J. Merz
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology; Ruhr-University Bochum; Bochum Germany
| | - Oliver T. Wolf
- Institute of Cognitive Neuroscience, Department of Cognitive Psychology; Ruhr-University Bochum; Bochum Germany
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