Cortisol awakening response over the course of humanitarian aid deployment: a prospective cohort study.
Cortisol awakening response over the course of humanitarian aid deployment: a prospective cohort study.
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DOI：
10.1080/20008198.2020.1816649
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发表时间：
2020-12-21
影响因子：
5
通讯作者：
Olff M
中科院分区：
文献类型：
--
作者：
Qing Y;van Zuiden M;Eriksson C;Lopes Cardozo B;Simon W;Ager A;Snider L;Sabin ML;Scholte W;Kaiser R;Rijnen B;Olff M
背景：国际部署的人道主义援助（HA）工作人员经常面临潜在的创伤性压力源。然而，目前尚不清楚HA部署和相关的创伤性应激是否与下丘脑-垂体-肾上腺（HPA）轴功能的长期变化有关。因此，我们调查了皮质醇觉醒反应（CAR）是否在部署后下降，以及这是否受到先前和最近的创伤暴露以及症状严重程度和感知社会支持的平行变化的调节。研究方法：在这项前瞻性研究中，n = 86名HA工作人员（68%女性）完成了关于创伤暴露、创伤后应激障碍（PTSD）、焦虑和抑郁症状和感知社会支持的问卷调查，以及在部署前、部署后早期和部署后3-6个月在觉醒时和觉醒后30分钟进行唾液皮质醇评估。结果如下：线性混合模型显示，随着时间的推移，CAR（B（SE）=-0.036（.011），p = .002）和唤醒皮质醇（B（SE）=-0.007（.003），p = .014）显著降低。唤醒皮质醇变化的程度显着缓和以前和最近的创伤暴露之间的相互作用。此外，在所有评估中，唤醒皮质醇下降幅度更大与平均焦虑和PTSD症状更高显著相关。社会支持没有显著影响。结论：我们观察到衰减的CAR和唤醒皮质醇后HA部署，与创伤暴露前和最近部署期间唤醒皮质醇的剂量反应效应。觉醒皮质醇变化与创伤后应激障碍和焦虑症状水平相关。我们的研究结果支持组织意识的必要性，即与工作有关的暴露可能具有长期的生物学效应。需要进一步研究评估症状和生物措施并行，以将目前的研究结果转化为个人层面的指导方针。人道主义援助工作可能会产生长期的生物影响。 皮质醇唤醒反应和唤醒皮质醇（AC）部署后下降。 AC变化与先前和最近的创伤相结合。 AC变化与PTSD和焦虑症状相关。
Background: Internationally deployed humanitarian aid (HA) workers are routinely confronted with potentially traumatic stressors. However, it remains unknown whether HA deployment and related traumatic stress are associated with long-term changes in hypothalamic-pituitary-adrenal (HPA) axis function. Therefore, we investigated whether cortisol awakening response (CAR) decreased upon deployment and whether this was moderated by previous and recent trauma exposure and parallel changes in symptom severity and perceived social support. Methods: In this prospective study, n = 86 HA workers (68% females) completed questionnaires regarding trauma exposure, posttraumatic stress disorder (PTSD), anxiety and depressive symptoms and perceived social support, as well as salivary cortisol assessments at awakening and 30 minutes post-awakening at before, early and 3–6 months post-deployment. Results: Linear mixed models showed significantly decreased CAR (b(SE) = −.036(.011), p = .002) and awakening cortisol over time (b(SE) = −.007(.003), p = .014). The extent of awakening cortisol change was significantly moderated by interactions between previous and recent trauma exposure. Also, a steeper awakening cortisol decrease was significantly associated with higher mean anxiety and PTSD symptoms across assessments. No significant effects were found for social support. Conclusions: We observed attenuated CAR and awakening cortisol upon HA deployment, with a dose-response effect between trauma exposure before and during the recent deployment on awakening cortisol. Awakening cortisol change was associated with PTSD and anxiety symptom levels across assessments. Our findings support the need for organizational awareness that work-related exposures may have long-lasting biological effects. Further research assessing symptoms and biological measures in parallel is needed to translate current findings into guidelines on the individual level. HIGHLIGHTS Humanitarian aid work can have long-lasting biological effects. Cortisol awakening response and awakening cortisol (AC) decreased upon deployment. AC change was associated with prior and recent trauma combined. AC change was associated with PTSD and anxiety symptoms.
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影响因子：
3.7
作者：
Lopes Cardozo B;Gotway Crawford C;Eriksson C;Zhu J;Sabin M;Ager A;Foy D;Snider L;Scholte W;Kaiser R;Olff M;Rijnen B;Simon W
通讯作者：
Simon W
影响因子：
3.8
作者：
Dedert, Eric A.;Calhoun, Patrick S.;Watkins, Lana L.;Sherwood, Andrew;Beckham, Jean C.
通讯作者：
Beckham, Jean C.
DOI：
10.1002/bs.3830190102
发表时间：
1974-01-01
期刊：
BEHAVIORAL SCIENCE
影响因子：
--
作者：
DEROGATIS, LR;LIPMAN, RS;COVI, L
通讯作者：
COVI, L
昼夜皮质醇斜率以及心理和身体健康结果：系统评价和荟萃分析。
影响因子：
3.7
作者：
Adam EK;Quinn ME;Tavernier R;McQuillan MT;Dahlke KA;Gilbert KE
通讯作者：
Gilbert KE
影响因子：
3.7
作者：
Daskalakis, Nikolaos P.;Bagot, Rosemary C.;Parker, Karen J.;Vinkers, Christiaan H.;de Kloet, E. R.
通讯作者：
de Kloet, E. R.