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Research Projects

Stress in Young People

Note that these studies were conducted as part of the Youth and Health programme which formally ceased at the end of March 2010, although team members have continued to prepare publications in this research area.
 
The concept of ‘stress’ has variously been equated with the causes of stress (as in stressors), subjective feelings (as perception and evaluation of potential harm) and with biological measures, where the focus is on the activation of specific physiological systems.  In the PaLS study, although data were collected on the subjective experience of stress, the principal focus was on biological systems, the most important being the psychoneuroendocrine response (PSR), which among other things involves the release of  the ‘stress hormone’, cortisol.  In addition to responding to stressors, cortisol follows a diurnal rhythm, levels rising sharply after awakening, then declining rapidly over the next few hours followed by a shallow decline over the rest of the day. The first period of (rapid) decline is called ‘morning cortisol’.  Typically, cortisol is elevated by exposure to acute and chronic stressors.

There is now a huge body of research on the PSR, much of it laboratory based, which focuses on reactions to stress.  Much less research has been conducted on community samples and even less on children and young people.  PaLS  was one of the first studies to collect morning cortisol via saliva samples in a naturalistic (school) setting, the results providing normative data for 15 year-olds in the community. 
 
Adjusting for known biological confounds (e.g. time since awakening), examination was made of the relationship between cortisol and social status represented by family socioeconomic status (SES) and school-based subjective status.  The results showed little or no relationship with three measures of SES (parental social class, deprivation and family affluence), thereby complementing the pattern of ‘relative equality’ found for most health measures in youth.  By contrast, cortisol levels were related to three different dimensions of school-based status, termed scholastic (academic), peer (popularity) and sports, but in different ways.  For 'scholastic status', cortisol increased as position decreased, the highest levels occurring among those with the lowest 'scholastic status', suggesting this position is stressful.  For 'peer status', an opposite relationship was found, those at the top having the highest cortisol levels; for males taking the form of a gradual increase with higher position, among females occurring only at the top.  This suggests that seeking and maintaining 'peer status' is stressful.  For 'sports status', the relationship varied by gender; among males, higher cortisol was associated only with the lowest position, among females with all positions except the top. 

Stress is recognised as a major contributor to many, if not all psychiatric disorders, and particularly so in relation to traumatic stress disorder and anxiety and depressive disorders. However, in spite of a large psychiatric literature, findings on the relationship between cortisol and disorders have been inconsistent, partly because of the small and idiosyncratic nature of many studies.  To study this, a sub-sample of 500 PaLS participants completed a computerised psychiatric interview.  With only one exception, there was no relationship between the experience of traumatic events (such as witnessing a death, or being attacked or beaten) and cortisol.  The exception was that cortisol was higher among females who reported being threatened with a weapon, but lower in males, a difference suggesting that the link between antisocial behaviour and cortisol operates differently for each gender. 
 
Further work looking at a broader range of psychiatric diagnoses and symptoms again found little relationship with cortisol, except in relation to gender.  In this case, males with ‘pure’ conduct symptoms had lower cortisol, females with a mixture of conduct and depressive symptoms had higher cortisol.  This suggests that in addition to gender, co-morbidity is an important factor to take into account in understanding the link between cortisol and psychiatric symptoms and disorder.
 

Publications

2012

Young R, Sweeting H, West P. Associations between DSM-IV diagnosis, psychiatric symptoms and morning cortisol levels in a community sample of adolescents. Social Psychiatry and Psychiatric Epidemiology 2012;47:723-733

pubmed  open access  

2011

Sweeting H, West P, Young R, Kelly S. Dimensions of adolescent subjective social status within the school community: description and correlates. Journal of Adolescence 2011;34:493-504

pubmed  open access  

2010

West P, Sweeting H, Young R, Kelly S. The relative importance of family socioeconomic status and school-based peer hierarchies for morning cortisol in youth: an exploratory study. Social Science & Medicine 2010;70:1246-53

pubmed  open access  

Young R. Trauma, attempted suicide and morning cortisol in a community sample of adolescents. Journal of Traumatic Stress 2010;23:288–291

open access  

2008

Kelly S, Young R, Sweeting H, Fischer J, West P. Levels and confounders of morning cortisol collected from adolescents in a naturalistic (school) setting. Psychoneuroendocrinology 2008;33:1257-68

pubmed  open access  

Glossary

  • Cortisol

    Cortisol is a hormone that is involved in the response to stress; it increases blood pressure and blood sugar levels and suppresses the immune system.  Changes in serum cortisol levels have been observed in connection with clinical depression, psychological distress, and such physiological stressors as hypoglycaemia, illness, fever and physical exertion.

  • SES Socio-economic Status
  • Suicidal ideation

    A common medical term for thoughts about suicide which may be as detailed as a formulated plan, without the suicidal act itself.

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