Gidlow Christopher J, Randall Jason, Gillman Jamie, Silk Steven, Jones Marc V
Centre for Sport, Health and Exercise Research, Staffordshire University, Brindley Building, Leek Road, Stoke-on-Trent, Staffordshire, ST4 2DF, UK.
Clinical Outcome Solutions, Unit 30, Basepoint, Shearway Road, Shearway Business Park, Folkestone, Kent, CT19 4RH, UK.
Psychoneuroendocrinology. 2016 Jan;63:163-9. doi: 10.1016/j.psyneuen.2015.09.022. Epub 2015 Sep 25.
Chronic stress can be important in the pathology of chronic disease. Hair cortisol concentrations (HCC) are proposed to reflect long term cortisol secretion from exposure to stress. To date, inconsistencies in the relationship between HCC and self-reported stress have been attributed to variation and limitations of perceived stress measurement. We report data from employees of two large public sector worksites (n=132). Socio-demographic, health, lifestyle, perceived stress scale (PSS), and work-related effort reward imbalance (ERI) were collected at baseline. Participants were asked to respond to mobile text messages every two days, asking them to report current stress levels (Ecological momentary assessment, EMA), and mean stress was determined overall, during work hours, and out of work hours. At 12 weeks, the appraisal of stressful life events scale (ALES) was completed and 3 cm scalp hair samples were taken, from which HCC was determined (to reflect cortisol secretion over the past 12 weeks). Mean response rate to EMA was 81.9 ± 14.9%. Associations between HCC and the various self-reported stress measures (adjusted for use of hair dye) were weak (all<.3). We observed significant associations with HCC for EMA measured stress responses received out of work hours (ρ=.196, p=.013) and ALES Loss subscale (ρ=.241, p=.003), and two individual items from ERI (relating to future work situation). In regression analysis adjusting for other possible confounders, only the HCC-ALES Loss association remained significant (p=.011). Overall, our study confirms that EMA provides a useful measurement tool that can gather perceived stress measures in real-time. But, there was no relationship between self-reported stress collected in this way, and HCC. The modest association between HCC and stress appraisal does however, provide some evidence for the role of cognitive processes in chronic stress.
慢性应激在慢性疾病的病理过程中可能起重要作用。毛发皮质醇浓度（HCC）被认为可反映长期暴露于应激下的皮质醇分泌情况。迄今为止，HCC与自我报告的应激之间关系的不一致，一直归因于感知应激测量的差异和局限性。我们报告了来自两个大型公共部门工作场所的员工数据（n = 132）。在基线时收集了社会人口统计学、健康、生活方式、感知应激量表（PSS）以及与工作相关的努力回报失衡（ERI）等信息。要求参与者每两天回复手机短信，报告当前的应激水平（生态瞬时评估，EMA），并确定总体、工作时间和非工作时间的平均应激水平。在12周时，完成应激性生活事件量表（ALES）的评估，并采集3厘米头皮毛发样本，从中测定HCC（以反映过去12周的皮质醇分泌情况）。EMA的平均回复率为81.9 ± 14.9%。HCC与各种自我报告的应激测量指标（校正染发剂使用情况）之间的关联较弱（均<0.3）。我们观察到，非工作时间收到的EMA测量的应激反应（ρ = 0.196，p = 0.013）、ALES损失子量表（ρ = 0.241，p = 0.003）以及ERI中的两个单项（与未来工作状况有关）与HCC存在显著关联。在调整其他可能的混杂因素的回归分析中，只有HCC - ALES损失关联仍然显著（p = 0.011）。总体而言，我们的研究证实EMA提供了一种有用的数据收集工具，可实时收集感知应激测量数据。但是，以这种方式收集的自我报告应激与HCC之间没有关系。然而，HCC与应激评估之间的适度关联确实为认知过程在慢性应激中的作用提供了一些证据。
