Latent trait cortisol (LTC) levels: Reliability, validity, and stability

Doane, Leah D.; Chen, Frances R.; Sladek, Michael R.; Lenten, Scott A. Van; Granger, Douglas A.

doi:10.1016/j.psyneuen.2015.01.017

Cited by 66 publications

(86 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low reliability is highly likely for the studies included in this review, given the high prevalence of 1-day saliva collection protocols. Along with short-term reliability issues, the long-term stability of diurnal cortisol measures is also likely to impact on results, and there is a growing literature to suggest that this is low [17]. For example, Ross et al [121] analysed visit-to-visit cortisol stability for the diurnal cortisol profile in a population of 46 healthy adults, providing 3-day cortisol profile samples at 2.5 monthly visits over 8 months and found only low-modest intra-class correlation coefficients (ICC) for the cortisol awakening response (ICC 0.219), the diurnal slope (ICC 0.473) and the area under the curve (ICC 0.556), with even lower stability at the individual level.…”

Section: Discussionmentioning

confidence: 99%

“…This is likely to impact on a priori decisions about the primary measurement parameter of interest, on hypotheses about directions of change and on conclusions about efficacy, target engagement and mechanisms of action. As well as these challenges, there are concerns in the literature about the long-term stability of this biomarker over periods of greater than 1 month [17], as well as concerns about its reliability in the shorter term due to day-to-day state effects [18] and the effects of non-compliance [19]. Concerns have also been raised about the responsiveness of the biomarker and how different contexts and populations may impact on this [20].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review

Ryan

Booth

Mollart³

et al. 2016

ann. behav. med.

View full text Add to dashboard Cite

BackgroundDysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is associated with diverse adverse health outcomes, making it an important therapeutic target. Measurement of the diurnal rhythm of cortisol secretion provides a window into this system. At present, no guidelines exist for the optimal use of this biomarker within randomised controlled trials (RCTs).PurposeThe aim of this study is to describe the ways in which salivary diurnal cortisol has been measured within RCTs of health or behavioural interventions in adults.MethodsSix electronic databases (up to May 21, 2015) were systematically searched for RCTs which used salivary diurnal cortisol as an outcome measure to evaluate health or behavioural interventions in adults. A narrative synthesis was undertaken of the findings in relation to salivary cortisol methodology and outcomes.ResultsFrom 78 studies that fulfilled the inclusion criteria, 30 included healthy participants (38.5 %), 27 included patients with physical disease (34.6 %) and 21 included patients with psychiatric disease (26.9 %). Psychological therapies were most commonly evaluated (n = 33, 42.3 %). There was substantial heterogeneity across studies in relation to saliva collection protocols and reported cortisol parameters. Only 39 studies (50 %) calculated a rhythm parameter such as the diurnal slope or the cortisol awakening response (CAR). Patterns of change in cortisol parameters were inconsistent both within and across studies and there was low agreement with clinical findings.ConclusionsSalivary diurnal cortisol is measured inconsistently across RCTs, which is limiting the interpretation of findings within and across studies. This indicates a need for more validation work, along with consensus guidelines.Electronic supplementary materialThe online version of this article (doi:10.1007/s12160-015-9753-9) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review

Ryan

Booth

Mollart³

et al. 2016

ann. behav. med.

View full text Add to dashboard Cite

show abstract

“…Data for the current study was drawn from the second time point of a longitudinal study examining adjustment during the transition from high school into college (see Doane et al, 2015). Seventy-six older adolescents ( M age = 18.53, SD = .37; 24% male) were assessed during the fall of their first semester of college.…”

Section: Methodsmentioning

confidence: 99%

Examining multiple sleep behaviors and diurnal salivary cortisol and alpha-amylase: Within- and between-person associations

Lenten

Doane

2016

Psychoneuroendocrinology

Self Cite

View full text Add to dashboard Cite

Sleep has been linked to the daily patterns of stress-responsive physiological systems, specifically the hypothalamic–pituitary–adrenal (HPA) axis and autonomic nervous system (ANS). However, extant research examining sleep and diurnal patterns of cortisol, the primary end product of the HPA axis, has primarily focused on sleep duration with limited attention on other facets of sleep. For example, it is not clear how specific aspects of sleep (e.g., sleep quality, sleep duration variability) are related to specific components of diurnal cortisol rhythms. Salivary alpha-amylase (sAA) has been recognized as a surrogate marker of ANS activity, but limited research has explored relations between sleep and sAA diurnal rhythms. The current study utilized an ecological momentary assessment protocol to examine within- and between-person relations between several facets of sleep behavior using multiple methods (e.g., subjective report, actigraphy) and salivary cortisol and sAA. Older adolescents (N = 76) provided saliva samples and diary entries five times per day over the course of three days. Sleep was assessed via questionnaire, through daily diaries, and monitored objectively using actigraphy over a four day period. Between-person results revealed that shorter average objective sleep duration and greater sleep duration variability were related to lower levels of waking cortisol and flatter diurnal slopes across the day. Within-person results revealed that on nights when individuals slept for shorter durations than usual they also had lower levels of waking cortisol the next day. Sleep was not related to the cortisol awakening response (CAR) or diurnal patterns of sAA, in either between-person or within-person analyses. However, typical sleep behaviors measured via questionnaire were related to waking levels of sAA. Overall, this study provides a greater understanding of how multiple components of sleep, measured in naturalistic environments, are related to cortisol and sAA diurnal rhythms, and how day-to-day, within-person changes in sleep duration contribute to daily variations in cortisol.

show abstract

“…Second, among the diurnal cortisol indicators studied in the literature (e.g., CAR, diurnal slope, and AUCg), AUCg is evidenced to be the most stable index, demonstrating the least day-to-day variability (followed by diurnal slope and CAR). 19–21 The stability of AUCg makes it a good candidate to represent individuals’ trait-like characteristics. Third, AUCg has been associated with the development of MDD.…”

mentioning

confidence: 99%

Diurnal Cortisol Interacts With Stressful Events to Prospectively Predict Depressive Symptoms in Adolescent Girls

Schuler

Ruggero

Goldstein

et al. 2017

Journal of Adolescent Health

View full text Add to dashboard Cite

Purpose The aim of present study was to test the diathesis-stress model of depression using baseline cortisol, prospective assessment of depression symptoms, and stressful life events. Methods The sample consisted of 527 adolescent girls aged 13.5 – 15.5 years without major depressive disorder (MDD). At baseline, saliva samples were collected at waking, 30 minutes after waking, and 8 pm on three consecutive days. Diurnal cortisol was indexed by cortisol awakening response (CAR) and area under the curve (AUCg). Stressful events during the preceding interval and current depressive symptoms were assessed 18-months following baseline. Results Stressful events and the interaction of CAR or AUCg with stressful events predicted depressive symptoms at 18-months, even after controlling for baseline depressive symptoms. Specifically, in the face of high levels of stress, baseline blunted CAR or smaller AUCg were associated with future depressive symptoms. This was more apparent for CAR than AUCg. The effect was reversed at low levels of stress, with heightened CAR associated with more severe depressive symptoms. Conclusions Blunted CAR and less daily cortisol output at baseline appear to accentuate the depressogenic effects of stressful events after 18 months, consistent with the diathesis stress model of HPA axis function in depression.

show abstract

Latent trait cortisol (LTC) levels: Reliability, validity, and stability

Cited by 66 publications

References 55 publications

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review

Use of Salivary Diurnal Cortisol as an Outcome Measure in Randomised Controlled Trials: a Systematic Review

Examining multiple sleep behaviors and diurnal salivary cortisol and alpha-amylase: Within- and between-person associations

Diurnal Cortisol Interacts With Stressful Events to Prospectively Predict Depressive Symptoms in Adolescent Girls

Contact Info

Product

Resources

About