Normative salivary cortisol values and responsivity in children

Abstract

This is a descriptive study reporting normative salivary cortisol values and responsivity to a hospital clinic visit and IV procedure in children. The study presented is a sub-project of a primary research study that examined parents coaching their children in the use of distraction for children requiring an IV placement. One measure of child response in the primary study, salivary cortisol, was included to further our understanding of children's physiologic response to stressful, painful stimuli. Salivary cortisol samples were obtained on 384 children, 4-10 years of age, on arrival to the clinic and 20 minutes after the IV insertion. Baseline samples were collected at home on a typical day for the child. Data from baseline samples were used to establish normative values between the hours of 8:00 am and 3:00 pm on a non-procedural day. Results demonstrated normative cortisol levels in children follow a pattern similar to the circadian pattern in adults, decreasing from early morning to midafternoon. Matched samples from control group children were used to evaluate group responsivity. Salivary cortisol levels on the baseline day were lower than levels obtained during the day of the procedure and tapered over time as expected (−8.7% + 6.7%; p=0.43). Cortisol levels on the clinic day were increased from baseline and increased further in response to IV placement (15.7% +6.7%; p=0.023). A location by time interaction was significant (p= 0.019). Findings demonstrate salivary cortisol is a useful measure of stress response that can be used to evaluate intervention effectiveness.

Acute effects of energy drinks in medical students

“…Cortisol is widely used as a stress marker, and its utility in this capacity was proven previously [50,51]. The levels of this hormone in saliva correlate with its respective plasma levels, and it is an excellent indicator of the secretion pattern of this hormone [52]. Caffeine had no effect on salivary cortisol levels in some studies [53,54], but it increased the levels in other study [55].…”

Comparison of Behavioral Intervention and Sensory-Integration Therapy in the Treatment of Challenging Behavior

“…It can be noted that the salivary cortisol measures observed in the present study are relatively low when compared with normative resting data for children in the general population. Up to the age of 11, mean cortisol levels in children appear to range from 0.12 to 0.30 lg/dl across the day (McCarthy et al 2009). The levels observed in the present study are more typical of levels ordinarily seen at one standard deviations below the mean for baseline measures taken at home on a typical day (0.06-0.15 lg/dl), which, if indicative of persistent reactivity to ambient stress, would approximate the 84th percentile of the population.…”

Effects of five parent-and-child risk factors on salivary cortisol levels and symptoms of posttraumatic stress disorder in school-age, critically ill children: Pilot study

“…42 Salivary cortisol levels are considered reasonable to measure in children, because evaluations of salivary cortisol are noninvasive, and HPA axis activity changes are reflected in saliva levels. 43 h e a r t & l u n g 4 0 ( 2 0 1 1 ) 2 3 6 e2 4 6…”