From allostasis to addiction: Cortisol dysregulation, daily stress and relations with 9-year alcohol and substance use disorder severity in community adults.

Adverse childhood experiences and prospective changes in diurnal cortisol activity during the transition to adolescence: Moderation by daily coping and adolescent sex.

PURPOSE Examining circadian hypothalamic-pituitary-adrenal (HPA) axis activity during adolescence is vital for understanding physiological changes. Limited research explores risk and protective factors for diurnal HPA activity. This study investigates how adverse childhood experiences (ACEs) and coping are associated with changes in diurnal cortisol patterns, using a combination of physiological biomarkers (i.e., salivary cortisol), daily diaries, and longitudinal assessments spanning two years. METHODS The sample included 316 Chinese adolescents (33% females; T1 Mage = 10.79 years, SD = 0.84). At T1, adolescents reported ACEs, completed 7-day diaries on coping, and provided saliva samples for three consecutive days. Two years later (T2), adolescents completed a follow-up assessment on diurnal cortisol activity. Latent change score modeling was conducted to investigate changing patterns in diurnal cortisol and associations of ACEs and coping with the changing patterns. RESULTS From T1 to T2, waking cortisol decreased, CAR increased, and diurnal cortisol slopes became steeper. ACEs were associated with initial levels of diurnal cortisol activity but not changes in it: more ACEs were linked to higher T1 waking cortisol and a smaller T1 CAR. Higher ACEs were also associated with later wake-up times; later wake-up was associated with lower T1 CAR, more blunted T1 diurnal slopes, and flatter diurnal slopes across time. Daily coping (mean and variability) moderated the associations between ACEs and diurnal cortisol. CONCLUSION By observing coping as a moderator between ACEs and cortisol patterns, this study demonstrates that associations between ACEs and diurnal cortisol differ across adolescents' coping use and coping variability.

Serotonin transporter polymorphism (5-HTTLPR) is associated with post-awakening cortisol measures in previous depression

It is suggested that 5-HTTLPR-related differences, when present, may be more detectable in overall post-awakening cortisol output than in baseline-relative increase, which is more detectable in overall post-awakening cortisol output than in baseline-relative increase.

Afternoon salivary cortisol shows no association with same-day state anxiety in community-dwelling older adults during the COVID-19 pandemic

Objectives Older adults experienced measurable psychological burden during the COVID-19 pandemic. Although salivary cortisol is widely used as a biomarker of hypothalamic–pituitary–adrenal axis activity, single time-point basal measurements may show inconsistent associations with anxiety. We examined whether afternoon salivary cortisol was cross-sectionally associated with same-day state anxiety in community-dwelling older adults during the COVID-19 pandemic. Methods Community-dwelling adults aged ≥65 years were recruited between May and November 2021 in rural Japan. Afternoon salivary cortisol (15:00–16:00) was measured using enzyme-linked immunosorbent assay from stored samples. State anxiety was assessed using the State–Trait Anxiety Inventory state scale (STAI-State). Multivariable linear regression models were fitted in the overall sample and in exploratory sex-stratified analyses, adjusting for demographic, psychological, cognitive, and COVID-19–related factors. Results The analyses included 76 participants (mean age 80.8 years; 68% female). The mean (standard deviation) STAI-State score was 40.7 (10.5), and median salivary cortisol was 0.13 μg/dL. In adjusted models, salivary cortisol was not associated with STAI-State score in the overall sample or in exploratory sex-stratified analyses. Effect estimates were close to null. Conclusions In this cohort of community-dwelling older adults in Japan during the COVID-19 pandemic, a single afternoon salivary cortisol measurement was not associated with same-day state anxiety. This null finding should be interpreted in the context of the present study design and measurement approach and does not rule out an association between cortisol and anxiety under other conditions.

Dissociation as a marker of emotion dysregulation: An examination in adolescent psychiatric inpatients using ecological momentary assessment.

BACKGROUND Dissociation is a transdiagnostic symptom and hypothesized to serve as a short-term regulatory mechanism in response to emotional stress. The present study examined the momentary dynamics between dissociation, negative affect, and cortisol in the day-to-day lives of adolescent psychiatric inpatients. METHODS Forty-eight adolescents (mean age: 15.85 years, SD: 1.15, 81% female) were recruited from psychiatric inpatient units. Following a diagnostic baseline assessment, participants completed twelve signal-contingent ecological momentary assessments per day over five consecutive days, each separated by one hour, reporting on dissociation and negative affect. Salivary cortisol was sampled concurrently. Data were analysed using Residual Dynamic Structural Equation Modelling. RESULTS No significant cross-lagged effects between dissociation and negative affect emerged. However, a significant contemporaneous association indicated that these variables co-occurred (st.est. = 0.236, 95%-CI: 0.191-0.280). Neither emotion regulation difficulties, borderline personality disorder nor childhood trauma assessed at baseline significantly moderated the cross-lagged or contemporaneous effects. A small cross-lagged effect of the cortisol × dissociation interaction on negative affect emerged (st.est. = -0.056, 95%CI: -0.081 to -0.028), indicating that higher levels of dissociation in combination with elevated cortisol levels predicted lower subsequent negative affect. DISCUSSION These findings provide partial support for theoretical conceptualization of dissociation as a marker for emotion dysregulation and underscore the need for studies employing combined psychological and biological assessments with higher sample frequencies than a one-hour interval to more precisely capture the short-lived temporal dynamics among dissociation, affect, and endocrine stress responses.

The role of physical activity in shaping the relationship between alcohol use and anxiety and depression symptoms: Findings from a U.S. nationwide cohort

Psychiatric Symptoms and Impulsivity in Patients with Substance Use Disorders: Associations with an Aggregate ASI Interviewer Severity Score

Background and Objectives: Psychiatric symptoms and multidimensional impulsivity may be associated with the clinical and functional heterogeneity of substance use disorders (SUDs), but evidence from Saudi Arabian treatment populations remains limited. This study examined concurrent associations with a study-specific aggregate of Addiction Severity Index (ASI-5) interviewer severity ratings. Materials and Methods: This cross-sectional study included 204 adults receiving inpatient detoxification or residential rehabilitation services in Najran, Saudi Arabia. The seven ASI interviewer ratings were summed as an aggregate score. Psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS), and impulsiveness using the Barratt Impulsiveness Scale-11 (BIS-11). Analyses included age- and sex-adjusted analyses of covariance, false-discovery-rate correction, bootstrap Spearman correlations, an a priori multivariable model with HC3 robust confidence intervals, and sensitivity analyses addressing content overlap, multicollinearity, influential observations, functional form, and the bounded outcome distribution. Results: The mean age was 34.4 ± 7.3 years; 78.9% were male. The aggregate score was 26.33 ± 4.15. It correlated strongly with BPRS total (ρ = 0.874, 95% CI 0.827–0.908) and moderately with BIS-11 total (ρ = 0.590, 95% CI 0.494–0.669). In the primary model (adjusted R2 = 0.864), age, BPRS total, motor impulsiveness, and non-planning impulsiveness were conditional correlates of greater aggregate burden; male sex was inversely associated, and polysubstance use was not. BPRS remained associated after exclusion of the ASI psychiatric domain. Separate impulsivity-domain and BIS-11 total models, 5000-resample bootstrap analysis, median regression, and fractional-logit analysis retained the principal psychiatric and impulsivity directions. The polysubstance coefficient varied across sensitivity models. Conclusions: Psychiatric symptom burden and selected impulsivity dimensions were concurrently associated with higher study-specific aggregate ASI interviewer severity scores. Integrated psychiatric and impulsivity assessment may help characterize patients with greater concurrent multidomain clinical burden; the aggregate score should not be interpreted as a validated global severity or prediction measure.