Salivary cortisol: a possible biomarker in evaluating stress and effects of interventions in young foster children?
Salivary cortisol: a possible biomarker in evaluating stress and effects of interventions in young foster children?
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唾液皮质醇：评估年幼寄养儿童压力和干预措施效果的可能生物标志物？
DOI：
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发表时间：
2013
影响因子：
6.4
通讯作者：
R. J. Gaag
中科院分区：
文献类型：
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作者：
H. V. Andel;L. Jansen;H. Grietens;E. Knorth;R. J. Gaag
年幼的寄养儿童很早就与其照顾者分离，在安置之前往往会经历严重的压力。然而，相当一部分儿童没有表现出明显的痛苦迹象，这使得寄养照料者难以意识到其寄养儿童的压力程度。潜在的证据使用唾液皮质醇水平作为一个维度，以评估在年轻的寄养儿童的压力量进行审查。此外，还讨论了唾液皮质醇在评估年幼寄养儿童减压干预措施中的适用性。使用数据库Medline、Psychinfo、Embase、Ebscohost和Academic Search Premier进行系统性综述。追踪了9项研究，其中唾液皮质醇用于测量家庭寄养或收养家庭中儿童的压力。压力一般，但也忽视，照顾者的早期损失，在第一次安置的年龄较小，以及更多的安置与改变下丘脑-垂体-肾上腺（HPA）轴功能在寄养儿童。此外，还发现了4项关于减压干预对寄养儿童HPA轴功能影响的研究，这些研究表明，以减压为基础的干预实际上有助于寄养儿童HPA轴功能的正常化，并且这种变化与行为功能的改善同时发生。虽然在这篇评论中讨论的论文的结果表明，昼夜皮质醇与唤醒和睡前测量可能是一个相关的工具，以评估压力在年幼的寄养儿童，这还不能从目前的研究得出结论，因为统计数据从寄养和收养的研究在这篇评论是不健全的，研究人员使用不同的方法来收集唾液皮质醇。然而，值得注意的是，所有研究都发现了与慢性压力（由虐待和忽视儿童造成）有关的水平降低的相同模式。
Young foster children undergo an early separation from their caregiver(s) and often experience severe stress before placement. However, a considerable part of the children do not show apparent signs of distress, making it difficult for the foster carer to be aware of the amount of stress in their foster child. Potential evidence for using salivary cortisol levels as a dimension to evaluate the amount of stress in young foster children is reviewed. Moreover, the applicability of salivary cortisol in the evaluation of stress-reducing interventions for young foster children is discussed. A systematic review was performed using the databases Medline, Psychinfo, Embase, Ebscohost, and Academic Search Premier. Nine studies were traced in which salivary cortisol was used to measure stress in children placed in family foster care or in adoptive families. Stress in general but also neglect, early loss of a caregiver, a younger age at first placement, and a higher number of placements were associated with an altered hypothalamic–pituitary–adrenal (HPA) axis function in foster children. Moreover, four studies on the effect of stress-reducing interventions on HPA-axis functioning of young foster children were found. These studies suggest that caregiver-based interventions can actually help to normalize the HPA-axis function in foster children, and that such changes co-occur with improved behavioral functioning. Although the results from the papers discussed in this review suggest that diurnal cortisol with a wake up and a bedtime measurement may be a relevant tool to evaluate stress in young foster children, this cannot yet be concluded from the present studies, because statistical data from the studies on foster care and adoption in this review were not robust and researchers used different methods to collect the salivary cortisol. Still, it is noteworthy that all studies did find the same pattern of reduced levels in relation to chronic stress (caused by maltreatment and neglect of the child).
影响因子：
17.7
作者：
Yehuda, R;Bierer, LM;Dolan, S
通讯作者：
Dolan, S