title: Do venepuncture procedures induce cortisol responses? A review, study, and synthesis for stress research.
abstract: Venepuncture procedures are frequently employed to continuously monitor humoral stress markers. As such procedures are conceived as "potent psychological and physiological stressors", there is a need to determine whether venepuncture procedures themselves elicit cortisol responses and if so, how to deal with them appropriately. In order to assess the rate of cortisol responses to venepuncture, we conducted a literature review, which suggested that venepuncture procedures induce cortisol responses with a probability of approximately 30%. By utilizing Bayesian analysis, this result was integrated with the cortisol data of 18 healthy men who were exposed to a venepuncture procedure twice (time lag: 1 week). The currently observed response rate of 47% differed substantially from the earlier findings, which we attribute to a self-selective sampling of participants. In addition, participants showing a response to the first venepuncture were highly likely to also show a response to the second one. In this regard, we discuss the presumed conditioning of cortisol responses to venepuncture procedures. To prevent the superposition of venepuncture-induced cortisol responses and responses induced by target stressors, we propose a time- and selection-based strategy: cortisol samples taken about 110min after venepuncture should be virtually adjusted for its superimposing effects. Furthermore, previous experiences of venepuncture were highly predictive for cortisol responsiveness. This association could be utilized in further studies to identify participants who will probably show a cortisol response to venepuncture.
authors.affiliation: Institute of Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Weckesser
authors.affiliation: Institute of Psychology, Technische Universität Dresden, 01062 Dresden, Germany; Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Franziska
authors.initials: F
authors.lastname: Plessow
authors.affiliation: Department of Psychiatry and Psychotherapy University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Pilhatsch
authors.affiliation: Institute of Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Muehlhan
authors.affiliation: Institute of Psychology, Technische Universität Dresden, 01062 Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
authors.affiliation: Institute of Psychology, Technische Universität Dresden, 01062 Dresden, Germany. Electronic address: robert.miller@tu-dresden.de.
authors.forename: Robert
authors.initials: R
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000523:psychology; D005239:Fear / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D010551:Personality; D018962:Phlebotomy / Q000523:psychology*; D013315:Stress, Psychological / Q000097:blood* / Q000523:psychology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; Stress; Venepuncture; Venipuncture