title: Intraindividual Cortisol Variability and Psychological Functioning in Caregivers of Hematopoietic Stem Cell Transplant Patients.
abstract: OBJECTIVE
  Caregiving for allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients carries a significant psychological burden, yet it remains unclear whether Allo-HSCT caregivers demonstrate disruptions to stress systems, such as the hypothalamic-pituitary-adrenal axis. Greater intraindividual cortisol variability (ICV) has been observed in psychiatric disorders; however, there is a knowledge gap evaluating ICV in caregivers. We predicted that greater ICV would be related to poorer mental health in Allo-HSCT caregivers.
  
  
  METHODS
  Allo-HSCT caregivers (n = 140) collected saliva for 3 consecutive days at 4 time points/d. Psychological variables included sleep quality and a summary composite score of overall mental health.
  
  
  RESULTS
  Regression analyses demonstrated that greater ICV was significantly related to poorer overall mental health (β = 0.25, p = .009), whereas poorer sleep did not reach significance (β = 0.16, p = .069). No significant relationships emerged for the cortisol area under the curve, diurnal decline, or awakening response.
  
  
  CONCLUSIONS
  Results extend prior work examining ICV as a unique marker that is possibly more sensitive than other widely applied measures of hypothalamic-pituitary-adrenal axis dysregulation to a distressed population of caregivers.
authors.affiliation: From the Departments of Internal Medicine (Sannes) and Psychiatry (Sannes, Mikulich-Gilbertson, Natvig, Laudenslager), University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Sannes
authors.forename: Susan K
authors.initials: SK
authors.lastname: Mikulich-Gilbertson
authors.forename: Crystal L
authors.initials: CL
authors.lastname: Natvig
authors.forename: Mark L
authors.initials: ML
authors.lastname: Laudenslager
mesh_terms: D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000378:metabolism* / Q000523:psychology*; D008875:Middle Aged; D012463:Saliva / Q000378:metabolism; D012893:Sleep Wake Disorders / Q000150:complications / Q000378:metabolism / Q000523:psychology; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications / Q000378:metabolism / Q000523:psychology
chemical_list: D006854:Hydrocortisone