The effects of performance anxiety on salivary ultra‐weak chemiluminescence

Response of ultra‐weak chemiluminescence (UCL) in saliva before and after an experimental examination was explored in 10 healthy undergraduate students. Participants were asked to perform a task under supervision that consisted of a serial aseptic manipulation for cell culture. Saliva was collected 30 min before, immediately after, 30 min after and 60 min after the stress exposure. One‐way repeated measures ANOVA for UCL revealed a significant difference across the four measurement occasions (F = 4.45, p < 0.05). Post hoc Dunnett's test clarified that UCL levels right after the stress exposure was significantly greater than that 30 min before the exposure (p < 0.05). The concentrations of secretory immunoglobulin A (sIgA) and cortisol in saliva were also measured. Two‐way ANOVA with repeated measures indicated that UCL and sIgA exhibited the same change pattern in the four occasions (F = 0.28, p = 0.84), whereas UCL changed differently from cortisol (F = 5.82, p < 0.005). It was suggested that salivary UCL may be a sensitive biomarker for acute psychological changes. Copyright © 2005 John Wiley & Sons, Ltd.     

The relationship between salivary biomarkers and state-trait anxiety inventory score under mental arithmetic stress: a pilot study

Measurement of stress hormones is a common objective method for assessment of mental stress. However, the stress of blood sampling alone may also increase stress hormone levels. In the present study, we sampled salivary biomarkers from healthy volunteers under noninvasive conditions and determined their efficacy to assess mental stress. Specifically, we examined the relationship between State Anxiety Inventory score (STAI-s) in subjects exposed to arithmetic stress and salivary chromogranin-A, alpha-amylase, or cortisol. The STAI-s was significantly correlated to salivary alpha-amylase (r = 0.589; P < 0.01) but not to salivary chromogranin-A or cortisol. Therefore, salivary alpha-amylase is a useful indicator of psychosocial stress.     

Leg massage therapy promotes psychological relaxation and reinforces the first-line host defense in cancer patients

Purpose

Patients with cancer suffer a wide range of physical symptoms coupled with psychological stress. Moreover, cancer chemotherapy induces immunosuppression and consequently causes respiratory infections. Massage therapy has been reported to reduce symptoms in cancer patients via an increase in psychosocial relaxation and to enhance and/or improve immune function.

Methods

In the present study, we determined whether leg massage could induce psychosocial relaxation and activate the first line of the host defense system. To assess effects of rest and leg massage, 15 healthy volunteers rested on a bed for 20 min on the first day, and 3 days later the subjects received a standardized massage of the legs for 20 min with nonaromatic oil. Twenty-nine cancer patients also received the same standardized massage of the legs. Anxiety/stress was assessed before and just after the rest or the massage using the State-Trait Anxiety Inventory (STAI-s) and visual analogue scale (VAS). To evaluate oral immune function, salivary chromogranin A (CgA) and secretory immunoglobulin A (sIgA) levels were measured.

Results

In healthy volunteers, rest significantly reduced VAS by 34% and increased sIgA by 61%. In contrast, leg massage significantly reduced both STAI-s and VAS by 24% and 63%, and increased both sIgA and CgA by 104% and 90%, respectively. In cancer patients, leg massage significantly decreased both STAI-s and VAS by 16% and 38%, and increased both salivary CgA and sIgA by 33% and 35%, respectively.

Conclusion

Leg massage may promote psychosocial relaxation and reinforce a first-line host defense with an increase in secretion of antimicrobial peptides.     

Cortisol Level Modulated by Integrative Meditation in a Dose‐dependent Fashion

Prior research has shown that an additional training session immediately after acute stress decreases release of salivary cortisol in a college student group trained with 5‐day integrative body–mind training (IBMT) in comparison with a control group given the same amount of relaxation training. However, 5 days of training does not influence the basal secretion of cortisol. The current study seeks to extend this finding and determine whether increasing amounts of IBMT will decrease the basal cortisol level, suggesting reduced stress to daily activities. Thirty‐four Chinese undergraduates were randomly assigned either to 4 weeks of IBMT or a relaxation control. Salivary cortisol levels at baseline before training and the three stages of a stress intervention test (i.e. rest, stress and additional 20‐min practice) after 2 and 4 weeks of training were assessed. The basal cortisol level decreased significantly in the IBMT but not in relaxation group after 2 and 4 weeks of training. An additional IBMT practice session immediately after acute stress produced significantly lower cortisol release for the IBMT group in comparison with relaxation at weeks 2 and 4. The results indicate that IBMT produces a change in the basal endocrine system and larger acute effects as the dose of training increases. Copyright © 2013 John Wiley & Sons, Ltd.     

Effect of snack eating on salivary α‐amylase,a novel stress marker

The aim of this study is to investigate the effect of snack eating on salivary α‐amylase (sAA) as compared with salivary cortisol. From 15 healthy males, saliva samples were collected every 30min from 14:00 to 18:00. Immediately after the sampling at 15:00, seven subjects (snack‐eating group) ate a snack. The sAA and cortisol levels were determined with commercial kits. In the snack‐eating group, there was a significant increase in both the levels of sAA and cortisol after snack eating at 15:30. Even higher salivary cortisol levels were detected at 16:00. In the control group, no significant changes were detected. These findings suggest that both the levels of sAA and salivary cortisol are affected by snack eating and that, before saliva sampling for stress measurement, a fasting period of about 90min is appropriate. Copyright © 2007 John Wiley & Sons, Ltd.     

Evaluation of Effects of Lavender and Peppermint Aromatherapy Using Sensitive Salivary Endocrinological Stress Markers

By measuring the sensitive salivary endocrinological stress markers cortisol and chromogranin A (CgA), we investigated effects on stress of lavender and peppermint aromas. Groups of volunteers were each exposed to an airborne organic essential oil: either lavender or peppermint or, for control, odourless jojoba. Saliva samples were collected immediately before and after the 10‐min exposure and 5 and 10 min later. Salivary cortisol and CgA levels were evaluated by enzyme‐linked immunosorbent assay. After exposure, in the peppermint aroma group, salivary cortisol statistically significantly decreased and salivary CgA statistically significantly increased. No similar changes were found in either the lavender aroma or the control group. These findings suggest that peppermint aroma may be useful for relieving stress. Copyright © 2011 John Wiley & Sons, Ltd.     

Investigation of Sex Differences In sIgA Response to the Trier Social Stress Test

Acute stressors can activate the immune system. While many immune system diseases disproportionally affect women, sex differences in adaptive immune response to acute, psychosocial stressors remain to be investigated. The present study tested the hypothesis that female participants experience increased immune response to acute psychosocial stress relative to male participants. Salivary secretory immunoglobulin A (sIgA) was assessed before and after the Trier Social Stress Test (TSST) and at two time points during a recovery period in healthy male (n = 25) and female (n = 24) participants. Exposure to the TSST resulted in significantly increased sIgA that returned to baseline during a subsequent recovery period. Baseline sIgA was higher among women, however, no differences between men and women in response to or recovery from the stressor were observed in the present study. This research describes an initial investigation of sex differences in immune response to acute psychosocial stressors and demonstrates similarity in sIgA response among male and female participants. Copyright © 2016 John Wiley & Sons, Ltd.     

A comparison of changes in secretory immunoglobulin A following a stress‐inducing and stress‐reducing task

Research suggests that the immune system may be adversely affected by chronic stress. There is some evidence that relaxation‐based practices may effect an increase in immune functioning, but recent findings suggest that acute stress may lead to similar increases. Given this, we used a counterbalanced within‐subjects design to directly compare the effects of a stressful mental arithmetic task and a relaxation‐based task on secretory immunoglobulin A (S‐IgA). Thirty participants were seen in small groups of two or three where they were administered both a mental arithmetic (stress) task and a relaxing hypnosis task. Four‐minute timed saliva samples were obtained immediately following the two experimental tasks and following two baseline periods. Results demonstrated that, compared with baseline, S‐IgA concentration and secretion rate were significantly higher following both the relaxation‐based task and stress task. Additionally, our data showed that the increases were short‐lived, decreasing significantly within 8 min following the completion of each task. Our results indicate that both stress‐reducing and stress‐inducing tasks can increase S‐IgA levels, and these results are discussed with reference to the potential differential mechanisms and clinical significance of such changes. Copyright © 2008 John Wiley & Sons, Ltd.     

Self‐reported Racial Discrimination and Endothelial Reactivity to Acute Stress in Women

This study investigated the effect of self‐reported racial discrimination on endothelial responses to acute laboratory mental stress among post‐menopausal women. One‐hundred thirteen women (n = 94 self‐identified as White and n = 19 self‐identified as racial/ethnic minority), 43% with type 2 diabetes, reported lifetime experiences of racial/ethnic discrimination. Repeated assessments of flow‐mediated dilation were performed at baseline, immediately after 5 min of mental arithmetic and at 20‐min recovery. Both White and racial/ethnic minority women reported lifetime discrimination, with rates significantly higher among minorities. Self‐reported lifetime discrimination was associated with attenuated flow‐mediated dilation at recovery. Confounding variables, including clinical characteristics, mood, personality traits, other life stressors and general distress, did not better account for the effect of racial discrimination. Neither race/ethnicity nor diabetes status moderated the effect. The perceived stressfulness of the mental arithmetic was not associated with the endothelial response. In conclusion, self‐reported lifetime discrimination is associated with attenuated endothelial recovery from acute mental stress. Elucidating the effects of discrimination and the biological mechanisms through which it affects the vasculature may suggest interventions to improve health. Copyright © 2012 John Wiley & Sons, Ltd.     

Impairments of Spatial Working Memory and Attention Following Acute Psychosocial Stress

Few studies have investigated the effect of an acute psychosocial stress paradigm on impaired attention and working memory in humans. Further, the duration of any stress‐related cognitive impairment remains unclear. The aim of this study was to examine the effect of an acute psychosocial stress paradigm, the Trier Social Stress, on cognitive function in healthy volunteers. Twenty‐three healthy male and female subjects were exposed to an acute psychosocial stress task. Physiological measures (salivary cortisol, heart rate and blood pressure) and subjective stress ratings were measured at baseline, in anticipation of stress, immediately post‐stress and after a period of rest. A neuropsychological test battery including spatial working memory and verbal memory was administered at each time point. Acute psychosocial stress produced significant increases in cardiovascular and subjective measures in the anticipatory and post‐stress period, which recovered to baseline after rest. Salivary cortisol steadily declined over the testing period. Acute psychosocial stress impaired delayed verbal recall, attention and spatial working memory. Attention remained impaired, and delayed verbal recall continued to decline after rest. Acute psychosocial stress is associated with an impairment of a broad range of cognitive functions in humans and with prolonged abnormalities in attention and memory. Copyright © 2014 John Wiley & Sons, Ltd.     

Monitoring stress tolerance and occurrences of upper respiratory illness in basketball players by means of psychometric tools and salivary biomarkers

The aim of the study was to evaluate the possible relationships between stress tolerance, training load, banal infections and salivary parameters during 4 weeks of regular training in fifteen basketball players. The Daily Analysis of Life Demands for Athletes' questionnaire (sources and symptoms of stress) and the Wisconsin Upper Respiratory Symptom Survey were used on a weekly basis. Salivary cortisol and salivary immunoglobulin A (SIgA) were collected at the beginning (before) and after the study, and measured by enzyme‐linked immunosorbent assay (ELISA). Ratings of perceived exertion (training load) were also obtained. The results from ANOVA with repeated measures showed greater training loads, number of upper respiratory tract infection episodes and negative sensation to both symptoms and sources of stress, at week 2 (p < 0.05). Significant increases in cortisol levels and decreases in SIgA secretion rate were noted (before to after). Negative sensations to symptoms of stress at week 4 were inversely and significantly correlated with SIgA secretion rate. A positive and significant relationship between sources and symptoms of stress at week 4 and cortisol levels were verified. In summary, an approach incorporating in conjunction psychometric tools and salivary biomarkers could be an efficient means of monitoring reaction to stress in sport. Copyright © 2010 John Wiley & Sons, Ltd.     

Effects of psycho–physical stress (competitive rafting) on saliva interleukin‐1 beta

The effects of psycho‐physical stress on immune function were evaluated by investigating the secretion rate of salivary interleukin‐1 beta (IL‐1β) during competitive rafting. Ten female and 20 male volunteers participated in this study. The concentration of IL‐1 β was determined in saliva using ELISA. We examined the statistical differences between T2/T1 (the changes observed during the training period) and C2/C1 (the changes before and after the competitive rafting) ratios by a Wilcoxon signed rank test. The ratio of IL‐1 β was significantly increased during competitive rafting (C2&sol;C1 = 3.6; p < 0.01), compared to the control ratio (T2&sol;T1 = 0.95; p < 0.01). The level of IL‐1 β at 8.00 a.m. decreased significantly between the first (11.9 ± 8.71 pmol/l) and the third day (7.9 ± 5.52 pmol/l) in all subjects (p < 0.01). In addition, the basal IL‐1 β levels significantly decreased between the beginning (8.00 a.m.) and the end of the day (6.00 p.m.), during the three consecutive days of collection (p < 0.01). These results may correspond to a circadian secretion rhythm of human saliva IL‐1 β. In conclusion, a disturbance of IL‐1 β salivary secretion is observed either after psycho‐physical stress or during intensive training. It may potentially affect the immune and endocrine status. Copyright © 2001 John Wiley & Sons, Ltd.     

Lecturing to 200 students and its effects on cytokine concentration and salivary markers of adrenal activation

Stress not only activates the SAM system and the hypothalamic–pituitary–adrenal axes, but also the immune system. The aims of this study are to assess the physiological variations in saliva (cytokines, cortisol and alpha‐amylase) and perceived stress in professors when they had to lecture to 200 students. A total of eight unstimulated saliva samples were collected from nine professors: four on a working day that included the lecture and four controls on a working day without a lecture. The professors also rated subjective stress on a seven‐point scale 5 min before the lecture, immediately after the lecture and at the same times on the control day. The lecture elicited substantial increases in subjective stress ratings, with the values on the lecture day significantly higher than those on the control day. Lecturing resulted in significant increases in Tumor Necrosis Factor (TNF)‐α, Interleukin (IL)‐2 and IL‐4 concentrations, but did not affect the IL‐10 values. These changes appeared to be concomitant with changes in the concentrations of the stress markers, alpha‐amylase and cortisol. The mechanisms by which psychosocial stress can induce cytokine changes and modify the activity of salivary alpha‐amylase are not entirely understood, and further research is thus warranted. Copyright © 2010 John Wiley & Sons, Ltd.     

Modulation of pain sensation by stress-related testosterone and cortisol

Stress increases cortisol and decreases testosterone. It is not known whether pain is affected by stress-related testosterone. Therefore, we investigated whether stress can affect pain perception by decreasing testosterone and increasing cortisol. Pain thresholds, pain and anxiety ratings and salivary testosterone and cortisol levels were measured in 46 healthy men during resting and stressful conditions. Pain was induced by electrical stimulation. Stress was induced by having participants perform a medical test. Stress significantly increased anxiety ratings and salivary cortisol levels, but decreased salivary testosterone levels. Stress also increased pain ratings and decreased pain thresholds. During stress, cortisol levels were negatively correlated with pain thresholds and testosterone levels were positively correlated with pain thresholds. Results indicated that testosterone can decrease and cortisol can increase pain induced by electrical stimulation, suggesting that acute clinical pain may be relieved by controlling stress and managing consequent stress-related testosterone and cortisol.     

Acute and chronic stress in cardiothoracic anaesthetists

A distinction is made between acute and chronic stress in the workplace. The distinction leads on to two types of question: (1) How does the one relate to the other? (2) Is it possible to distinguish between acute and chronic stress physiologically? Preliminary attempts to tackle the latter question are reported. The subjects were anaesthetists on a cardiothoracic unit and the physiological measures taken were urinary cortisol and salivary flowrate. Perceived stress and arousal were monitored using self-report techniques. Among the results obtained were the following:

• 1 Self-reported arousal was higher in the morning than the afternoon.
• 2 The level of arousal was associated with salivary flow, flow being weaker when arousal was higher and vice versa.
• 3 Self-reports of stress were associated with higher than average urinary cortisol levels.
• 4 The mean level of urinary cortisol over 24 hours was significantly higher for the group than that found in the general population.

     

The role of dehydroepiandrosterone on functional innate immune responses to acute stress

The androgen dehydroepiandrosterone (DHEA) responds to stress activation, exhibits anti‐glucocorticoid properties, and modulates immunity in diverse ways, yet little is known of its role in acute stress responses. In this study, the effects of DHEA and its sulfate ester DHEA‐S on human male immune function during exposure to an acute stressor is explored. Variation in DHEA, DHEA‐S, testosterone, and cortisol, along with bacterial killing assays, was measured in response to a modified Trier Social Stress test in 27 young adult males. Cortisol was positively related to salivary innate immunity but only for participants who also exhibited high DHEA responses. Additionally, DHEA positively and DHEA‐S negatively predicted salivary immunity, but the opposite was observed for serum‐based innate immunity. The DHEA response to acute stress appears to be an important factor in stress‐mediated immunological responses, with differential effects on immunity dependent upon the presence of other hormones, primarily cortisol and DHEA‐S. These results suggest that DHEA plays an important role, alongside other hormones, in modulating immunological shifts during acute stress.     

Can we influence the neurological development and hair cortisol concentration of offspring by reducing the stress of the mother during pregnancy? A randomized controlled trial

The objective was to evaluate the effects of a stress management cognitive behavioural therapy followed during pregnancy on subsequent childhood on hair cortisol at birth and on neurodevelopment and Hair Cortisol Concentrations (HCC) at 6 months of age. The study sample included 48 pregnant women, divided into two groups: 24 women in the Therapy Group (TG) and 24 women who received standard pregnancy care (control group (CG); CG). To test the therapy efficacy, an evaluation of the HCC and psychological stress, psychopathological symptomatology and resilience was conducted before and after the treatment. The level of cortisol in their hair was obtained during pregnancy and that of their babies at birth. Six months after birth, a cortisol sample was taken from the hair and the babies' neurodevelopment was evaluated based on a Bayley-III test. The TG presented reductions in psychological stress and psychopathological symptomatology after treatment. On the other hand, the CG increased their cortisol concentrations between the pre and post intervention, remaining stable in the TG. Moreover, results showed that TG babies had lower cortisol concentrations at birth and obtained significantly higher cognitive and motor development scores at 6 months. These findings support that providing psychological care to pregnant women may not only have a benefit on these women's mental state, but may also benefit the neurodevelopment of their offspring.     

Stress Effects: A Study of Salivary Cortisol Levels in Third‐year Medical Students

The physical, mental and emotional stresses experienced during the training and careers of physicians have been linked to increased rates of anxiety, depression and suicide. Increased stress leads to alterations in the hypothalamic–pituitary–adrenal (HPA) axis, which can determine multisystem modulations with acute and chronic consequences. This study investigated salivary cortisol patterns in third‐year medical students performing clinical work at a US medical school. Morning and evening salivary cortisol samples were collected from students during the last 2 weeks of each of three successive clinical rotations and while on vacation. Salivary cortisol levels were measured using Siemens radioimmunoassay kits (Siemens Medical Solutions Diagnostics, Los Angeles, CA, USA). Statistical analysis used mixed‐effects regression models. Eleven students submitted 64 salivary samples. Statistically significant blunting of the diurnal cortisol variation was observed in students on inpatient rotations. HPA axis changes occur in third‐year medical students performing inpatient clinical work. These findings can inform curriculum planning, rotation‐specific guidelines and the development of student wellness programmes. Copyright © 2011 John Wiley & Sons, Ltd.     

Anti‐stress effect of yoga‐type breathing: modification of salivary cortisol,heart rate and blood pressure following a step‐climbing exercise

This paper reports salivary cortisol levels and cardiovascular adjustments monitored after the performance of physical exercise in a subject (healthy man, 58 years old) who had practised and taught yoga techniques for a number of years. The subject performed two different step‐climbing trials which were varied according to the different breathing recovery techniques used. Immediately after the step‐climbing, the subject was asked either to get his breath back spontaneously (as reference) or by 3 min breathing using the ‘Istity Method’, based on the prolongation or amplification of the steps of the breath (breathing in–out) with short regular rest intervals. The measurements of the basal heart rate, blood pressure and cortisol concentration in the saliva were made just before starting, and 5, 15 and 30 min after the end of step‐climbing. Results suggest that the Istity breathing method can induce rapid modification of the cardiovascular function and attenuation of the cortisol level after exposure to physical stress. It might be of interest to pursue further studies of this effect, perhaps not confined to yoga experts, since the ‘Istity Method’ can be implemented by anyone after a short and simple training period. Copyright © 2002 John Wiley & Sons, Ltd.     

Does low urinary sIgA predispose to urinary tract infection?

Median urinary secretory IgA (sIgA) (ELISA technique in unprocessed urine) was 1.36 mg/liter (range, 0.29 to 2.31) in healthy female controls at various times of the menstrual cycle. It was significantly lower in women with urinary tract infection (UTI) without antibody-coated bacteria. Such decrease was found both in women with acute UTI episodes (median, 0.16; range, 0.06 to 1.71) and in asymptomatic nonbacteriuric women with a history of UTI (median, 0.52; range, 0.05 to 2.13). In the latter women, sIgA in nasal secretions tended to be low, but salivary sIgA was unchanged. Urinary sIgA was elevated significantly in individuals with nephrostomy and antibody-coated bacteria (14.4 mg/liter, range, 3.6 to 20). The study showed that locally synthesized sIgA immunoglobulins were low in the urine of individuals with recurrent UTI independent of the presence or absence of bacteriuria at the time of the study. UTI per se did not interfere with sIgA secretion as shown by high sIgA in patients with upper UTI. Low urinary sIgA may represent one factor predisposing to recurrent UTI.