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King AP, Leichtman JN, Abelson JL, et al. Ecological salivary cortisol analysis-- part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels. J Am Psychiatr Nurses Assoc. 2008;14(4):285-96doi: 10.1177/1078390308321939.
King, A. P., Leichtman, J. N., Abelson, J. L., Liberzon, I., & Seng, J. S. (2008). Ecological salivary cortisol analysis-- part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels. Journal of the American Psychiatric Nurses Association, 14(4), 285-96. https://doi.org/10.1177/1078390308321939
King, Anthony P, et al. "Ecological salivary cortisol analysis-- part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels." Journal of the American Psychiatric Nurses Association vol. 14,4 (2008): 285-96. doi: https://doi.org/10.1177/1078390308321939
King AP, Leichtman JN, Abelson JL, Liberzon I, Seng JS. Ecological salivary cortisol analysis-- part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels. J Am Psychiatr Nurses Assoc. 2008 Aug;14(4):285-96. doi: 10.1177/1078390308321939. PMID: 21665772; PMCID: PMC3124079.
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J Am Psychiatr Nurses Assoc. 2008 Aug;14(4):285-96. doi: 10.1177/1078390308321939.

Ecological salivary cortisol analysis-- part 2: relative impact of trauma history, posttraumatic stress, comorbidity, chronic stress, and known confounds on hormone levels.

Journal of the American Psychiatric Nurses Association

Anthony P King, Jennifer N Leichtman, James L Abelson, Israel Liberzon, Julia S Seng

Affiliations

  1. University of Michigan, Ann Arbor.

PMID: 21665772 PMCID: PMC3124079 DOI: 10.1177/1078390308321939

Abstract

BACKGROUND: Although bio-psycho-social health research is an ideal, samples adequate for complex modeling require biomarker specimens from hundreds of participants. Ecological sampling departs from laboratory study norms, with implications for analysis.

OBJECTIVE: To inform ecological study designs, this article compares salivary cortisol levels and effect sizes of "focal" psychiatric factors, such as trauma history, posttraumatic stress diagnosis, comorbidity, and chronic stress, and "nuisance" factors, including endocrine disorders and medications and physiological factors such as gestational age and smoking.

STUDY DESIGN: This is a descriptive analysis of ecologically collected cortisol specimens, assayed in an ongoing perinatal psychobiological study, addressing methodological considerations.

RESULTS: Focal and nuisance factors are often interdependent with similar effect sizes. Careful specimen deletion decisions and model specification are needed to achieve the hoped-for external validity while maintaining internal validity.

CONCLUSIONS: Results of multivariate models lend support to the validity and usefulness of an ecological approach to incorporating biomarkers in health research. J Am Psychiatr Nurses Assoc, 2008; 14(4), 285-296. DOI: 10.1177/1078390308321939.

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