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Salivary cortisol response to acute stress and its relation to psychological factors in women with chronic trapezius myalgia – a pilot study
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-2530-4126
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden.
Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden.
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2010 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 35, no 5, 674-685 p.Article in journal (Refereed) Published
Abstract [en]

This study investigated differences in HPA axis function, measured as salivary cortisol concentrations, between 18 women with chronic trapezius myalgia (MYA) and 30 healthy female controls. In addition, the interactions between HPA axis reactions to psychosocial stress and aspects of pain, health and psychological symptoms were analyzed. Salivary cortisol was measured both in daily life, to assess the circadian profile, and in the laboratory during light repetitive work and standardized psychosocial stress (Trier Social Stress Test, TSST). MYA and CON exhibited similar circadian rhythms and comparable salivary cortisol response magnitudes after TSST. In subjects defined as responders to the TSST, the mean peak time point of the cortisol response after TSST differed significantly between MYA and CON. Furthermore, negative psychological states and higher pain intensity were related to a slower HPA axis response to TSST. Low circadian variations in cortisol and smaller cortisol responses to TSST were found among subjects scoring high on anxiety sensitivity. Thus, a relatively favorable sample of female chronic trapezius myalgia patients exhibited normal circadian rhythm and normal salivary cortisol response magnitudes after a psychosocial stress test. In the subgroup of responders, the MYA group showed indications of a slower salivary cortisol response to psychosocial stress. Further studies are needed to elucidate the possibility of altered HPA axis activity in terms of a slower salivary cortisol response.

Place, publisher, year, edition, pages
2010. Vol. 35, no 5, 674-685 p.
Keyword [en]
salivary cortisol; HPA axis; chronic pain; musculoskeletal disorders; stress; Trier Social Stress Test (TSST)
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-54334DOI: 10.1016/j.psyneuen.2009.10.007ISI: 000278431500005PubMedID: 19900762OAI: oai:DiVA.org:liu-54334DiVA: diva2:302842
Available from: 2010-03-10 Created: 2010-03-10 Last updated: 2017-12-12
In thesis
1. I feel terrible! Can you measure that?: Exploring psychophysiological stress responses and their interactions with performance, subjective reports and health status
Open this publication in new window or tab >>I feel terrible! Can you measure that?: Exploring psychophysiological stress responses and their interactions with performance, subjective reports and health status
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite recent research advances, there are still several common medical conditions whose underlying mechanisms are poorly understood. In conditions with few or diffuse physical findings, it can be difficult to diagnose and determine the state of the condition and its effects on working ability or performance, and the health care practitioners have to rely on the patient’s self-reports. Identification of objective measurements that are sensitive enough to aid in diagnosis or determination of the state of these conditions would thus be valuable. Psychophysiological measurements are generally non-invasive and have the potential to serve as such diagnostic or prognostic tools. In this thesis, psychophysiological reactions to different stressors were recorded in two selected medical conditions; namely motion sickness and chronic trapezius myalgia (musculoskeletal pain). These subjective conditions are unpleasant, unwanted and apparently serve no survival purpose. It is therefore important to elucidate any physical findings associated with them to, eventually, find new means to prevent the development of these conditions or to ameliorate symptoms.

The overall aim of the thesis was to explore the development of psychophysiological responses to stressors in relation to performance and subjective reports in healthy individuals and in women with chronic trapezius myalgia. More in detail, the purpose was to identify psychophysiological responses that could provide information about the mechanisms behind, or serve as candidates for characterization of motion sickness and chronic trapezius myalgia, respectively.

Responses to motion sickness, triggered by optokinetic stimulation, were studied in healthy individuals, whereas responses to repetitive low-force work and psychosocial stress were studied in women with chronic trapezius myalgia and in pain-free controls. In both medical conditions, the psychophysiological responses were accompanied by subjective reports. The effects of motion sickness on two different aspects of memory performance were tested during exposure to optokinetic stimulation. In the studies of chronic trapezius myalgia, psychophysiological responses were also related to health status, i.e., being a patient or a pain-free control and measurements of pain intensity, psychological symptoms, sleep-related problems and quality of life.

The psychophysiological responses to optokinetic stimulation were inconclusive. Moderate levels of motion sickness did not affect memory performance, whereas decreased short term memory performance was seen in subjects reporting high levels of motion sickness. The autonomic responses and stress hormone secretion in response to low-force repetitive work and psychosocial stress in the chronic trapezius myalgia group were similar to those of the pain-free controls. However, muscle activity in the trapezius muscle was generally higher in the chronic trapezius myalgia group. There were indications of negative psychological states being related to a slower response and lower circadian variations of stress hormone secretion.

With the present methods, it was possible to measure general stress responses but none of the measurements showed sufficient specificity to serve as predictors or indicators of motion sickness and chronic musculoskeletal pain, respectively. Summarizing, I cannot objectively measure how you feel; I still have to rely on your description of your condition.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 67 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1164
Keyword
psychophysiology, motion sickness, chronic pain, stressor, performance, autonomic responses, HPA axis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54345 (URN)978-91-7393-457-2 (ISBN)
Public defence
2010-04-09, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
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Available from: 2010-03-15 Created: 2010-03-10 Last updated: 2013-09-10Bibliographically approved

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Sjörs, AnnaLarsson, BrittGerdle, Björn

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