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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 (? = -0.36, p < 0.001), driven by a positive association between SoC and DHEA levels (? = 0.28, p = 0.002). Self-care was also associated with lower Cortisol:DHEA ratios (? = -0.24, p = 0.005), due to self-care being associated with higher DHEA (? = 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.

SUBMITTER: Burgin D

PROVIDER: S-EPMC7779549 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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

Bürgin David D Kind Nina N Schröder Martin M Clemens Vera V Fegert Jörg M JM Eckert Anne A Buchheim Anna A O'Donovan Aoife A Boonmann Cyril C Schmid Marc M

Frontiers in psychiatry 20201221

<b>Background:</b> 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. <b>Objectives:</b> We aimed to investigate if measures related to resilience [sense of coherence (SoC), self-effica ...[more]

PMID: 33408649

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Project description:BackgroundStudies show that the hypothalamic-pituitary-adrenal (HPA) axis is dysregulated in depression. Some studies suggest that variation in the serotonin transporter genotype (hereafter 5HTT) modulates both risk for depression and psychopathological HPA axis responsiveness. Rhesus monkeys are well suited to model such relationships. Rhesus macaque models of human psychopathology have assessed the effect of the serotonin transporter (rh5HTT) on levels of cortisol in stressed subjects. These studies show that that under conditions of stress, heterozygous females (Ls) reared under adversity exhibit high levels of cortisol. Studies have not to our knowledge, however, assessed the potential additive effect on the cortisol response in a number of macaque subjects homozygous for the serotonin transporter short allele (ss). Moreover, little is known about the level of the central or peripheral nervous system at which the 5HTT genotype acts to modulate the cortisol response.MethodsThis study assesses a relatively large number of subjects homozygous and heterozygous for the rh5HTT short and long alleles (a) during stress; (b) following a dexamethasone suppression test; and (c) following an adrenocorticotropic hormone (ACTH) challenge. Subjects included 190 infant rhesus macaques (Macaca mulatta - 84 males and 106 females; 118 LL, 60 Ls, and 12 ss subjects), obtaining two blood plasma samples during the stress of separation from their mothers. Then on the following day, we obtained a blood sample following a dexamethasone test, and later that day we obtained a blood sample after an ACTH challenge test. Subjects ranged in age between 90 and 128 days, with a mean age of 107 days.ResultsSubjects homozygous for the short allele had significantly higher levels of cortisol across all test conditions, when compared to those homozygous for the long allele, or those heterozygous with Ls alleles. Subsequent analyses showed a high correlation between individual cortisol levels across the three different tests.ConclusionsThese data suggest that subjects homozygous for the short allele are more likely to show dysregulated cortisol levels in response to stress. Given the correlation in individual responses of the HPA axis across the different tests, our data suggest that the effect of the 5HTT genotype shows some commonality in its regulation of stress, feedback, and ACTH-stimulated cortisol output. Our data suggest that under conditions of stress, the serotonin transporter may modulate HPA axis psychopathology.

Project description:BackgroundThere is inconsistency in the literature regarding the nature of hypothalamic-pituitary-adrenal (HPA) axis functionality in post-traumatic stress disorder (PTSD).PurposeThe review aimed to investigate HPA axis functionality via the diurnal profile of cortisol as it relates to PTSD.MethodsThe authors conducted a systematic review of the literature from June 2017 - March 2019 in accordance with The PRISMA Statement in the following four databases: PubMed, MEDLINE, ScienceDirect and PsycINFO with Full Text. The search strategy was limited to articles in English language, published in peer-reviewed journals within the last decade and human studies. Search terms included "post-traumatic stress disorder" OR "PTSD", AND "hypothalamic pituitary adrenal axis" OR "HPA axis" AND "diurnal cortisol" OR "cortisol". PTSD sufferers of all trauma types, genders and socioeconomic statuses were included provided there was a "healthy" control group and an inclusion of reporting on inter-group measurements of diurnal cortisol profiles as a portrayal of HPA axis functionality.ResultsA total of 10 studies met the criteria for inclusion in this review. The association between HPA axis functionality and PTSD was evaluated by the measurement of salivary and/or plasma cortisol concentrations. Only two studies demonstrated an association between PTSD and diurnal cortisol when compared with respective control groups while three studies found no associations. The remaining five studies found partial, mostly negative associations between PTSD and diurnal cortisol.ConclusionDespite some indications of an association between PTSD and dysregulated HPA axis functionality as demonstrated by diurnal cortisol output, the current review has revealed mixed findings. As such, a complete understanding of HPA axis dysregulation as it relates to PTSD remains unestablished. Given the findings, further investigation into the relationship between PTSD trauma-exposed and non-PTSD trauma-exposed individuals and diurnal cortisol is warranted.

Dataset Information

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

Publications

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

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