The Stress of Caring—Resilience and HPA-Axis Activity in Hair Samples of Youth Residential Caregivers

Abstract

Background: Professional caregivers in youth residential care institutions experience frequent verbal and physical aggression as well as multiple stressors as part of their everyday work, leading to high levels of burnout and staff turnover. Resilience might buffer against psychophysiological stress response and therefore be crucial for well-being in professional caregivers.Objectives: We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-efficacy and self-care] and attachment security of caregivers were cross-sectionally associated with stress markers in hair samples [cortisol and dehydroepiandrosterone (DHEA)].Method: Participants (n = 134; 64.2% women) reported on individual resilience measures and provided hair samples for cortisol and DHEA assays. Attachment was assessed in a subsample using the Adult Attachment Projective Picture System (AAP, n = 69). Linear regression models were fitted to estimate the association between resilience measures and the Cortisol:DHEA ratio, cortisol and DHEA, controlling for gender and age.Results: SoC was associated with a lower Cortisol:DHEA ratio (β = −0.36, p < 0.001), driven by a positive association between SoC and DHEA levels (β = 0.28, p = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (β = −0.24, p = 0.005), due to self-care being associated with higher DHEA (β = 0.21, p = 0.016). HPA-axis measures were not associated with self-efficacy nor with attachment patterns in a subsample.Conclusions: Our findings imply that youth residential care institutions might benefit from programs focusing on enhancing SoC and self-care practices. Fostering a meaningful, comprehensible and manageable professional climate in caregiving environments and implementing self-care in routine practices might enhance not only well-being but also physical health of professional caregivers and in this way buffer adverse health effects of chronic stressors.

Physiological Indicators of Acute and Chronic Stress in Securely and Insecurely Attached Dogs Undergoing a Strange Situation Procedure (SSP): Preliminary Results

“…Despite that, there is a surprisingly low number of studies investigating hair cortisol concentrations in relation to attachment insecurity, in humans. While there is evidence that a sub-optimal caregiving behaviour from a parent may be associated with higher hair cortisol levels in the child [ 72 , 73 , 74 ], there seems to be no direct association between the latter and attachment insecurity neither in young [ 75 ] nor in adult individuals [ 76 ]. In this pilot study, we did not assess the owner’s behaviour during the SSP.…”

The emotional impact of disrupted environmental contexts: Enrichment loss and coping profiles influence stress response recovery in Long–Evans rats

“…Higher DHEA:CORT ratios are associated with emotional resilience considering that lower ratios of DHEA to cortisol levels have been observed to be predictive of treatment‐resistant depression and decreased hippocampal volumes 30,31 . Additionally, higher DHEA in proportion to cortisol has been associated with emotional resilience, 35,51 perhaps as a result of the purported antagonistic actions of DHEA to glucocorticoids 20 . Additionally, past research suggests that higher levels of DHEA and DHEA(S) are predictive of emotional resilience 52,53 .…”

The Molecular Basis of Resilience: A Narrative Review

“…In addition, DHEA has antidepressant and anxiolytic effects (38). It has also been shown to grant higher levels of self-care, and overall resilience, in previous studies (39). Many epigenetic changes have also been shown to change the way the HPA axis can respond to stress, including DNA methylation to dampen the response of the HPA axis (40).…”