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

Stalder, Tobias; Lupien, Sonia J.; Kudielka, Brigitte M.; Adam, Emma K.; Pruessner, Jens C.; Wüst, Stefan; Dockray, Samantha; Evans, Philip D.; Kirschbaum, Clemens; Miller, Robert; Wetherell, Mark; Finke, Johannes B.; Klucken, Tim; Clow, Angela

doi:10.1016/j.psyneuen.2022.105946

Cited by 41 publications

(12 citation statements)

References 53 publications

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“…There are several limitations to the current study. First, the present data do not fully conform to the consensus guidelines on the assessment of the CAR ( Stalder et al, 2022 ), which were published after the conception of our study. Most importantly, we did not employ objective measures for the verification of participants’ sampling times.…”

Section: Discussioncontrasting

confidence: 70%

Revisiting the stress recovery hypothesis: Differential associations of cortisol stress reactivity and recovery after acute psychosocial stress with markers of long-term stress and health

Degering

Linz

Puhlmann

et al. 2023

Brain, Behavior, & Immunity - Health

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Section: Discussioncontrasting

confidence: 70%

Revisiting the stress recovery hypothesis: Differential associations of cortisol stress reactivity and recovery after acute psychosocial stress with markers of long-term stress and health

Degering

Linz

Puhlmann

et al. 2023

Brain, Behavior, & Immunity - Health

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“…It is of note that non-adherence to saliva sampling in ambulatory settings has been shown to exert a significant impact on the resulting cortisol data (114,115) and that the present data does not fully conform to the recently provided consensus guidelines on the assessment of the CAR (116,117), which were published after the conception of our study. Most importantly, we did not employ objective measures for the verification of participants' sampling times.…”

Section: Discussionmentioning

confidence: 63%

“…Most importantly, we did not employ objective measures for the verification of participants' sampling times. Hence, diurnal cortisol data have to be treated with some caution since the possibility of nonadherence-related confounding cannot be excluded (104)(105)(106)(107). We nevertheless addressed the issue of non-adherence through an experience sampling approach based on mobile phones handed out to our participants.…”

Section: Discussionmentioning

confidence: 99%

Differential increase of hippocampal subfield volume after socio-affective mental training relates to reductions in diurnal cortisol

Valk

Engert

Puhlmann

et al. 2023

Preprint

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The hippocampus forms a central modulator of the HPA-axis, impacting the regulation of stress on brain structure, function, and behavior. The current study assessed whether three different types of 3-months mental training modules geared towards nurturing a) attention-based mindfulness, b) socio-affective skills, or c) socio-cognitive abilities may impact hippocampal integrity by reducing stress. We evaluated mental training-induced changes in hippocampal subfield volume and intrinsic functional connectivity, based on resting-state fMRI connectivity analysis in a group of healthy adults (N=332). We then related these changes to changes in diurnal and chronic cortisol levels. We observed increases in bilateral cornu ammonis volume (CA1-3) following the 3-months compassion-based module targeting socio-affective skills (Affect module), as compared to socio-cognitive skills (Perspective module) or a waitlist cohort that did not undergo an intervention. Structural changes were paralleled by increases in functional connectivity of CA1-3 when fostering socio-affective as compared to socio-cognitive skills. Moreover, training-related changes in CA1-3 structure and function consistently correlated with reduction in cortisol output. In sum, we provide a link between socio-emotional behavioral intervention, CA1-3 structure and function, and cortisol reductions in healthy adults.

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“…Third, noncompliance to the saliva collection protocol was verified through written records provided by the participants instead of relying on information drawnfrom electronic devices. Consequently, our CAR measurement does not fully adhere to current guidelines (Stalder et al, 2022). Nevertheless, based on the participants' reported sampling times, most complied with the b, standardized regression coefficient.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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

Cantave,

Brendgen,

Lupien

et al. 2023

Child Psychology Psychiatry

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BackgroundExposure 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.MethodsParticipants 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.ResultsYouth 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.ConclusionsOur 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.

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

Cited by 41 publications

References 53 publications

Revisiting the stress recovery hypothesis: Differential associations of cortisol stress reactivity and recovery after acute psychosocial stress with markers of long-term stress and health

Revisiting the stress recovery hypothesis: Differential associations of cortisol stress reactivity and recovery after acute psychosocial stress with markers of long-term stress and health

Differential increase of hippocampal subfield volume after socio-affective mental training relates to reductions in diurnal cortisol

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

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