Acute stress, memory, attention and cortisol

Vedhara, Kavita; Hyde, Julia; Gilchrist, Iain D.; Tytherleigh, Michelle Y.; Plummer, Sue

doi:10.1016/s0306-4530(00)00008-1

Cited by 254 publications

(173 citation statements)

References 34 publications

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“…Heart rate and cortisol were selected because they are able to reflect reliably changes over time during a given task and for a given task repeated over time (heart rate as a fast response measure and cortisol as a slow response measure -20-40 min -after a stimulation). In particular measures of cortisol levels were selected as it has been suggested that cortisol levels are a ''useful index of subjective stress'' [48], allow to ''assess relationship between perceived stress, activation and performance'' [49], and are related to ''cognitive performance'' [50].…”

Section: Discussionmentioning

confidence: 99%

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

Meunier

Merckaert

Libert

et al. 2013

Patient Education and Counseling

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Section: Discussionmentioning

confidence: 99%

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

Meunier

Merckaert

Libert

et al. 2013

Patient Education and Counseling

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“…In contrast, Buchanan and Lovallo (2001), examining the effect of exogenous cortisol administration on human memory, demonstrated enhancement of memory specifically associated with emotionally arousing information. Studies have also demonstrated an association between hypocortisolemia and enhanced short-term memory, although there was no correlation with verbal memory (Vedhara et al, 2000). The theory of a hormonal basis for cognitive dysfunction resulting from dehydration is further challenged by the results of several studies identifying a positive effect of cerebral DDAVP on memory (Beckwith et al, 1990).…”

Section: Hormonal Theoriesmentioning

confidence: 92%

“…Achieving euhydration, in such cases, is associated with normalizing of the serum cortisol levels (Francesconi et al, 1989). The results of the aforemen- (Vedhara et al, 2000). The deleterious effects of pharmacological steroids on cognitive function are well recognized.…”

Section: Hormonal Theoriesmentioning

confidence: 99%

Impaired cognitive function and mental performance in mild dehydration

2003

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Dehydration is a reliable predictor of impaired cognitive status. Objective data, using tests of cortical function, support the deterioration of mental performance in mildly dehydrated younger adults. Dehydration frequently results in delirium as a manifestation of cognitive dysfunction. Although, the occurrence of delirium suggests transient acute global cerebral dysfunction, cognitive impairment may not be completely reversible. Animal studies have identified neuronal mitochondrial damage and glutamate hypertransmission in dehydrated rats. Additional studies have identified an increase in cerebral nicotinamide adenine dinucleotide phosphate-diaphorase activity (nitric oxide synthase, NOS) with dehydration. Available evidence also implicates NOS as a neurotransmitter in long-term potentiation, rendering this a critical enzyme in facilitating learning and memory. With ageing, a reduction of NOS activity has been identified in the cortex and striatum of rats. The reduction of NOs synthase activity that occurs with ageing may blunt the rise that occurs with dehydration, and possibly interfere with memory processing and cognitive function. Dehydration has been shown to be a reliable predictor of increasing frailty, deteriorating mental performance and poor quality of life. Intervention models directed toward improving outcomes in dehydration must incorporate strategies to enhance prompt recognition of cognitive dysfunction.

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“…Stress may impede performance through impaired attentional processing, 16 longer reaction time, 17 impairment of memory retrieval 18,19 and less cooperative team behavior. 20 In other circumstances, however, stress has been shown to enhance short-term memory 21 and improve performance. 20 It is likely that the role of cognitive appraisal, the trainee's perception of the stressor and their available coping resources, determines the impact on performance.…”

Section: Discussionmentioning

confidence: 99%

High-fidelity simulator technology may not be superior to traditional low-fidelity equipment for neonatal resuscitation training

et al. 2011

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Objective: Despite completing accredited resuscitation training, neonatal trainees often feel unprepared to deal with real-life clinical emergencies. High-fidelity simulator (HFS) technology offers the potential of recreating a realistic stressful clinical environment to aid training and evaluation. To date, there are limited data examining the physiological impact of this training modality in comparison to less costly alternatives. The objective of this study was to compare the effects of low-fidelity simulator (LFS) versus HFS technology on performance levels, objective and subjective measures of stress in neonatal trainees.Study Design: Sixteen neonatal fellows were invited to participate in a prospective randomized study. Subjects were divided into pairs and randomized to LFS or HFS for completion of scenario I. After an interval of 1 month, fellow teams crossed over to complete scenario II using the alternative simulator technology. Technical and non-technical skills were assessed using validated resuscitation scoring tools. Participants recorded subjective stress at sequential time points before and after each simulation. Buccal cortisol was measured at each corresponding time point and comparison between HFS and LFS groups was made.Result: The mean overall resuscitation performance score was 75.8%±10, but there was no difference in performance between HFS and LFS groups. There was also no significant difference in non-technical skills performance between groups. Salivary cortisol increased over the duration of the simulated experience, but there were no differences between the two groups (P ¼ 0.001, two-way repeated measures analysis of variance). We also identified changes in subjective measures of stress (P<0.001, analysis of variance) over time, but again there were no differences between groups.Conclusion: Simulated neonatal resuscitations induce a significant stress response in neonatal trainees; however, we were unable to identify any difference in stress measures between HFS and LFS. These data suggest that HFS technology offers no additional stress-inducing benefit.

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Acute stress, memory, attention and cortisol

Cited by 254 publications

References 34 publications

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

The effect of communication skills training on residents’ physiological arousal in a breaking bad news simulated task

Impaired cognitive function and mental performance in mild dehydration

High-fidelity simulator technology may not be superior to traditional low-fidelity equipment for neonatal resuscitation training

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