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Assessment of the cortisol awakening response: Expert consensus guidelines.
Psychoneuroendocrinology. 2016 Jan; 63:414-32.P

Abstract

The cortisol awakening response (CAR), the marked increase in cortisol secretion over the first 30-45 min after morning awakening, has been related to a wide range of psychosocial, physical and mental health parameters, making it a key variable for psychoneuroendocrinological research. The CAR is typically assessed from self-collection of saliva samples within the domestic setting. While this confers ecological validity, it lacks direct researcher oversight which can be problematic as the validity of CAR measurement critically relies on participants closely following a timed sampling schedule, beginning with the moment of awakening. Researchers assessing the CAR thus need to take important steps to maximize and monitor saliva sampling accuracy as well as consider a range of other relevant methodological factors. To promote best practice of future research in this field, the International Society of Psychoneuroendocrinology initiated an expert panel charged with (i) summarizing relevant evidence and collective experience on methodological factors affecting CAR assessment and (ii) formulating clear consensus guidelines for future research. The present report summarizes the results of this undertaking. Consensus guidelines are presented on central aspects of CAR assessment, including objective control of sampling accuracy/adherence, participant instructions, covariate accounting, sampling protocols, quantification strategies as well as reporting and interpreting of CAR data. Meeting these methodological standards in future research will create more powerful research designs, thus yielding more reliable and reproducible results and helping to further advance understanding in this evolving field of research.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Stalder T
Department of Psychology, TU Dresden, Dresden, Germany. Electronic address: tobias.stalder@tu-dresden.de.
Kirschbaum C
Department of Psychology, TU Dresden, Dresden, Germany.
Kudielka BM
Department of Psychology, University of Regensburg, Regensburg, Germany.
Adam EK
School of Education and Social Policy, Northwestern University, Evanston, USA.
Pruessner JC
Department of Psychiatry, McGill University, Montreal, Canada.
Wüst S
Department of Psychology, University of Regensburg, Regensburg, Germany.
Dockray S
School of Applied Psychology, University College Cork, Cork, Ireland.
Smyth N
Department of Psychology, University of Westminster, London, UK.
Evans P
Department of Psychology, University of Westminster, London, UK.
Hellhammer DH
Department of Psychology, Trier University, and Stresszentrum Trier, Germany.
Miller R
Department of Psychology, TU Dresden, Dresden, Germany.
Wetherell MA
Department of Psychology, Northumbria University, Newcastle, UK.
Lupien SJ
Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada.
Clow A
Department of Psychology, University of Westminster, London, UK.

MeSH

Circadian RhythmConsensusDiagnostic Techniques, EndocrineExpert TestimonyHumansHydrocortisonePractice Guidelines as TopicPredictive Value of TestsReproducibility of ResultsSalivaSpecimen HandlingWakefulness

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26563991

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Citation

Stalder, Tobias, et al. "Assessment of the Cortisol Awakening Response: Expert Consensus Guidelines." Psychoneuroendocrinology, vol. 63, 2016, pp. 414-32.
Stalder T, Kirschbaum C, Kudielka BM, et al. Assessment of the cortisol awakening response: Expert consensus guidelines. Psychoneuroendocrinology. 2016;63:414-32.
Stalder, T., Kirschbaum, C., Kudielka, B. M., Adam, E. K., Pruessner, J. C., Wüst, S., Dockray, S., Smyth, N., Evans, P., Hellhammer, D. H., Miller, R., Wetherell, M. A., Lupien, S. J., & Clow, A. (2016). Assessment of the cortisol awakening response: Expert consensus guidelines. Psychoneuroendocrinology, 63, 414-32. https://doi.org/10.1016/j.psyneuen.2015.10.010
Stalder T, et al. Assessment of the Cortisol Awakening Response: Expert Consensus Guidelines. Psychoneuroendocrinology. 2016;63:414-32. PubMed PMID: 26563991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of the cortisol awakening response: Expert consensus guidelines. AU - Stalder,Tobias, AU - Kirschbaum,Clemens, AU - Kudielka,Brigitte M, AU - Adam,Emma K, AU - Pruessner,Jens C, AU - Wüst,Stefan, AU - Dockray,Samantha, AU - Smyth,Nina, AU - Evans,Phil, AU - Hellhammer,Dirk H, AU - Miller,Robert, AU - Wetherell,Mark A, AU - Lupien,Sonia J, AU - Clow,Angela, Y1 - 2015/10/20/ PY - 2015/10/12/received PY - 2015/10/16/revised PY - 2015/10/16/accepted PY - 2015/11/14/entrez PY - 2015/11/14/pubmed PY - 2016/12/30/medline KW - Adherence KW - CAR KW - Covariates KW - Guidelines KW - Measurement KW - Saliva SP - 414 EP - 32 JF - Psychoneuroendocrinology JO - Psychoneuroendocrinology VL - 63 N2 - The cortisol awakening response (CAR), the marked increase in cortisol secretion over the first 30-45 min after morning awakening, has been related to a wide range of psychosocial, physical and mental health parameters, making it a key variable for psychoneuroendocrinological research. The CAR is typically assessed from self-collection of saliva samples within the domestic setting. While this confers ecological validity, it lacks direct researcher oversight which can be problematic as the validity of CAR measurement critically relies on participants closely following a timed sampling schedule, beginning with the moment of awakening. Researchers assessing the CAR thus need to take important steps to maximize and monitor saliva sampling accuracy as well as consider a range of other relevant methodological factors. To promote best practice of future research in this field, the International Society of Psychoneuroendocrinology initiated an expert panel charged with (i) summarizing relevant evidence and collective experience on methodological factors affecting CAR assessment and (ii) formulating clear consensus guidelines for future research. The present report summarizes the results of this undertaking. Consensus guidelines are presented on central aspects of CAR assessment, including objective control of sampling accuracy/adherence, participant instructions, covariate accounting, sampling protocols, quantification strategies as well as reporting and interpreting of CAR data. Meeting these methodological standards in future research will create more powerful research designs, thus yielding more reliable and reproducible results and helping to further advance understanding in this evolving field of research. SN - 1873-3360 UR - https://www.unboundmedicine.com/medline/citation/26563991/Assessment_of_the_cortisol_awakening_response:_Expert_consensus_guidelines_ DB - PRIME DP - Unbound Medicine ER -