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Introduction: Stress is one of the most common trigger factors for epileptic seizures and is strongly related to clinical and emotional variables. Despite its influence in the course of the disease, there is an absence of instruments for measuring perceived stress in people with drug-resistant epilepsy. Therefore, this study develops and validates the Epilepsy Perceived Stress Inventory for Adults (EPSI-A), a self-report inventory in Spanish designed to quantify perceived chronic stress in this population., Method: The sample consisted of 236 patients with drug-resistant epilepsy who underwent a neuropsychological assessment in which anxiety, depression, and quality of life were explored. In addition, from 125 patients in the sample, 9 measures of salivary cortisol were collected during the evaluation., Results: The EPSI-A consisted of 15 items, with higher scores indicating higher perceived stress. The exploratory factor analysis showed a four-factor solution: epilepsy concerns (5 items); impact on daily performance (4 items); social consequences (3 items); and epilepsy severity (3 items). These factors explained 63.3 % of the total variance. Internal consistency reliability measured with McDonald's omega and Cronbach's alpha coefficients was satisfactory, with values ≥ 0.78 (except for epilepsy severity with values of 0.59 and 0.58, respectively). Construct validity was demonstrated by its correlation with several psychological scales and clinical variables., Conclusions: The results showed that the EPSI-A is a reliable and valid tool for assessing perceived chronic stress in people with epilepsy. Its conciseness, rapid administration time, and specificity make it an appropriate instrument for this population., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Drug-resistant epilepsy usually requires the use of polytherapy with antiseizure medications (ASMs) for management, which could involve side and adverse effects that may impact quality of life (QOL). This systematic review summarizes the evidence about the relationship between ASM polytherapy and QOL in epilepsy patients, considering clinical, sociodemographic, and psychological variables., Method: This review followed the PRISMA guidelines and was registered in PROSPERO. The studies examined were collected from PubMed/MEDLINE, Scopus, Web of Science, and Embase. The data extracted were categorized into three categories: therelationship between the number of ASMs and QOL, differences in QOL between patients taking polytherapy and patients taking monotherapy, and therole of other variables on QOL., Results: The review included 34 studies. Thirty examined the relationship between the number of ASMs and QOL, 93.3% of them identifying a significant association between a higher number of ASMs and poorer QOL. Fifteen studies analyzed differences in QOL between patients receiving polytherapy and those on monotherapy, all of them showing poorer QOL in those on polytherapy. Thirty-two studies considered other factors beyond polytherapy as determinants of QOL, including clinical, sociodemographic, and psychological variables, and higher seizure frequency and mood comorbidities (depression and anxiety) emerged as the strongest predictors of poor QOL., Conclusions: Polytherapy, despite being necessary for managing drug-resistant epilepsy, significantly contributes to impairing QOL. Effective seizure control remains critical, but a multifactorial approach addressing mental health and social determinants is essential for improving QOL in epilepsy patients. Future research should focus on optimizing treatment strategies that balance seizure control by minimizing the negative impact of polytherapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Drug-resistant temporal lobe epilepsy (TLE) is a neurological disorder characterized by cognitive deficits. This study examined whether patients with TLE and different cognitive phenotypes differ in cortisol levels and affectivity while controlling for demographic and clinical variables. Method s : In this cross-sectional study, 79 adults with TLE underwent neuropsychological evaluation in which memory, language, attention/processing speed, executive function, and affectivity were assessed. Six saliva samples were collected in the afternoon to examine the ability of the hypothalamic-pituitary-adrenal (HPA) axis to descend according to the circadian rhythm (C1 to C6). The cortisol area under the curve concerning ground (AUC g ) was computed to examine global cortisol secretion., Results: Three cognitive phenotypes were identified: memory impairment, generalized impairment, and no impairment. The memory-impairment phenotype showed higher cortisol levels at C4, C5, and C6 than the other groups ( p  = 0.03, η 2 = 0.06), higher cortisol AUC g than the generalized-impairment phenotype ( p  = 0.004, η 2 = 0.14), and a significant reduction in positive affectivity after the evaluation ( p  = 0.026, η 2 = 0.11). Higher cortisol AUC g and reductions in positive affectivity were significant predictors of the memory-impairment phenotype ( p  < 0.001; Cox and Snell R 2 = 0.47)., Conclusions: Patients with memory impairment had a slower decline in cortisol levels in the afternoon, which could be interpreted as an inability of the HPA axis to inhibit itself. Thus, chronic stress may influence hippocampus-dependent cognitive function more than other cognitive functions in patients with TLE.

Purpose: To assess whether performance in attention and executive functions evaluated with the Epitrack screening tool before surgery can differentiate memory and quality of life (QOL) profiles, and detect different post-surgical change patterns in these variables in patients with epilepsy., Methods: This is a longitudinal study. Seventy-seven patients with drug-resistant epilepsy (mean age = 37.91) underwent a neuropsychological assessment before and one year after surgery. Epitrack, a screening tool that exclusively evaluates attention and executive functioning, was administered in the pre-surgical assessment, and verbal and visual memory and QOL were assessed before and after surgery., Results: Patients with impaired Epitrack performance had poorer verbal and visual memory than those with intact Epitrack performance, regardless of the time point (for all, p  < 0.0001). They also showed a post-surgical decline in immediate verbal recall ( p  = 0.04) and discriminability ( p  = 0.001). Patients with intact Epitrack performance did not exhibit this decline. Epitrack total score significantly contributed to 13 and 11% of the variance of post-surgical changes in immediate verbal recall and discriminability, respectively. Epitrack groups did not differ in QOL profiles or changes, but post-surgical immediate verbal recall improvements were related to post-surgical QOL improvements., Conclusion: Our findings underline the utility of Epitrack screening tool to detect different patterns of verbal and visual memory dysfunction, as well as to predict post-surgical verbal memory decline in patients with drug-resistant epilepsy. Patients with lower pre-surgical Epitrack scores appear to be at increased risk for post-surgical memory decline.

Objective: The aim was to examine the effect of polytherapy (i.e., the number of administered anti-seizure medications (ASMs)) on memory, and whether the interaction between the number of ASMs and attentional/executive functioning affect presurgical memory functioning and postsurgical memory changes in patients with drug-resistant epilepsy., Methods: Two studies were carried out. Study 1 consisted of a presurgical assessment of 125 adult patients, in which attention/executive function (EpiTrack screening tool) and memory were assessed (cross-sectional study). Of them, 72 patients underwent a second postsurgical evaluation, in which memory was assessed (Study 2). Patients were distributed into groups based on EpiTrack performance and number of ASMs., Results: The interaction between the number of ASMs and the attentional/executive functioning significantly affected presurgical memory, with patients with impaired EpiTrack performance taking three-four ASMs having poorer scores than patients with intact EpiTrack performance taking three-four ASMs (for all, p < .0001). This interaction also affected postsurgical memory changes, with patients with impaired Epitrack performance taking three-four ASMs having higher postsurgical decline than those with intact Epitrack performance taking three-four ASMs (for all, p < .005). No differences were found in patients taking two ASMs. Furthermore, the number of ASMs was associated with presurgical memory performance and postsurgical memory changes only in patients with impaired EpiTrack performance (for all, p < .05)., Conclusions: Our findings underline the utility of EpiTrack, together with the clinical information on the number of prescribed ASMs, to corroborate the impact of polytherapy on memory and to optimize the prediction of postsurgical memory changes., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Cenobamate is a recently approved antiseizure medication that proved to be safe and effective in randomized controlled trials. However, little is known about its impact on some areas frequently affected by epilepsy. For this reason, we explored the effects of cenobamate on cognitive performance, as well as on negative affectivity and quality of life in a sample of patients with drug-resistant epilepsy., Methods: Two prospective cohort studies were carried out. In Study 1, 32 patients (22 men and 10 women) underwent a baseline (T0) and a short-term (T1) neuropsychological assessment after 3 months of cenobamate administration. In Study 2, 22 patients (16 men and 6 women) from the T1 sample also underwent a baseline and a follow-up evaluation (T2) 6 months after T0., Results: No significant differences were found in cognitive variables, negative affectivity, and quality of life either in Study 1 or Study 2. Similarly, based on the reliable change index, it was found that most patients showed no changes in these variables., Significance: These results suggest that cenobamate is a safe antiseizure medication in terms of cognition, negative affectivity, or quality of life since no adverse events have been found after 3 and 6 months of treatment., Plain Language Summary: Cenobamate is a new antiseizure medication. In patients with epilepsy, cenobamate seems to not affect cognition, anxiety, depression, or quality of life., (© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Introduction: Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life., Methods: 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration., Results: Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life., Discussion: These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Catalán-Aguilar, González-Bono, Lozano-García, Tormos-Pons, Hampel, Villanueva and Cano-López.)

Purpose: Memory deficits are very frequent in patients with drug-resistant epilepsy, but they predict a small proportion of variance of their quality of life (QOL) in previous studies, possibly due to the lack of consideration of mediating factors of this relationship. This study aimed to examine whether trait anxiety mediates the relationship between memory and QOL in this population, controlling the influence of demographic and seizure-related factors., Methods: In this cross-sectional study, 119 adults with drug-resistant temporal lobe epilepsy (TLE) underwent a neuropsychological evaluation, in which memory, anxiety, and QOL were assessed., Results: In the total sample, better delayed memory had an effect on better QOL indirectly through lower trait anxiety (B = 0.13, SE = 0.06, p = 0.04, ab cs  = 0.13; κ 2  = 0.18; PM ind  = 0.76). Additionally, delayed memory has not a direct association with QOL (B = 0.04, SE = 0.09, p = 0.64, Cohen's f  2  = 0.005; PM dir  = 0.24), and the total effect of delayed memory on QOL tended to reach statistical significance (B = 0.17, SE = 0.10, p = 0.08). The proposed mediation model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, SRMR = 0.009, and χ 2 (1) = 0.50, p = 0.48) and explained 38% of the variance of QOL., Conclusion: These findings suggest that trait anxiety is an important factor in understanding the relationship between memory and QOL in patients with TLE, considering the influence of demographic and seizure-related variables, and may have relevant implications for decision-making in this population., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction: Academic and employment insertion is one of the issues that most concern people with epilepsy, but little is known about its relationship with quality of life., Aim: We aimed to analyze the effects of the academic and employment insertion on quality of life, anxiety, depression, social support, and executive functions, and the relationships among these variables in patients with drug-resistant epilepsy., Patients and Methods: Fifty-nine patients with drug-resistant temporal lobe epilepsy were classified into two groups: with academic or employment insertion (n = 25) and without insertion (n = 34) and underwent a neuropsychological evaluation., Results: Patients with insertion had a significantly better quality of life, lower trait anxiety, and higher social support, and tended to have a lower percentage of errors and higher percent conceptual level responses than those without insertion. Academic/employment insertion had indirect effects on quality of life through its relationship with global social support and trait anxiety., Conclusions: Our findings provide a model for understanding the quality of life in patients with temporal lobe epilepsy for an integral perspective of the patient and points out the key role of increased social support and reduced anxiety associated with academic and employment insertion to improve quality of life. These results could favor the implementation of programs that promote academic or employment reinsertion, considering the relevance of socio-emotional domains.

Background: Anti-seizure medications (ASMs) have been related to poor cognitive function, but their relationship with intracarotid amobarbital procedure (IAP) results remains unclear., Aims of the Study: To elucidate whether the number and drug load of ASMs are associated with memory scores of the IAP and the neuropsychological assessment., Methods: Fifty-nine adult patients with drug-resistant epilepsy (mean age = 36.1, SD = 11.6) underwent bilateral IAP (with drawings and words as memory items) and a neuropsychological assessment to assess the risk of post-surgical memory decline. Total ASM drug load was calculated by summing the daily dose/defined daily dose ratio of every ASM of each patient. Pearson's correlations and hierarchical regressions were computed., Results: Total IAP memory score was associated with total ASM drug load (r = -0.30, p = 0.02) and seizure frequency (r = -0.25, p = 0.05). After controlling clinical variables, total ASM drug load explained 16% of the variance of total IAP memory score. This relationship was especially prominent in patients with left hemisphere focus (r = -0.33, p = 0.04). The number of current ASMs was not related to IAP memory score (r = -0.16, p = 0.24). The number or drug load of ASMs were not related to neuropsychological assessment results (for all, p > 0.07)., Conclusions: Our findings suggest that total drug load can be a confounding variable in the IAP memory performance that could explain, at least in part, the reverse asymmetries reported in different studies., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Temporal lobe epilepsy (TLE) surgery is an effective procedure that produces cognitive changes. Factors modulating such changes have been proposed, but the influence of cognitive reserve remains unclear., Objective: To examine the effect of intellectual quotient (IQ) on postsurgical changes in verbal fluency, naming, and verbal and visual memory in a sample of patients with TLE., Patients and Methods: 64 adult patients with drug-resistant TLE (mean age ± SD: 39.16 ± 11.67) underwent a neuropsychological evaluation before and one year after surgery., Results: Patients with high IQ showed better immediate visual memory before surgery than those with medium IQ, as well as an absence of postsurgical changes. Patients with high manipulative IQ had better naming before surgery than those with medium manipulative IQ, as well as a significant postsurgical worsening. Both before and after surgery, patients with high IQ showed better phonemic and semantic verbal fluency and short- and long-term verbal memory than those with medium IQ., Conclusions: IQ is a relevant factor in the evolution of immediate visual memory and naming after surgery in patients with TLE. Surgery does not impact on the advantage of high IQ patients in verbal fluency and verbal memory, suggesting that cognitive reserve has a positive effect on cognitive function, even after TLE surgery.

Objectives: To assess whether cognitive performance predicts quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy (TLE), using the Epitrack cognitive screening tool, while considering the mediating role of the number of anti-seizure medications (ASMs) and controlling for seizure-related, social, and emotional factors., Methods: Seventy-five adult patients with drug-resistant TLE (mean age = 39.76 years, SD = 11.66) underwent a presurgical neuropsychological assessment., Main Outcome Measures: Cognitive performance (Epitrack), depression (BDI-II), trait anxiety (STAI); and QOL (QOLIE-31) were assessed., Results: Adjusting for seizure-related, social, and emotional factors, the Epitrack total score significantly contributed to QOL composite score, and energy and cognitive self-rating subscales. We found a significant indirect effect of the Epitrack total score on QOL composite score and seizure worry and social functioning subscales via the number of ASMs., Conclusion: Our findings underline the relevance of cognitive functioning on QOL and the clinical utility of Epitrack to track cognitive side effects of ASMs and, consequently, to predict and manage QOL in this population., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Stress has been suggested as a trigger factor for seizures in epilepsy patients, but little is known about cortisol levels, as indicators of stress, in adults with epilepsy. This systematic review summarizes the evidence on this topic. Following PRISMA guidelines, 38 articles were selected: 14 analyzing basal cortisol levels, eight examining antiepileptic drugs (AEDs) effects, 13 focused on seizure effects, and three examining stress. Higher basal cortisol levels were found in patients than in healthy people in studies with the most homogeneous samples (45% of 38 total studies). Despite heterogeneous results associated with AEDs, seizures were related to increases in cortisol levels in 77% of 38 total studies. The only study with acute stress administration found higher cortisol reactivity in epilepsy than in healthy controls. In studies using self-reported stress, high seizure frequency was related to increased cortisol levels and lower functional brain connectivity. Findings suggest that epilepsy could be considered a chronic stress model. The potential sensitizing role of accumulative seizures and issues for future research are discussed., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

People with drug-resistant epilepsy are exposed to unpredictable and uncontrollable seizures, which can be considered as a chronic stress condition. Additionally, these patients present memory deficits and a high prevalence of depression and anxiety. Cortisol, the main stress hormone, has a modulatory role on memory in healthy individuals and patients with emotional disorders, but its role in memory and emotional processes remains unclear in people with epilepsy. This study analyzes the differences in cortisol levels in people with epilepsy with high and low memory performance, and the relationships among cortisol levels, epilepsy-related factors, memory, anxiety, and depression. Fifty-two adults with drug-resistant epilepsy underwent a neuropsychological evaluation, in which nine saliva samples were collected to analyze the ability of the hypothalamic-pituitary-adrenal axis to descend in accordance with the circadian rhythm. Cortisol area under the curve (AUC) was computed to study the global cortisol changes. Patients with low immediate and delayed memory performance and left-hemisphere focus showed higher cortisol levels. Additionally, patients with low memory scores had higher cortisol AUC, and therefore slower declining levels in the afternoon. Memory performance was negatively related to the cortisol AUC and trait anxiety, being both reliable predictors of memory performance, especially in patients with left-hemisphere focus. These results suggest that memory deficits in people with drug-resistant epilepsy may be influenced by exposure to cortisol derived from chronic stress. Additionally, trait anxiety could contribute to increasing the vulnerability to stress., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: To investigate the relative contribution of factors non-directly related to seizures such as negative affectivity, social support, somatic symptoms and memory performance on quality of life (QOL) in patients with drug-resistant epilepsy., Methods: This is a cross-sectional study. Seventy patients with drug-resistant epilepsy were consecutively recruited from the inpatient Epilepsy Unit, Hospital Universitario y Politécnico La Fe, between April 2015 and October 2017. Medical history provided demographic characteristics of the patients (sex, age, and educational level), and clinical data (age at epilepsy onset, duration of epilepsy in years, frequency of seizures per month, type of seizures and number of AEDs). Pre-surgical assessment included diagnosis of the type of epilepsy and the lateralization of the epileptogenic area. All the patients underwent a neuropsychological assessment in which QOL (QOLIE-31), negative affectivity, social support, somatic symptoms, and memory were evaluated., Results: Negative affectivity (including anxiety-trait and depression), social support, neurosensory symptoms, and long-term verbal memory were significantly related to QOL composite score (for all, p < .009), subscales of QOL showing different sensitivities to them. Even after controlling for negative affectivity, neurosensory symptoms and long-term verbal memory significantly contribute to QOL composite score (p = .0001)., Conclusion: Results suggest that clinical management of patients with drug-resistant epilepsy should consider the treatment of verbal memory impairments at an early stage. Recognition of negative affectivity, poor social support and high somatic symptoms would also lead health professionals to develop different strategies to improve the QOL of patients with drug-resistant epilepsy., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Introduction: Stimulation-evoked focal to bilateral tonic-clonic seizure (FBTCS) can be a stressful and possibly harmful adverse event for patients during cortical stimulation (CS). We evaluated if drug load reduction of antiepileptic drugs (AEDs) during CS increases the risk of stimulation-evoked FBTCS., Material and Methods: In this retrospective cohort study, we searched our local database for patients with drug-resistant epilepsy who underwent invasive video-EEG monitoring and CS in the University Hospital la Fe Valencia from January 2006 to November 2016. The AED drug load was calculated with the defined daily dose. We applied a uni- and multivariate logistic regression model to estimate the risk of stimulation-evoked FBTCS and evaluate possible influencing factors. Furthermore, we compared patients whose AEDs were completely withdrawn with those whose AEDs were not., Results: Fifty-eight patients met the inclusion criteria and were included in the analysis. Stimulating 3806 electrode contact pairs, 152 seizures were evoked in 28 patients (48.3%). Ten seizures (6.6%) in seven patients (12.1%) evolved to FBTCS. In the univariate and multivariate analysis, a 10% reduction in drug load was associated with an increase of the odds ratio (OR) of stimulation-evoked FBTCS by 1.9 (95%-CI 1.2, 4.0, p-value=0.04) and 1.9 (95%-CI 1.2, 4.6, p-value=0.04), respectively. In patients, whose AEDs were completely withdrawn the OR of FBTCS increased by 9.1 (95%CI 1.7, 69.9, p-value=0.01) compared with patients whose AEDs were not completely withdrawn. No other factor (implantation type, maximum stimulus intensity, number of stimulated contacts, history of FBTCS, age, gender, or epilepsy type) appears to have a significant effect on the risk of stimulation-evoked FBTCS., Conclusions: The overall risk of stimulation-evoked FBTCS during CS is relatively low. However, a stronger reduction and, especially, a complete withdrawal of AEDs are associated with an increased risk of stimulation-evoked FBTCS., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Chronic exposure to seizures in patients with left hemisphere (LH) epileptic focus could favor higher activation in the contralateral hemisphere during language processing, but the cognitive effects of this remain unclear. This study assesses the relationship between asymmetry in hemispheric activation during language fMRI and performance in verbal and non-verbal tasks. Whereas prior studies primarily used fMRI paradigms that favor frontal lobe activation and less prominent activation of the medial or superior temporal lobes, we used a verbal comprehension paradigm previously demonstrated to activate reliably receptive language areas. Forty-seven patients with drug-resistant epilepsy candidates for surgery underwent a multidisciplinary assessment, including a comprehensive neuropsychological evaluation and an fMRI verbal comprehension paradigm. Patients were distributed in two groups depending on laterality indexes (LI): typical hemispheric asymmetry (unilateral left activation preponderance; n = 23) and atypical hemispheric asymmetry (bilateral or unilateral right preponderance; n = 24). Right-handedness and right hemisphere (RH) focus were significant predictors of typical asymmetry. Patients with typical activation pattern presented better performance intelligence quotient and verbal learning than patients with atypical hemispheric asymmetry (for all, p < 0.014). Patients with LH focus had more frequently atypical hemispheric asymmetry than patients with RH focus (p = 0.05). Specifically, they showed lower LI and this was related to worse performance in verbal and non-verbal tasks. In conclusion, an increased activation of homologous RH areas for verbal comprehension processing could imply a competition of cognitive resources in the performance of the same task, disrupting cognitive performance., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: People with autism spectrum disorders (ASD) often have comorbid ADHD symptoms. ASD and ADHD are both associated with high intrauterine testosterone (T) levels. This study aims to investigate whether masculinization predicts inattention symptoms in parents, and in their ASD-affected offspring., Method: The sample consisted of 32 parents with ASD-affected children (13 male, 19 female) and 32 offspring individuals (28 male, 4 female). Masculinization of parents was measured by 2D:4D finger ratio, and current T levels. Inattention in both parents and in their offspring was measured with behavior questionnaires., Results: The results indicated that masculinized 2D:4D explains inattentive ADHD symptoms in ASD parents and in their offspring. These predictions are mediated by T and inattention symptoms of ASD parents, respectively., Conclusion: These findings suggest the existence of a masculinized endophenotype in ASD parents, which may be characterized by high attentional sensitivity to T effects.

A contribution to a special issue on Hormones and Human Competition. Psychoneuroendocrine effects of competition have been widely accepted as a clear example of the relationship between androgens and aggressive/dominant behavior in humans. However, results about the effects of competitive outcomes are quite heterogeneous, suggesting that personal and contextual factors play a moderating role in this relationship. To further explore these dimensions, we aimed to examine (i) the effect of competition and its outcome on the psychobiological response to a laboratory competition in young men, and (ii) the moderating role of some cognitive dimensions such as causal attributions. To do so, we compared the responses of 56 healthy young men faced with two competitive tasks with different instructions. Twenty-eight men carried out a task whose instructions led subjects to think the outcome was due to their personal performance ("merit" task), whereas 28 other men faced a task whose outcome was attributable to luck ("chance" task). In both cases, outcome was manipulated by the experimenter. Salivary steroid hormones (testosterone and cortisol), cardiovascular variables (heart rate and blood pressure), and emotional state (mood and anxiety) were measured at different moments before, during and after both tasks. Our results did not support the "winner-loser effect" because no significant differences were found in the responses of winners and losers. However, significantly higher values on the testosterone and cardiovascular variables, along with slight decreases in positive mood, were associated with the merit-based competition, but not the chance-based condition. In addition, an exploratory factorial analysis grouped the response components into two patterns traditionally related to more active or more passive behaviors. Thus, our results suggest that the perception of contributing to the outcome is relevant in the psychobiological response to competition in men. Overall, our results reveal the importance of the appraisal of control and causal attribution in understanding human competitive interactions., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Temporal lobe epilepsy (TLE) surgery is an effective procedure that can produce cognitive changes. However, the prognostic factors related with cognitive outcomes need to be better understood. The aim of the present study is to know if age at surgery is a reliable predictor of verbal memory competence and considering factors such as: hemisphere; type of surgery; pre-surgical seizure frequency; and epilepsy duration. Sixty-one typically dominant patients with drug-resistant TLE (34 with left TLE [L-TLE] and 27 with right TLE [R-TLE]) underwent a neuropsychological assessment before and a year after surgery. Results showed that R-TLE patients had better evolution in short- and long-term verbal memory and naming than L-TLE patients (for all, p >.04). L-TLE patients also more frequently showed a strong and reliable decline in these functions than R-TLE patients. No effects for gender or type of surgery were found. From a multivariate approach, patients with improvements in verbal competence underwent surgery at earlier ages and suffered epilepsy for less time (for all, p <0.4). The relevance of age at surgery was confirmed as a predictor of long-term verbal memory changes, although the frequency of partial seizures also explains, at least partially, these changes. In addition, the frequency of partial seizures explains short-term verbal memory changes. These results emphasize the importance of early intervention, independently of the resected hemisphere, in order to minimize the cognitive side-effects of epilepsy treatment, as well the need to consider cognitive functions as related processes and network dependent., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Negative affect (NA) and chronic stress are separately associated with health imbalances, and the interaction between the two aspects remains unclear. Care of relatives with long-term pathologies could be a likely model in the study of this issue, as caregivers frequently report chronic stress and health complaints. The aim of this study is examine the role of NA on psychophysiological stress-induced response and health in schizophrenia caregivers., Method: Forty-one caregivers were distributed into two groups accordingly to their scores in NA. Thirteen non-caregivers were included as a control group. Participants were exposed to a repeated acute psychosocial stress while salivary cortisol, immunoglobulin A (IgA), and skin conductance level (SCL) were measured before, during, and after stress. Mood, state-anxiety, care conditions and perceived general health were also assessed., Results: Caregivers with higher NA reported negative perceptions, worse health, and greater decreases in cortisol and IgA response than caregivers with low NA and than non-caregivers., Conclusions: NA could reduce the capability to develop adaptive psychophysiological stress responses. From a preventive view, the evaluation of NA could be useful to detect and assist high-risk individuals in potentially chronically stressed populations.

Acute stress and decision making (DM) interact in life - although little is known about the role of ambiguity and risk in this interaction. The aim of this study is to clarify the effect of acute stress on DM under various conditions. Thirty-one young healthy men were randomly distributed into two groups: experimental and control. DM processes were evaluated before and after an experimental session. For the experimental group, the session consisted of an acute stress battery; and the protocol was similar for the control group but the instructions were designed to minimize acute stress. Cardiovascular variables were continuously recorded 30 minutes before the DM tasks and during the experimental session. Cortisol, glucose, mood responses, and personality factors were also assessed. Acute stress was found to enhance disadvantageous decisions under ambiguous conditions (F(1, 29) = 4.16, p = .05, η2 p = .13), and this was mainly explained by the stress induced cortisol response (26.1% of variance, F(1, 30) = 11.59, p = .002). While there were no significant effects under risky conditions, inhibition responses differed between groups (F(1, 29) = 4.21, p = .05, η2 p = .13) and these differences were explained by cardiovascular and psychological responses (39.1% of variance, F(3, 30) = 7.42, p < .001). Results suggest that DM tasks could compete with cognitive resources after acute stress and could have implications for intervention in acute stress effects on DM in contexts such as addiction or eating disorders.

Caring for offspring diagnosed with a chronic psychological disorder such as autism spectrum disorder (ASD) is used in research as a model of chronic stress. This chronic stress has been reported to have deleterious effects on caregivers' cognition, particularly in verbal declarative memory. Moreover, such cognitive decline may be mediated by testosterone (T) levels and negative affect, understood as depressive mood together with high anxiety and anger. This study aimed to compare declarative memory function in middle-aged women who were caregivers for individuals with ASD (n = 24; mean age = 45) and female controls (n = 22; mean age = 45), using a standardised memory test (Rey's Auditory Verbal Learning Test). It also sought to examine the role of care recipient characteristics, negative mood and T levels in memory impairments. ASD caregivers were highly sensitive to proactive interference and verbal forgetting. In addition, they had higher negative affect and T levels, both of which have been associated with poorer verbal memory performance. Moreover, the number of years of caregiving affected memory performance and negative affect, especially, in terms of anger feelings. On the other hand, T levels in caregivers had a curvilinear relationship with verbal memory performance; that is, increases in T were associated with improvements in verbal memory performance up to a certain point, but subsequently, memory performance decreased with increasing T. Chronic stress may produce disturbances in mood and hormonal levels, which in turn might increase the likelihood of developing declarative memory impairments although caregivers do not show a generalised decline in memory. These findings should be taken into account for understanding the impact of cognitive impairments on the ability to provide optimal caregiving.

Several studies have found disruptions in cortisol awakening response in informal caregivers. Institutional support may modulate these effects, and this study analyses how the health of caregivers is affected when institutional support is provided for families of people with high-functioning autism. Self-reported health, depression and cortisol awakening response were analysed in three groups: supported caregivers, non-supported caregivers and non-caregivers. Non-supported caregivers presented higher somatic symptoms and lower cortisol awakening response than the supported caregiver and non-caregiver groups. A high number of somatic symptoms and low functionality of offspring were related to a lower cortisol awakening response only in the non-supported caregiver group. These findings demonstrate the importance of institutional support for improving the health of caregivers., (© The Author(s) 2013.)

Intimate partner violence (IPV) perpetrators have been categorized into two groups based on their heart rate (HR) reactivity to stress following Gottman's studies. Overall, type I perpetrators tend to show autonomic underarousal, whereas type II or reactive perpetrators present a hyper-reactivity in anticipation of stress. In this study, changes in HR, pre-ejection period (PEP), vagal ratio as well as psychological state variables (anxiety and anger) in response to stress were assessed, comparing a group of type II IPV perpetrators (based on violence reports and psychological assessment; n = 17; mean age = 37) with non-violent controls (n = 17; mean age = 35) using modified version of the Trier Social Stress Test. IPV perpetrators had higher HRs and lower vagal ratios than controls, particularly during the recovery period. Moreover, the former presented shorter PEPs than controls. There were no differences between groups in the magnitude of response of the HR, PEP or vagal ratio. High baseline anxiety and anger were associated with an HR increase during the preparation time in IPV perpetrators but not in controls. These findings indicate a different cardiovascular pattern of response to psychosocial stress in IPV perpetrators, especially during recovery. Thus, they contribute to understanding the biological functioning of violence sub-types, supporting the validity of cardiovascular measures as diagnostic indicators for IPV classification.

The negative consequences of caring for people with developmental disabilities have been widely described. However, the ability to bounce back from the stress derived from care situations has been less studied. Those caregivers who have shown this ability are considered as resilient. This study aims to evaluate the relationship between resilience and self-reported health and cortisol awakening response (CAR) in a sample of caregivers of people with autism spectrum disorders (ASD). It also aims to evaluate the role of social support as a mediator in the association between resilience and health. Caregivers with higher resilience show better perceived health, lower morning cortisol levels, and less area under the curve with respect to ground (AUCg). Social support was positively related to resilience and mediated the relationship between resilience and perceived health. This mediating effect was not found in the association between resilience and CAR. Resilience could be a protective factor that modulates the negative consequences of chronic stress in the care context. Social support could be an important variable mediating the effects of resilience on health outcomes in caregivers. All these results must be considered when implementing effective psychological programs for helping caregivers., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Aggressive behavior and immune activity are shown to be positively associated in perpetrators of intimate partner violence (IPV). This relationship follows an inverted-U curve, with the most violent individuals showing lower levels of immunocompetence than those with a history of moderate violence. Moreover, the activational and organizational effects of testosterone (T) may indirectly stimulate the immune response. Given this, we used the Trier Social Stress Test to establish whether the salivary immunoglobulin A (sIgA) response to acute stress was a specific psychobiological feature in perpetrators of intimate partner violence (IPV). IPV perpetrators showed higher sIgA levels than controls for the preparation period. Moreover, higher anger expression and T (baseline and AUCi) were only related to higher sIgA levels in IPV perpetrators. We hypothesize that in IPV perpetrators, the use of violence against partners could benefit their psychological well-being - through immunological modifications such as mucosal immunity changes expressed by the sIgA - and so be rewarding for them. This research may provide a wider explanation of why IPV perpetrators use violence against their partners., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Intimate partner violence (IPV) perpetrators were categorized into 2 groups using Gottman et al.'s (1995) typology depending on their skin conductance (SC) reactivity to stress. Overall, type I perpetrators tend to show autonomic underarousal, whereas type II perpetrators present a preparatory hyperreactivity to confront stress. Moreover, impulsivity traits and testosterone (T) levels may modulate SC responses to increase the risk of proneness to violence. In this study, SC response to stress was assessed by comparing IPV perpetrators with non-violent controls while performing a modified version of the Trier Social Stress Test (TSST). Subjects with a history of IPV demonstrated higher non-specific SC responses during the recovery period than the non-violent controls. Nonetheless, there were no differences between groups in the case of mean SC levels. Furthermore, impulsivity and baseline T levels were associated with higher SC level reactivity during a preparation period only in IPV perpetrators, with both relationships being mediated by anger expression. Our results confirm that the IPV perpetrators correspond physiologically to type II and support the validity of SC as a diagnostic indicator for IPV classification. Our findings contribute to the development of effective treatment and prevention programs that could benefit from the use of biological indicators for analyzing the risk of recidivism in IPV perpetrators., (© 2013.)

Hormonal and neuropsychological impairment in intimate partner violence (IPV) perpetrators could play a role in domestic violence. For characterizing whether there is a specific psychobiological response to stress, participants who had previously been jailed for IPV and controls were compared for testosterone and cortisol levels, tested for 2D:4D ratio (as an indicator of masculinization), and given several trait questionnaires and neuropsychological tests related to executive functions and theory of mind. After performing the Trier Social Stress Test (TSST), IPV perpetrators experienced decreases in salivary testosterone (T) levels, a moderate worsening of mood, slight anxiety, and a salivary cortisol (C) level increase. Moreover, high basal T was related with high levels of anger and anxiety and worse mood. However, that basal mood does not significantly alter T levels in response to stress. Nonetheless, controls experienced smaller changes in T and larger changes in C and psychological mood. With respect to neuropsychological and cognitive empathic features, IPV perpetrators showed poorer executive performance and emotional recognition than controls. In addition, deficits in both neuropsychological domains were positively associated. Regarding emotional empathy, IPV perpetrators showed higher levels of personal distress than controls. The 2D:4D ratio was lower in IPV perpetrators than in controls. Moreover, only in the former a smaller 2D:4D ratio was related to large increases in T in response to stress and poor emotional recognition. Together with social aspects involved in IPV, differences in psychobiological variables and their relationships could play a relevant role in the onset and perpetuation of violent behavior., (© 2013 Wiley Periodicals, Inc.)

Taking care of offspring suffering a long-term illness such as schizophrenia is one of the more stressful life experiences. Care conditions may act as a protective factor in the health of the caregiver. The present study assesses heart rate (HR), blood pressure (BP), and mood responses to psychosocial stress in 16 mothers receiving specialised support for the care of their offspring (CARE+) and in 11 mothers caring for their offspring without support (CARE-). The CARE- group take care of less functional and more symptomatic offspring; and display higher basal, but lower HR, responses after stress than the CARE+ group. No significant group effects were found for BP. For mood states, there were significant decreases in the anger subscale in the CARE- group that were not found in the CARE+ group. HR was related to active and passive coping styles, trait anxiety, and years spent providing care. In the total sample, other significant relationships between cardiovascular responses and life events and personality traits have been found. In sum, the data suggests that specialised support for patients may modulate cardiovascular responses to repeated stress in caregivers.

Instances of sustained cooperative behaviour in humans can be considered as an adaptive strategy that enhances the probability of reaching a goal. This study investigates psychophysiological responses to cooperation in healthy subjects, while considering outcome and gender as potential moderators of these responses. Salivary cortisol levels (Csal), heart rate (HR), skin conductance level (SCL), nonspecific skin conductance responses (NSRs), and mood states were measured at different points before, during and after a Lego house-building task in undergraduate men (n = 22) and women (n = 20). Once the task was finished, the experimenter informed the participants about the outcome obtained (positive or negative). Cooperation produces an increase in HR, SCL, and NSR responses. When the outcome is positive it produces a gradual diminution in Csal levels, but when the outcome is negative there is a significant increase in Csal levels after the task followed by a progressive decrease. Men with positive outcomes showed a lower area under curve (AUC) in Csal than women with a negative outcome. Men had more NSR responses in all periods other than the rest period. Several mood states are differently affected by the combined effect of outcome and gender. Our laboratory results can be generalized to other situations in which negotiation, mediation, and cooperative strategies are relevant for taking decisions and/or solving problems. The authors wish to thank Dr Tinca Polderman and John Rawlins for the revision of the English text. This study was supported by the Ministry of Business, Research and Science of the Valencia Regional Government (GVPRE/2008/260, GVACOMP/2010/250, and PROMETEO/2011/048) and the Ministry of Science and Education of the Spanish Government (PSI2008-04408/PSIC).

Testosterone to cortisol (T/C) ratios could be associated with feelings and expression of anger as high testosterone and low cortisol levels indicate a predisposition to violence. The basal T/C ratio has recently been proposed as a marker for proneness to social aggression; so far, however, only its value as an indicator of state anger or violence has been investigated. Given this, we aimed to establish whether the T/C ratio response to acute stress was a specific psychobiological feature in individuals with a history of violence, namely, perpetrators of intimate partner violence (IPV). T/C ratio and anger responses were compared in men jailed for IPV and controls using the Trier Social Stress Test. IPV perpetrators had higher T/C ratios than controls, during the preparation period, and 15 and 30 minutes post-task. In IPV perpetrators, high T/C ratios were linked to better self-esteem and good mental health. An increase in anger may increase proneness to violence by altering hormones and, thereby, increasing T/C ratios. The basal T/C ratio together with acute stress responses and other indicators could serve as a marker to identify men at high risk of reacting violently to their partners.

In the caregiving model of chronic stress, few studies have been conducted with young middle-aged samples and no data exists about acute stress response in this population. To extend knowledge in this issue, health complaints and psychological, endocrine, and immunological responses to stress have been assessed in a cross-sectional sample of 41 parents of offspring with autistic spectrum disorder (ASD) in comparison with 37 non-caregiver parents. Salivary cortisol and immunoglobulin A (IgA) levels were measured before, during, and after a mental psychosocial stressor, while mood and state anxiety were evaluated before and after the stress. Health complaints, personality traits, socio-economic status, and characteristics of the care recipient were assessed. Caregivers reported more health complaints showing buffered cortisol and IgA responses and greater increases in fatigue to acute stress than the controls. In terms of predictive power of health complaints, IgA levels, care status, and severity of the care recipient are especially relevant for caregivers. Results strongly suggest a dysregulation in the immune and hormonal stress-induced responses in middle-aged caregivers, with immune component and care characteristics as the main modulators of health complaints. A deficit in the adaptive capability of stress response is plausible in this population, emphasizing the need to consider family approaches when planning protocols for assistance to ASD patients., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Several ethological reports have indicated that cooperative behaviors play an adaptive role. However, research has focused on competition in men, and there have been few studies on cooperation. This study aims to analyze the cortisol and psychological responses in women to a cooperative situation compared with a competitive situation in a laboratory context. The sample was distributed into four groups depending on the task and the outcome obtained: Positive cooperation, negative cooperation, competition with victory, and competition with defeat. Our results show that, in comparison with competition, cooperation produces different effects in cortisol, but not in psychological states. Nevertheless, these effects occur only when the task outcome and its appraisal are considered. Only the participants who cooperated and obtained a positive outcome and those who competed and lost showed significant decrements of cortisol. Internal attribution was higher in groups with more stable cortisol levels, suggesting a possible modulator effect of controllability in the way the situation was experienced. These results could be generalized to situations in which negotiation, mediation, and cooperative strategies are relevant for making decisions and/or solving problems.

This study aimed to evaluate neuroendocrine responses and changes in perceptual asymmetry following an induced negative affect. Cortisol increasing in response to negative affect has been reported, while current brain models of emotion processing link negative affect to the right hemisphere. In this study, the Velten Mood Induction Procedure was used to generate neutral or negative affect in 44 healthy subjects. The PANAS scales were used to assess self-reported mood. A consonant-vowel dichotic listening (DL) test was applied after the neutral and negative affect inductions, and levels of salivary cortisol were determined by radioimmunoassay. For the negative affect condition, and congruent with the hypothesis tested, PANAS positive scores diminished (p<0.001) and PANAS negative scores increased (p<0.001), yielding an inverse correlation between them. A significant increase in cortisol levels was also seen (p<0.04). When taking cortisol reactivity into account, PANAS negative scores were higher for high-than for low-cortisol responders (p<0.02). Regarding DL, an increase in left ear items (p<0.04) and a decrease in right ear items (p<0.03) reported for those subjects who obtained a right ear advantage in the neutral condition. An explanation in terms of Kinsbourne's model for attentional-activation influences on DL is postulated and implications for the issue of affective illness are also discussed.

This study compares the anticipatory hormonal and psychological responses of 17 male judo players to an official competition with the data obtained during eight resting sessions carried out at the same time of day, throughout an entire sports season. Testosterone (T) and cortisol (C) levels were determined 1 h and 30 min before competition, and mood, anxiety and expectancies were also evaluated. C levels and anxiety scores were concurrently higher before the contest than in resting conditions; however, non-significant correlations between them were found. The anticipatory T response was not significant for the whole group. However, one group of subjects did display T increases, higher C levels, and higher motivation to win scores than the other group. Furthermore, this group also obtained a better outcome. Thus, this hormonal pattern and its relationships with psychological variables suggest an adaptive psychobiological response to a competition. Results are discussed in the context that neuroendocrine response to competition is associated with cognitive appraisal.

The aim of this study was to test the hypothesis that individual differences in testosterone (T) are associated with different patterns of linguistic lateralization and hand preference. Twenty left-handed (LH) and 19 right-handed (RH) women filled in a handedness questionnaire and performed a consonant-vowel dichotic listening test (DL-CV). Salivary T was measured by radioimmunoassay (RIA). LH women showed significantly lower mean salivary T than RH women. T levels were negatively correlated with the absolute value of the DL laterality index. Subjects with right ear advantage (REA) were classified into strongly and weakly lateralized following Wexler et al. method (Brain Lang. 13 (1981) 13). When taking into account hand preference, a pattern emerged in that RH-strongly lateralized and LH-weakly lateralized women showed similar T levels. The lowest level appeared for LH-strongly lateralized women and the highest for RH-weakly lateralized women, being significantly different from each other. The results are discussed in terms of several theories that have proposed a link between testosterone and cerebral lateralization.

As a continuation of the study carried out by Svare more than 15 years ago (Horm. Behav. 22 (1988), 139) and to determine the tendencies of the evolution of behavioral endocrinology since then, our aim was to extend his work until 2000, assuming that the journal Hormones and Behavior would be representative of the field at large. To study this 14-year period and compare it with Svare's data, we kept the same criteria and categories, behavioral patterns, and species. Our results show that "sexual behavior" in "rodents" is still the most extensive field studied by behavioral endocrinologists, although frequency of other topics is increasing, above all "aggressive and emotional responses," and especially the interrelationships between them. Interestingly, studies dedicated to humans are slowly becoming more common. In addition to these analyses, we obtained the several citations received by a randomly selected sample of articles during the period that was divided by the number of years when the articles can be potentially cited. These ratios revealed that research on "humans," within the category of species, and on "memory, learning, and conditioning" and "aggressive and emotional responses," within the behavioral categories, present the highest visibility in the literature. Furthermore, this analysis was complemented with information about the main receptor journals of the papers published in Hormones and Behavior, classified by the same categories. All these data, although limited by the analysis of only one journal, permitted us to reflect on whether the evolution tendencies formulated by Beach (Horm. Behav. 15 (1981), 325) for this discipline were applicable to the period studied, thus confirming its status as a mature discipline for the last quarter of the 20th century.

Gender moderates psychophysiological responses to stress. In addition to the hormonal background, different psychological states related to social stressors, such as anxiety and mood, could affect this response. The purpose of this study was to examine the existence of gender differences in the cardiovascular and electrodermal responses to a speech task and their relationship with anxiety and the mood variations experienced. For this, non-specific skin conductance responses (NSRs), heart rate (HR), and finger pulse volume (FPV) were measured at rest, and during preparation, task and recovery periods of an academic career speech in undergraduate men (n=15) and women (n=23), with assessment of changes in the state version of the State-Trait Anxiety Inventory (STAI-S) and in the Profile of Mood States (POMS) questionnaires. Men and women did not differ in trait anxiety, hostility/aggressiveness, or in the appraisal of the task, which were evaluated with the trait version of the State-Trait Anxiety Inventory (STAI-T), the Buss and Durkee Hostility Inventory (BDHI), and a self-report elaborated by ourselves, respectively. Women had higher FPV in all periods except during the task, and were more reactive to the stressor in state anxiety, and in the amplitude of NSRs. No gender differences for HR and for the frequency of NSRs were found. Anxiety and mood states were differently related to cardiovascular and electrodermal measurements in men and women. Further studies should consider the hormonal variations in addition to the psychological dimensions, in order to offer a more integrative perspective of the complex responses to stress.

Relationships between perceived exertion and blood lactate have usually been studied in laboratory or training contexts but not in competition, the most important setting in which sports performance is evaluated. The purpose of this study was to examine the relationships between psychological and physiological indices of the physical effort in a competition setting, taking into account the duration of effort. For this, we employed two Ratings of Perceived Exertion (RPE and CR-10) and lactic acid plasma concentration as a biological marker of the effort performed. 13 male judo fighters who participated in a sports club competition provided capillary blood samples to assay lactate concentrations and indicated on scale their Recall of Perceived Exertion in the total competition and again in just the Last Fight to compare the usefulness of RPE and CR-10 in assessing discrete bouts of effort and a whole session. Analysis showed that perceived exertion or the effort made during the whole competition was positively and significantly related to maximal lactate concentration and lactate increase in competition, thus extending the validity of this scale to sports contests. The Recall of Perceived Exertion scores were not significantly correlated with the duration of effort.

Physical fitness moderates the psychophysiological responses to stress. This study attempts to determine whether the degree of fitness could affect the response to physical and psychological stress after comparing two groups of men with good physical fitness. Saliva samples from 18 elite sportsmen, and 11 physically active subjects were collected to determine hormonal levels after carrying out a maximal cycle ergometry. Heart rate and skin conductance level were continuously recorded before, during, and after a modified version of the Stroop Color-Word Task. With similar scores in trait anxiety and mood, elite sportsmen had lower basal salivary testosterone, testosterone/cortisol ratio, and HR before an ergometric session than physically active subjects, but no differences were found in salivary cortisol and blood pressure. Salivary testosterone and cortisol responses were lower and testosterone/cortisol ratio responses higher in elite sportsmen. During the Stroop Task, elite subjects showed lower heart rate and skin conductance level over the entire measurement period, and greater heart rate recovery with respect to the baseline values than physically active subjects. The effects of two standardised laboratory stressors on a set of psychophysiological variables were different when elite sportsmen and physically active subjects were compared.

In various species, competitive encounters influence hormonal responses in a different way depending on their outcome, victory or defeat. This study aimed to investigate the effects of sports competition and its outcome on hormonal response, comparing it with those displayed in situations involving non-effort and non-competitive effort. To this end, serum testosterone (T), cortisol (C) and prolactin (PRL) were measured in 26 judoists who participated in three sessions (control, judo fight and ergometry). The relationship between hormonal changes and psychological variables before and after the fight were also analysed. Our results showed a hormonal response to competition, which was especially characterized by an anticipatory rise of T and C. Depending on outcome, significant higher C levels were found in winners in comparison to losers through all the competition but not in T or PRL, both groups expending a similar physical effort. Furthermore, similar hormonal responses to the fight and to a non-competitive effort with the same caloric cost were found, other than with PRL. Winners showed a higher appraisal of their performance and satisfaction with the outcome, and perceived themselves as having more ability to win than losers, although there were no significant differences in motivation to win. Finally, the relationships found between T changes in competition and motivation to win, as well as between C response and self-efficacy suggest that in humans hormonal response to competition is not a direct consequence of winning and losing but rather is mediated by complex psychological processes.

Effects of testosterone propionate, an anabolic-androgenic steroid (AAS), on aggression in gonadally intact male mice were examined. Animals were given weekly injections of 3.75, 7.5, 15, and 30 mg/kg of drug or sesame oil for 10 weeks. During the last 3 weeks, behavioral tests were conducted and at the end of the experiment, body, liver and testes weight and hormonal data were collected. The treatment had minimal behavioral and endocrine effects. It resulted in shorter latencies of 'threat' only in the last agonistic encounter, increases in testosterone levels and decreases in testes weight in a non-linear dose-dependant way. The action of treatment was different on threat and attack, the latter being unaffected. The behavioral effects in the total sample were only found in aggressive animals selected on the basis of their latency of attack in the first encounter.