Hair steroid before and after COVID-19 in preschoolers: the moderation of family characteristics.

BACKGROUND: Frequent or prolonged exposure to stressors may jeopardize young children's health. The onset of the COVID-19 pandemic, coupled with disruptions in daily routines and social isolation resulting from public health preventive measures, have raised concerns about its potential impact on children' experienced stress, particularly for young children and vulnerable families. However, whether the pandemic was accompanied by changes in physiological stress remains unknown as perceived stress is not a good proxy of physiological stress. This study examined if preschoolers showed increasing hair steroid concentrations following the onset of the COVID-19 pandemic and whether family characteristics may have exacerbated or buffered these changes. METHODS: 136 preschoolers (2-4 years) provided hair for steroid measurement (cortisol, dehydroepiandrosterone (DHEA), cortisone, cortisol-to-DHEA ratio, cortisol-to-cortisone ratio) in October-November 2019 (T0) and in July-August 2020 (T1). A 2-centimeter hair segment was analyzed, reflecting steroid production over the two months leading up to collection. Family income, conflict resolution and lack of cohesion, as well as parents' COVID-19 stress were reported by parents. Linear mixed models for repeated measures and Bayes factors were used. RESULTS: No significant changes were noted from before to after the onset of the COVID-19 pandemic for most hair steroids. However, a moderating role of family conflict resolution was noted. Children living with parents with a better ability to resolve conflicts had lower levels of DHEA compared to those who had more difficulty managing conflicts. Additionally, lower levels of family cohesion and income were linked to some steroids, especially DHEA, suggesting that these factors may relate to children's physiological stress. Finally, boys had higher DHEA levels than girls. CONCLUSION: Our findings suggest that stress biomarkers were comparable from before to during the COVID-19 pandemic. This observation holds true despite the pandemic being perceived by many as a novel, unpredictable, and potentially threatening event. Findings further suggest that family characteristics are associated with hair steroid, especially DHEA, which deserves further investigation.

Hair cortisol stability after 5-year storage: Insights from a sample of 17-year-old adolescents.

Background: Hair has become an increasingly valuable medium to investigate the association between chronic stress, stable differences in systemic cortisol secretion and later health. Assessing cortisol in hair has many advantages, notably its non-invasive and retrospective nature, the need for a single biospecimen and convenient storage until analysis. However, few studies offered empirical evidence documenting the long-term temporal stability of hair cortisol concentration (HCC) prior to analysis, especially in humans. Yet, knowing how long hair samples can be stored without compromising the accuracy of cortisol measurement is of crucial importance when planning data collection and analysis. This study examined the stability of HCC in hair samples assayed twice, five years apart. Methods: We randomly selected from a larger distribution of HCC measured in 17-year-old participants 39 hair samples to be reanalyzed five years later, under the same general conditions. Samples were assayed in duplicate using a luminescence immunoassay and compared with the original HCC using the Lin's concordance correlation coefficient (CCC), Bland-Altman plot analysis and Wilcoxon rank test. Results: Findings indicated a good concordance and temporal stability between the two samples assayed five years apart (CCC [95% confidence interval] = 0.84 [0.72-0.91]), although a small decrease in HCC was noted 5 years later (8.4% reduction, p = 0.001). Conclusion: Our study confirms that hair samples, when stored at room temperature and away from sunlight, can be assayed for at least five years without risking a loss of precision in HCC measurement.

Toxoplasma gondii infection in people with schizophrenia is related to higher hair glucocorticoid levels.

Introduction: Toxoplasma gondii (TG) is a common protozoan parasite infecting approximately one third of the human population. Animal studies have shown that this parasite can manipulate its host behavior. Based on this, human studies have assessed if TG can be involved in mental health disorders associated with important behavioral modifications such as schizophrenia. However, results have been discrepant. Given that TG has a strong impact on fear and risk-taking processes in animal studies and that fear and risk-taking behaviors are associated with the human stress response, we tested whether glucocorticoid biomarkers (salivary and hair) differ in people with schizophrenia and controls as a function of TG status. Methods: We measured TG antibodies in blood samples, as well as salivary and hair glucocorticoid levels in 226 people with schizophrenia (19.9% women, mean age = 39 years old) and 129 healthy individuals (controls) (45.7% women, mean age = 41 years old). Results: The results showed that people with schizophrenia infected with TG presented significantly higher hair glucocorticoid concentrations than non-infected people with schizophrenia. This effect was not found in control participants. No effect was observed for salivary glucocorticoid levels. Additionally, there were no associations between TG infection and positive psychotic symptoms nor impulsivity. Discussion: These results show that people with schizophrenia present high levels of hair glucocorticoid levels only when they are infected with TG. Further studies performed in populations suffering from other mental health disorders are needed to determine if this effect is specific to schizophrenia, or whether it is generalized across mental health disorders.

The Signature Biobank: A longitudinal biopsychosocial repository of psychiatric emergency patients.

The Signature Biobank is a longitudinal repository of biospecimen, psychological, sociodemographic, and diagnostic data that was created in 2012. The Signature Consortium represents a group of approximately one hundred Quebec-based transdisciplinary clinicians and research scientists with various expertise in the field of psychiatry. The objective of the Signature Biobank is to investigate the multi-faceted underpinnings of psychiatric disorders among patients in crisis. The Signature Consortium is expanding and includes new active members that seek to highlight the contributions made by Signature Biobank since its inception. This article details our research protocol, directions, and summarizes contributions. To date, we have collected biological samples (n = 1,986), and questionnaire data (n = 2,085) from psychiatric emergency patients of the Institut universitaire en santé mentale de Montréal (Quebec, Canada), with a large proportion from whom both data types were collected (n = 1,926). In addition to this, a subsample of patients was followed-up at hospital discharge, and two additional outpatient clinic appointments (n = 958 with at least one follow-up). In addition, a socio-demographically matched comparison group of individuals who were not hospitalized for psychiatric disorders (n = 149) was recruited from the surrounding catchment area. To summarize, a systematic review of the literature shows that the Signature Biobank has contributed to better characterizing psychiatric comorbidities, biological profiles, and psychosocial functioning across some of the most common psychiatric disorders, including psychosis, mood, anxiety, and substance use disorders. The Signature Biobank is now one of the world's largest repositories of data collected from patients receiving care at a psychiatric emergency unit.

Concurrent and prospective associations between family socioeconomic status, social support and salivary diurnal and hair cortisol in adolescence.

BACKGROUND: Exposure to socioeconomic adversity is hypothesized to impact hypothalamic-pituitary-adrenal (HPA) axis activity and cortisol secretion, but existing evidence is inconsistent. Yet, few studies have investigated this association using a developmental approach that considers potential protective contextual factors. This study examined the role of stability and changes in family socioeconomic status (SES) in the prediction of multiple cortisol indicators and tested whether social support moderated these associations. METHODS: Participants were part of a population-based sample of twin pairs recruited at birth. Family SES was assessed in early childhood (ages 0-5) and mid-adolescence (age 14). Social support was assessed at ages 14 and 19. Diurnal cortisol (n = 569) was measured at age 14 at awakening, 30 min later, in the afternoon and evening over four non-consecutive days. Hair cortisol concentration (HCC, n = 704) was measured at age 19. All data were collected before the pandemic and multilevel regression models were conducted to account for the nested data structure. RESULTS: Youth exposed to lower family SES levels in childhood and mid-adolescence had a flatter diurnal slope and higher HCC compared with those who experienced upward socioeconomic mobility in mid-adolescence. Contrastingly, mid-adolescence SES showed no association with the diurnal slope or HCC for youth from higher-SES households in early childhood. Moreover, youth raised in higher-SES families in early childhood had a higher CAR in mid-adolescence if they reported greater social support in mid-adolescence. Social support also moderated the SES-cortisol association in mid-adolescence, with higher-SES youth showing higher awakening cortisol secretion when reporting more social support. CONCLUSIONS: Our findings support the hypothesis that early socioeconomic adversity sensitizes HPA axis activity to later socioeconomic disadvantage, which may bear consequences for socioemotional and behavioral functioning.

Learning to embrace one's stress: the selective effects of short videos on youth's stress mindsets.

BACKGROUND AND OBJECTIVES: Stress is not inherently negative. As youth will inevitably experience stress when facing the various challenges of adolescence, they can benefit from developing a stress-can-be-enhancing mindset rather than learning to fear their stress responses and avoid taking on challenges. We aimed to verify whether a rapid intervention improved stress mindsets and diminished perceived stress and anxiety sensitivity in adolescents. DESIGN AND METHODS: An online experimental design randomly exposed 233 Canadian youths aged 14-17 (83% female) to four videos of the Stress N' Go intervention (how to embrace stress) or to control condition videos (brain facts). Validated questionnaires assessing stress mindsets, perceived stress, and anxiety sensitivity were administered pre- and post-intervention, followed by open-ended questions. RESULTS: The intervention content successfully instilled a stress-can-be-enhancing mindset compared to the control condition. Although Bayes factor analyses showed no main differences in perceived stress or anxiety sensitivity between conditions, a thematic analysis revealed that the intervention helped participants to live better with their stress. CONCLUSIONS: Overall, these results suggest that our intervention can rapidly modify stress mindsets in youth. Future studies are needed to determine whether modifying stress mindsets is sufficient to alter anxiety sensitivity in certain adolescents and contexts.

When asking 'are you stressed?' is not enough: Hair cortisol, subjective stress, and alcohol use during the first year of the pandemic.

The onset of the COVID-19 pandemic was accompanied by an increase in alcohol use in a third of the population worldwide. To date, the literature shows that subjective reports of stress predicted increased alcohol use during the early stages of the pandemic. However, no studies have investigated the effect of physiological stress (via the stress hormone cortisol) on alcohol use during the pandemic. This study aimed to identify the predictive value of cortisol and/or subjective stress on alcohol use during the first year of the pandemic. Every three months, between June 2020 and March 2021, 79 healthy adults (19-54 years old) answered online questionnaires assessing alcohol use. In May 2020, participants reported pre-pandemic alcohol use, while in June 2020, participants reported current alcohol use, subjective stress measures, and provided a 6 cm hair sample. The latter allowed us to quantify the cumulative levels of cortisol produced in the three months prior to and following the start of the mandatory lockdown measures in March 2020 in Quebec, Canada. A relative change in hair cortisol was computed to quantify the physiological stress response. While controlling for sex, age, and psychiatric diagnoses, multilevel linear regressions revealed that alcohol use increased only among people with concomitant high subjective stress and elevated hair cortisol concentrations. Moreover, this increased alcohol use remained elevated one year later. This study documents the importance of simultaneously considering stress biomarkers and subjective stress to identify people at risk of increasing their alcohol use during major stressful life events.

Stress, anxiety, emotion regulation and social support in parent-child dyads prior to and during the onset of the COVID-19 pandemic.

In March 2020, and in order to assess the impact of the COVID-19 pandemic on stress and mental health in parent-child dyads using pre-pandemic measures, we recontacted participants from a 2019 study. A total of 136 dyads of Canadian parents (77% mothers, mean age = 44.48 years/old) and children (63% girls, 77% aged 10-12 years/old and 23% aged 15-17 years/old) completed self-report measures of perceived stress, anxiety (state/sensitivity) and emotion regulation strategies (cognitive reappraisal/expressive suppression). Children additionally completed measures of co-rumination and perceived social support from friends, parents, and teachers. Results revealed a significant increase in parents' stress and state anxiety during the pandemic compared to before, but not in their children. Dyads' anxiety sensitivity remained unchanged, as well as parents' use of cognitive reappraisal and expressive suppression. Children showed similar use of cognitive reappraisal, but less expressive suppression and co-rumination during the pandemic compared to before. Children reported similar perceived social support from all sources over time. Finally, parental and children scores were not significantly correlated at either time. These results suggest that during the onset of the COVID-19 pandemic, parents and children responded differently in terms of stress, anxiety, and emotion regulation strategies.

The phenotypic associations and gene-environment underpinnings of socioeconomic status and diurnal cortisol secretion in adolescence.

While converging evidence suggests that both environmental and genetic factors underlie variations in diurnal cortisol, the extent to which these sources of influence vary according to socioeconomic status (SES) has seldom been investigated, particularly in adolescence. To investigate whether a distinct genetic and environmental contribution to youth's diurnal cortisol secretion emerges according to family SES and whether the timing of these experiences matters. Participants were 592 twin pairs, who mostly came from middle-income and intact families and for whom SES was measured in childhood and adolescence. Diurnal cortisol was assessed at age 14 at awakening, 30 min later, in the afternoon and evening over four nonconsecutive days. SES-cortisol phenotypic associations were specific to the adolescence period. Specifically, higher awakening cortisol levels were detected in wealthier backgrounds, whereas higher cortisol awakening response (CAR) and diurnal changes were present at both ends of the SES continuum. Moreover, smaller genetic contributions emerged for awakening cortisol in youth from poorer compared to wealthier backgrounds. The results suggest that the relative contribution of inherited factors to awakening cortisol secretion may be enhanced or suppressed depending on the socio-family context, which may help to decipher the mechanisms underlying later adjustment.

Evaluation and update of the expert consensus guidelines for the assessment of the cortisol awakening response (CAR).

The cortisol awakening response (CAR) is frequently assessed in psychobiological (stress) research. Obtaining reliable CAR data, however, requires careful attention to methodological detail. To promote best practice, expert consensus guidelines on the assessment of the CAR were published (Stalder et al., 2016, PNEC). However, it is unclear whether these highly cited guidelines have resulted in actual methodological improvements. To explore this, the PNEC editorial board invited the present authors to conduct a critical evaluation and update of current CAR methodology, which is reported here. (i) A quantitative evaluation of methodological quality of CAR research published in PNEC before and after the guidelines (2013-2015 vs. 2018-2020) was conducted. Disappointingly, results reveal little improvement in the implementation of central recommendations (especially objective time verification) in recent research. (ii) To enable an update of guidelines, evidence on recent developments in CAR assessment is reviewed, which mostly confirms the accuracy of the majority of the original guidelines. Moreover, recent technological advances, particularly regarding methods for the verification of awakening and sampling times, have emerged and may help to reduce costs in future research. (iii) To aid researchers and increase accessibility, an updated and streamlined version of the CAR consensus guidelines is presented. (iv) Finally, the response of the PNEC editorial board to the present results is described: potential authors of future CAR research to be published in PNEC will be required to submit a methodological checklist (based on the current guidelines) alongside their article. This will increase transparency and enable reviewers to readily assess the quality of the respective CAR data. Combined, it is hoped that these steps will assist researchers and reviewers in assuring higher quality CAR assessments in future research, thus yielding more reliable and reproducible results and helping to further advance this field of study.

Stress can lead to an increase in smartphone use in the context of texting while walking.

Texting while walking (TWW) is a dangerous behavior that can lead to injury and even death. While several studies have examined the relationship between smartphone use and stress, to our knowledge no studies have yet investigated the relationship between stress and TWW. The objective of the present study was to investigate this relationship by examining the effects of stress on TWW, the effects of TWW on subsequent stress, and the effect of stress on multitasking performance. A total of 80 participants completed two sequential tasks in a laboratory while they walked on a treadmill and responded to a biological motion stimulus imitating the movement of another pedestrian. In the unrestricted task, participants were given the choice to use their personal phones. In the controlled task, they carried a text conversation with a research assistant while they walked and responded to the stimulus. Stress was measured via questionnaire and saliva collection for measure of cortisol (a stress hormone) before and after each task. Results show that greater psychological stress and cortisol variations were associated with a greater number of phone uses during the unrestricted task. Greater phone use during the unrestricted task was associated with lower subsequent psychological stress in women and total time of phone use was correlated with subsequent cortisol levels. Stress measured before the controlled task had no effect on multitasking performance, but participants with moderate performance were those with the highest cortisol levels. Our results suggest that stress could be a precursor to TWW and that it could affect a pedestrian's ability to stay safe when using their smartphone.

Association between the timing of family socioeconomic deprivation and adolescence hair cortisol among adolescent twins: A study of the genetic and environmental processes involved.

BACKGROUND: While evidence shows that lower socioeconomic status (SES) is related to dysregulated hair cortisol concentration (HCC), the genetic and environmental processes underlying this association remain understudied. OBJECTIVES: (1) to examine whether childhood and adolescence SES are phenotypically related to late adolescence HCC and to what extent these associations are explained by common underlying genetic factors (2) to estimate whether the genetic and environmental etiology of HCC varies according to SES and the timing of these experiences. METHODS: Participants were 422 twin pairs for whom SES was measured in childhood (ages 0-5 years) and adolescence (age 14 years). Hair cortisol was assessed at age 19. RESULTS: Additive genetic factors explained 39% of variability in HCC, whereas nonshared environmental factors accounted for the remaining 61%. A significant negative association emerged between HCC and family SES assessed in adolescence (ß=-.11,p = .02), which was entirely explained by common underlying environmental influences. We also found evidence of stronger genetic contributions to HCC among youths who lived in more disadvantaged households during childhood in comparison to those from wealthier backgrounds. CONCLUSIONS: This study provides first-time evidence that the association between adolescence SES and HCC is environmentally-explained and that genetic influences underlying HCC are not uniformly distributed across the family SES continuum measured during childhood. These findings may pave the way for a fuller understanding of the impact of early adversity on HPA axis activity.

The Cortisol Assessment List (CoAL) A tool to systematically document and evaluate cortisol assessment in blood, urine and saliva.

Background: The reliable assessment of cortisol is a necessary requirement to produce replicable research. Several recommendations to increase cortisol assessment reliability exist. However, cortisol assessment methodology is still rather heterogeneous. For this reason, the Cortisol Assessment List (CoAL) was created.The CoAL can be used to guide researchers during the planning phase and document which measures were taken to increase cortisol data reliability in original studies. Moreover, the CoAL can be used to evaluate data quality in meta research. The items representing strategies to obtain reliable cortisol data can be weighted to indicate which are absolutely necessary to consider and which could be applied less restrictively in order to balance data quality and feasibility. In this paper, the construction process of the CoAL is described. Methods: Item synthesis of the CoAL included a literature search to extract empirically based suggestions regarding the reliable assessment of cortisol. Estimates for the item weighting system were obtained by inviting experts in the field to participate in an online survey (n = 25). Inter-rater reliability (IRR) of the CoAL, was determined by letting independent raters use the CoAL to evaluate a set of randomly selected original studies (k = 90). Results: The CoAL was divided into four subscales related to the reporting of sampling procedures, the consideration of state covariates, trait covariates and exclusion criteria. Survey results indicated high agreement among experts for most items (89%) with approximately half of the items in the CoAL being classified as necessary (Cortisol Awakening Response (CAR): 52%; basal cortisol: 52%; reactive cortisol: 44%) in order to obtain reliable cortisol data. Inter-rater agreement was very high (Cohen's Kappa = .98 - 0.99), indicating sufficient psychometric quality of the CoAL. Discussion: The CoAL is the first tool to systematically plan, document and evaluate cortisol assessment. The survey results indicate that the majority of respondents are aware of essential requirements to increase data reliability. However, results were heterogeneous for some items, highlighting the need to start a process of developing a broad scientific consensus regarding reliable cortisol assessment. The implementation of the CoAL could be a first step in this direction. In conclusion, the CoAL reflects empirical evidence and expert knowledge regarding cortisol assessment and can be used as a flexible tool to plan and document empirical studies or evaluate cortisol data quality in meta research.

Open and reproducible science practices in psychoneuroendocrinology: Opportunities to foster scientific progress.

This perspective article was written by invitation of the editors in chief as a summary and extension of the symposium entitled Psychoneuroendocrine Research in the Era of the Replication Crisis which was held at the virtual meeting of the International Society of Psychoneuroendocrinology 2021. It highlights the opportunities presented by the application of open and reproducible scientific practices in psychoneuroendocrinology (PNE), an interdisciplinary field at the intersection of psychology, endocrinology, immunology, neurology, and psychiatry. It conveys an introduction to the topics preregistration, registered reports, quantifying the impact of equally-well justifiable analysis decisions, and open data and scripts, while emphasizing 'selfish' reasons to adopt such practices as individual researcher. Complementary to the call for adoption of open science practices, we highlight the need for methodological best practice guidelines in the field of PNE, which could further contribute to enhancing replicability of results. We propose concrete steps for future actions and provide links to additional resources for those interested in adopting open and reproducible science practices in future studies.

'Doctor, I am so stressed out!' A descriptive study of biological, psychological, and socioemotional markers of stress in individuals who self-identify as being 'very stressed out' or 'zen'.

Surveys report that about three-quarters of visits to general practitioners in America are for stress-related complaints. Animal and human studies have consistently demonstrated that exposure to acute and/or chronic stress leads to the activation of the autonomic nervous system (ANS) and/or hypothalamic-pituitary-adrenal (HPA) axis, and to the production of catecholamines and glucocorticoids. Yet, many studies performed in humans do not report significant associations between subjective feelings of stress and increases in these stress biomarkers. Consequently, it is not clear whether the stress-related complaints of individuals are associated with significant increases in these stress biomarkers. In the present study, we measured whether individuals who self-identify as being 'very stressed out' or 'zen' present differences in psychological (depression and anxiety symptoms), biological (basal and reactive levels of glucocorticoids and alpha-amylase) and socioemotional (emotion regulation, mind wandering, personality, resilience and positive mental health) factors associated with stress. Salivary levels of cortisol and alpha-amylase were obtained in the home environment and in reaction to the Trier Social Stress Test in 123 adults aged between 19 and 55 years. All participants completed questionnaires assessing the psychological and socioemotional factors described above. The results showed that groups significantly differed on almost all psychological and socioemotional factors, although we found no significant group differences on biological markers of stress (cortisol or alpha-amylase). These results suggest that when people complain of being 'very stressed out', what they may really be alluding to is an experience of psychological distress that is related to poor emotion regulation capacities. It is thus possible that the construct of stress used by people to discuss their internal state of 'stress' is quite different than the construct of stress measured in animal and human laboratories using biomarkers of 'stress'.

A Cross-Sectional Study Investigating Canadian and Australian Adolescents' Perceived Experiences of COVID-19: Gender Differences and Mental Health Implications.

The coronavirus (COVID-19) disease pandemic has been associated with adverse psychological outcomes. This cross-cultural study (N = 1326, 71% female) aimed to investigate Canadian and Australian adolescents' subjective experiences of COVID-19, gender differences, and psychological implications. Mixed-methods analyses were used to examine differences in COVID-19 experiences and mental health outcomes between country and gender in a Canadian (N = 913, 78% female) and an Australian sample (N = 413, 57% female) of adolescents. Canadian adolescents reported increased COVID-19 discussions and more concerns related to their COVID-19 experiences compared to Australian adolescents. Girls consistently reported more concerns related to COVID-19 and poorer psychological outcomes compared to boys. School lockdown for the Canadian sample may have played a role in these country differences. Further, girls might be at significantly more risk for mental health concerns during COVID-19, which should be considered in adolescent mental health initiatives during the pandemic. Although school disruption and separation of peers due to the pandemic likely have a role in adolescent perceived stressors and mental health, the differences between Canadian and Australian adolescents were less clear and future investigations comparing more objective pre-COVID-19 data to current data are needed.

Mental Health and Social Support of Sexual and Gender Diverse People from Québec, Canada During the COVID-19 Crisis.

Purpose: Sexual and gender minority (SGM) people are at increased risk for psychological distress compared with cisgender heterosexual people. Specific SGM subgroups include lesbian, gay, bisexual, gender diverse, and asexual people who each experience unique psychosocial challenges that can result in different mental health outcomes. The coronavirus disease 2019 (COVID-19) pandemic may have further exacerbated mental health disparities among these groups. The aim of this study was to compare lesbian, gay, bisexual, gender diverse, asexual, and cisgender heterosexual people's mental health and social support during the first 4 months of the COVID-19 crisis. Methods: This study used a cross-sectional online survey from March 26th, 2020 to July 7th, 2020 in Québec, Canada. A total of 2908 individuals (n = 304 SGM people, n = 2604 cisgender heterosexual people) completed questionnaires measuring perceived social support, perceived stress, symptoms of depression and anxiety, as well as loneliness. Results: SGM people presented worse health outcomes than cisgender heterosexual people on all questionnaires (p < 0.001). Post hoc analyses showed that particularly marginalized SGM subgroups, including bisexual and asexual people, reported the poorest mental health. Moderation analyses revealed that the buffering effect of social support on depressive symptoms was four times stronger among SGM people (ΔR2 = 0.041; p < 0.001) than among cisgender heterosexual people (ΔR2 = 0.010; p < 0.001). Conclusion: This study suggests that fostering social connectedness among SGM people may be especially beneficial in buffering against distress in the face of a crisis.

Transition from preschool to school: Children's pattern of change in morning cortisol concentrations.

Many studies show a general increase in stress hormones at the exposure to school entry, but inconsistencies among them due to small samples with varying methodologies and very few time-points, preclude robust conclusions. The current study aimed to describe the pattern of morning cortisol concentration in children across the transition from preschool to school by examining whether we could identify a response to the school entry, but also an anticipatory stress response (pre-entry) and a stress adaptation response (post-entry). We further tested the robustness of this pattern across several characteristics. Participants were 384 children recruited from two cohorts of the 3D pregnancy study, and followed across their transition from preschool to kindergarten. Children's morning salivary cortisol samples were collected over five time-points: twice before school entry, once at school entry and twice after school entry (one sample per time-point). Although no anticipatory stress response was observed two weeks before school entry, latent growth curve models showed that most children's morning cortisol concentrations increased during the first two weeks of school, and was not associated with any sociodemographic characteristics, supporting the hypothesis that school entry is a normative environmental stressor. In contrast, two months after school entry, some children showed stress adaptation whereas others showed a prolonged stress response to school entry. This between-children variance could not be explained by any specific sociodemographic characteristic. This study showed that the morning stress response rises at school entry and is sustained for at least two weeks in most children. However, the observed variability in the stress adaptation response remains to be elucidated and linked to functional correlates.

Anxiety in the Classroom: Only Girls' Anxiety Is Related to Same-Sex Peers' Anxiety.

Many teens report experiencing anxiety in school, which can negatively impact their well-being. Considering that adolescents tend to adopt the same behaviors as their classmates with whom they spend, on average, 923 h every year, the current exploratory study (1) assessed whether an association exists between a student's state anxiety score and his/her classmates' average trait anxiety scores and (2) examined whether this association differed between boys and girls, as well as between elementary school and high school students. During two consecutive school years, 1044 Canadian students (59% girls) from six elementary schools (aged 10−12) and seven high schools (aged 15−17) completed the State-Trait Anxiety Inventory for Children. Multilevel analyses revealed a same-sex peer effect of classmates' anxiety in girls only (ß = 0.40, p < 0.001). This effect was similar for elementary and high school girls (ß = 0.07, p = 0.27). Interestingly, no association was found for boys, same-sex peers (ß = 0.11, p = 0.25), or opposite-sex peers (ß = −0.01, p = 1.00). Our results suggest that factors related to sex may reinforce anxiety in school settings. Future studies should confirm these results and explore the mechanisms involved in this sex-specific difference.

The Association of Childhood Maltreatment, Sex, and Hair Cortisol Concentrations With Trajectories of Depressive and Anxious Symptoms Among Adult Psychiatric Inpatients.

OBJECTIVE: Depression and anxiety symptoms are commonly observed among clinical populations, especially among women and maltreated individuals. Few investigations have, however, assessed the existence of distinct symptoms trajectories among clinical populations and how these relate to childhood maltreatment, sex differences, and stress physiology indexed by hair cortisol concentrations (HCCs). The current study a) identified distinct depression and anxious trajectories in a sample of psychiatric inpatients followed up prospectively from their admission to a psychiatric emergency service, and b) examined whether HCC, childhood maltreatment, and sex independently and jointly predict these trajectories. METHODS: Adult inpatients (n = 402; 55% women) were recruited upon admission to psychiatric emergency service (T1) during which HCC (reflecting cortisol secretion for the last 3 months), childhood maltreatment, and depression and anxiety symptoms were assessed. Symptoms were reevaluated when patients were discharged from the hospital (T2), admitted to outpatient clinics (T3), and 12 months later or at the end of outpatient treatment (T4). RESULTS: Three trajectories were identified for depression and anxiety symptoms. Among men, higher HCC predicted higher odds of evincing chronic depressive symptoms compared with a low stable trajectory (odds ratio [OR] = 3.46, 95% confidence interval [CI] = 1.43-8.40). Greater childhood maltreatment among men predicted higher chances of exhibiting chronic anxious symptoms than the low stable (OR = 1.47, 95% CI = 1.07-2.02) and the high decreasing trajectories (OR = 0.70, 95% CI = 0.51-0.95). Opposite findings were noted for women. CONCLUSIONS: Childhood maltreatment and HCC should be further investigated as predictors of anxious and depressive trajectories, during which sex-specific associations ought to be considered.