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Stress and stress-related health impairments are major problems in human life and elucidating the biological pathways linking stress and disease is of substantial importance. However, the identification of mechanisms underlying a dysregulation of major components of the stress response system is, particularly in humans, a very challenging task. Salivary cortisol responses to diverse acute challenge paradigms show large intra- and interindividual variability. In order to uncover mechanisms mediating stress-related disorders and to potentially develop new therapeutic strategies, an extensive phenotyping of HPA axis stress responses is essential. Such a research agenda depends on substantial knowledge of moderating and intervening variables that affect cortisol responses to different stressors and stimuli. The aim of this report is, therefore, to provide a comprehensive summary of important determinants of, in particular, human salivary cortisol responses to different kinds of laboratory stimuli including acute psychosocial stress as well as pharmacological provocation procedures. This overview demonstrates the role of age and gender, endogenous and exogenous sex steroid levels, pregnancy, lactation and breast-feeding, smoking, coffee and alcohol consumption as well as dietary energy supply in salivary cortisol responses to acute stress. Furthermore, it briefly summarizes current knowledge of the role of genetic factors and methodological issues in terms of habituation to repeated psychosocial stress exposures and time of testing as well as psychological factors, that have been shown to be associated with salivary cortisol responses like early life experiences, social factors, psychological interventions, personality as well as acute subjective-psychological stress responses and finally states of chronic stress and psychopathology.
Despite many articles reporting the problems of dichotomizing continuous measures, researchers still commonly use this practice. The authors' purpose in this article was to understand the reasons that people still dichotomize and to determine whether any of these reasons are valid. They contacted 66 researchers who had published articles using dichotomized variables and obtained their justifications for dichotomization. They also contacted 53 authors of articles published in Psychological Methods and asked them to identify any situations in which they believed dichotomized indicators could perform better. Justifications provided by these two groups fell into three broad categories, which the authors explored both logically and with Monte Carlo simulations. Continuous indicators were superior in the majority of circumstances and never performed substantially worse than the dichotomized indicators, but the simulations did reveal specific situations in which dichotomized indicators performed as well as or better than the original continuous indictors. The authors also considered several justifications for dichotomization that did not lend themselves to simulation, but in each case they found compelling arguments to address these situations using techniques other than dichotomization. (c) 2009 APA, all rights reserved.
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