Mind the gap between feeling bad and feeling dead: Stress but not death reminders elicit endocrine responses.

Stressors and mortality salience share considerable conceptual overlap. Thus, we examined the impact of a standard mortality salience and a standard stress manipulation on the activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis via endocrine measures of stress; a neutral control condition completed the design. The results revealed that stress elicits increased salivary α-amylase and salivary cortisol reactions; however, no endocrine reactions were found in the mortality salience and the control conditions. To the contrary, we did not find any differences regarding positive and negative affect between any conditions. Implications for social and health psychology are being discussed.

Salivary cortisol in ambulatory assessment--some dos, some don'ts, and some open questions.

The impact of stress on health and disease is an important research topic in psychosomatic medicine. Because research on hypothalamic-pituitary-adrenal (HPA) axis regulation under controlled laboratory studies lacks ecological validity, it needs to be complemented by a research program that includes momentary ambulatory assessment. The measurement of salivary cortisol offers the possibility to trace the free steroid hormone concentrations in ambulant settings. Therefore, in this article, we first discuss the role of salivary cortisol in ambulatory monitoring. We start with a brief description of HPA axis regulation, and we then consider cortisol assessments in other organic materials, followed by a presentation of common salivary markers of HPA axis regulation suitable for ambulatory assessment. We further provide an overview on assessment designs and sources of variability within and between subjects (intervening variables), acknowledge the issue of (non)compliance, and address statistical aspects. We further give an overview of associations with psychosocial and health-related variables relevant for ambulatory assessment. Finally, we deal with preanalytical aspects of laboratory salivary cortisol analysis. The relative simplicity of salivary cortisol assessment protocols may lead to an overoptimistic view of the robustness of this method. We thus discuss several important issues related to the collection and storage of saliva samples and present empirical data on the stability of salivary cortisol measurements over time.

Effects of nightmares on the cortisol awakening response: An ambulatory assessment pilot study.

Previous studies have reported an association between sleep-related factors such as sleep duration, sleep quality and time of awakening with the cortisol awakening response (CAR). Preliminary evidence suggests that frequent nightmares are associated with a blunted CAR. In the present pilot study we investigated the effect of acute nightmares on the CAR and the cortisol profile of the subsequent day using a within-subject ambulatory assessment study design. Thirty healthy volunteers who reported frequent nightmares enrolled in the study. Over a period of 14 days, salivary samples in addition to sleep-related and state variables were collected at home over the day. Salivary profiles of free cortisol and alpha amylase for up to two days following a nightmare were compared to those following a neutral dream. Overall, mood and health were decreased and the CAR was elevated following nightmares compared to neutral dreams. No differences were found for alpha amylase and for all variables over the remaining part of the day. Results suggest that sleep-related factors such as the occurrence of nightmares account for a certain amount of variance observed in the CAR. This has important methodological implications for CAR studies in general and might have even more relevance for studies in clinical populations suffering from chronic sleep disturbances.

Adhesion molecules and cytokine expression in fibromyalgia patients: increased L-selectin on monocytes and neutrophils.

Several lines of evidence implicate the immune system in the pathophysiology of fibromyalgia (FM). We investigated the role of cytokines and adhesion molecules involved in immune cell trafficking and the influence of 1.5 mg of dexamethasone (DEX) per os on their expression. L-selectin was elevated on monocytes and neutrophils of FM patients. Differences in group response to DEX were observed for CD11b on NK cells, sICAM-1 and IL-2. This study shows a slight disturbance in the innate immune system of FM patients, and suggests an enhanced adhesion and recruitment of leukocytes to inflammatory sites.

It's not that bad: error introduced by oral stimulants in salivary cortisol research.

Evidence that oral stimulants can produce interference effects in salivary cortisol assays has led to advice to avoid their use. However, in studies with young children, the use of these saliva-producing substances increases compliance with collection procedures. Four experiments are described to examine the effects of two commonly used stimulants, SweetTarts and Koolaid. Across these experiments, interference effects produced by different quantities of these stimulants (0.025, 0.1, and 0.2 g) and those produced in two commonly used assays, DELFIA and EIA, were explored. The impact of using cotton rolls soaked with an oral stimulant prior to saliva collection was also examined. In general, oral stimulants did not affect the rank ordering of cortisol values, as the results for stimulant-treated samples were highly correlated with those of untreated samples (approximately .90 for serially collected samples and .95 for aliquots of the same saliva pool). Depending on which assay was used, however, oral stimulants increased or decreased the cortisol levels reported, with effects sizes in the small to medium range. Thus, oral stimulants should not be used with only a portion of the subjects in a study, nor should researchers assay stimulant-treated samples from the same study using different assays. When used sparingly, oral stimulants can be employed without compromising the quality of salivary cortisol data.