Adolescents' Daily Worry, Morning Cortisol, and Health Symptoms

Abstract

Purpose To assess short-term effects of daily worries on hypothalamic-pituitary-adrenal (HPA) axis activity and later implications for adolescents’ health symptoms. We hypothesized that heightened worry would be associated with stronger next-morning cortisol awakening response (CAR) to prepare the body for the demands of the upcoming day. Guided by biological adaptation to stress theories, we also hypothesized that dysregulated CAR would heighten associations between worries and later health symptoms, while also testing direct associations between worries and dysregulated CAR and health. Methods Ninety-nine late adolescents during Waves 5 and 6 of a longitudinal study reported on 26 worries for 10 days. On three of the 10 days, participants also provided morning saliva samples that were assayed for cortisol to capture the CAR. At both waves, participants reported on 22 common health symptoms. Results Multilevel models showed significant within-person associations between high daily worries and next-morning heightened CAR for females. Contrary to expectation, worries were inversely related to concurrent health symptoms. For the whole sample, CAR moderated the effect of worries on later health symptoms: Worries were positively associated with health symptoms in adolescents with high CAR and inversely associated with health symptoms for those with low CAR. Conclusions In this sample of typically developing adolescents, worries alone do not increase the risk for common health complaints and may be somewhat protective in the short run. However, high worries in the context of high CAR appear to increase the risk for health symptoms.

Perseverative cognition, distracted communication, and well‐being in everyday social interaction

“…Worry is often defined as negative thinking about future events that might occur (Brosschot & van der Doef, 2006). Worry, like rumination, is assessed in myriad ways (e.g., Likert-type measures, lists of worries; Arbel, Shapiro, Timmons, Moss, & Margolin, 2017;Zoccola et al, 2011). Our worry measure was based on existing perseverative cognition research.…”

Music listening as distraction from everyday worries

“…As seen in Arbel et al (2017), anxiety and worry reduction may lead to better positive health consequences and if music listening can help create soundscapes of well-being, this is what we need to develop in our societies (schools, educational programs & health care institutions) in the future. Prior research supports the connection between music listening in particular and a reduction in anxiety and stress (Nilsson, 2008;Nyklicek, 1997;Khalfa, Bella, Roy, Perets & Lupien, 2003;Richards, 2007) and so we need to better understand how this can be utilized in the most effective manner to target different groups.…”

“…Our daily lives are permeated by worries that vary from passing concerns to those on which we ruminate for hours, and which begin to interfere with everyday tasks. Arbel, Shapiro, Timmons, Moss and Margolin (2017) recently reinstated 'worry' at the forefront of the research agenda, arguing that although it is a commonly experienced phenomenon that can be dismissed by others off-hand, it is in fact 'a complex, multidimensional process involving cognition, affect, and biologically based stress responses' . As part of this argument, the authors point to further research in the field that indicates that although worry can in some ways be benign and play the role of motivating an individual to take action (see also Arbel et al, 2017), in others worry is connected to symptoms of ill health including fatigue, musculoskeletal pain, and gastrointestinal issues (Verkull, Brosschot, Gebhardt & Thayer, 2010), and chronic experiences of worry leading to exacerbated insomnia (McGowan, Behar & Luhmann, 2016;Morin, 1993).…”

“…The picture is, of course, nuanced. For example, in their study of adolescents, Arbel et al (2017) found that worry may also carry with it some protective health effects outside of at-risk groups, although in the longterm they assert that the effects of the cortisol awakening response that anxiety induces may lead to greater negative health consequences. Furthermore, distraction from worry itself has been thought not be desirable in a straightforward sense, and may play a role in maintaining its impact 'in the same way that avoidance slows the extinction of conditioned fear' unless, however, the problems about which the individual concerns themselves are 'insoluble' (Matthews, 1990, p. 457).…”

<p>Occasional acne; an acne variant</p>

“…Bouma et al14 proved that cortisol responses to social stress vary between boys, free-cycling girls and girls on oral contraceptive pills (OCPs). Arbel et al15 proved that worries are associated positively with health symptoms in adolescents with high cortisol awakening response affecting the small endocrine organ of pilosebaceous unit. 16 Nevertheless, DHEAS concentration – as well as cortisol – increases throughout the initial session of (acute stress), then cortisol drops but DHEAS remains sustained over longer time than cortisol after the period of acute stress in rhesus monkeys.…”