期刊
JOURNAL OF CLINICAL MEDICINE
卷 10, 期 4, 页码 -出版社
MDPI
DOI: 10.3390/jcm10040576
关键词
chronic stress; parental cancer; functional impairment; cortisol; inflammation; cancer and oncology
资金
- National Institute of Mental Health [R21 MH102437, R01 MH112585]
- Brain and Behavior Research Foundation (NARSAD)
- Clinical Scientist Training Program at the University of Pittsburgh School of Medicine (2017-2019)
- TL1 Predoctoral Training Award - National Institute of Health [5TL1TR001858-04]
Parental cancer is associated with early increase in cortisol levels in offspring, leading to increased functional impairment. Over time, HCC decreased in the stress group, but higher total cortisol output was associated with increased functional impairment.
Purpose: Chronic stress is associated with increased risk for maladaptive psychological responses during childhood, adolescence, and young adulthood. Adults exposed to chronic stress during childhood exhibit dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and inflammation. There are no studies examining the impact of stress on biological stress responses and functional impairment in adolescents and young adults early after the onset of a stressor. Methods: The sample consisted of 59 offspring, aged 11-25 years, 33 of parents diagnosed with cancer and 26 controls from families with no cancer or severe chronic illness in parents or siblings. Cancer patients and their families were recruited within an average of 62 days (SD = 35.9) and followed at 6 and 9 months later. Functional impairment was assessed and hair cortisol concentrations (HCC), salivary cortisol, and inflammatory markers were measured. Mixed regression analyses were conducted. Results: The stress group showed higher functional impairment (beta = -5.5, 95% CI (-10.4, -0.06), p = 0.03, d= -0.40) and HCC (beta = 10.5, 95% CI (-5.5, -0.50), p < 0.001, d = 1.43). However, HCC were reduced over time in the stress group (beta= -0.3, 95% CI (-0.04, -0.01), p < 0.001, d = -1.08). Higher total cortisol output was associated with increased functional impairment over time (beta = -3.0, 95% CI (-5.5, -0.5), p = 0.02, d = -0.60). Conclusions: Parental cancer is associated with early increase in cortisol, which was associated with increased functional impairment in offspring. Clinicians need to assess and monitor psychiatric symptoms and functioning in these offspring early on following parental cancer diagnosis.
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