Noisy spit: parental noncompliance with child salivary cortisol sampling
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Published on: December 18, 2013
Victoria C Smith1, Lea R Dougherty
1Department of Psychology, University of Maryland, College Park, MD, 20742.
Insights
Parental compliance in collecting children's salivary cortisol impacts stress hormone levels. Electronic monitoring revealed noncompliance was linked to altered waking cortisol and cortisol awakening response (CAR) in preschoolers.
Area of Science:
- Developmental psychology
- Neuroendocrinology
- Pediatric research
Background:
- Assessing the hypothalamic-pituitary-adrenal (HPA) axis in young children often relies on parental collection of salivary cortisol.
- Parental compliance is crucial for the validity of ambulatory cortisol measures, but data on compliance rates are lacking.
- Understanding compliance effects is vital for accurate interpretation of HPA axis functioning in early childhood.
Purpose of the Study:
- To investigate the impact of parental compliance on salivary cortisol measures, specifically the cortisol awakening response (CAR) and diurnal cortisol slopes.
- To compare subjective parent-reported compliance with objective electronic monitoring of compliance.
- To examine the association between objective parental noncompliance and cortisol patterns in preschool-aged children.
Main Methods:
- Eighty-one parents of children aged 3-5 years collected salivary cortisol samples at multiple time points over two weekdays.
- Parental compliance was assessed via parent self-report and an electronic monitoring device.
- Cortisol awakening response (CAR) and diurnal cortisol slopes were analyzed in relation to compliance data.
Main Results:
- Objective compliance rates, measured by electronic monitoring, were lower than subjective parent-reported compliance.
- Parental noncompliance, identified through electronic monitoring, was significantly associated with higher waking cortisol levels.
- Noncompliance was also linked to a blunted cortisol awakening response (CAR).
Conclusions:
- Objective measurement of parental compliance is essential in developmental neuroendocrine research involving salivary cortisol.
- Parental noncompliance can systematically bias findings related to the cortisol awakening response (CAR) and diurnal cortisol patterns.
- Future studies should incorporate objective compliance monitoring to ensure the reliability of ambulatory HPA axis assessments in children.
Abstract:
Studies assessing hypothalamic-pituitary-adrenal (HPA) axis functioning in young children commonly involve parental collection of salivary cortisol in ambulatory settings. However, no data are available on the compliance of parents in collecting ambulatory measures of children's salivary cortisol. This study examined the effects of parental compliance on the cortisol awakening response (CAR) and diurnal cortisol slopes in a sample of preschool-age children (ages 3-5). Eighty-one parents were instructed to collect their child's salivary cortisol samples upon their child's waking, 30 and 45 min post-waking and before bedtime on two weekdays. Subjective parental compliance was assessed using parent-report, and objective parental compliance was assessed using an electronic monitoring device. Rates of compliance were higher based on parent-report than electronic monitoring. Parental noncompliance as indicated by electronic monitoring was associated with higher waking cortisol and lower CAR. Findings suggest the need to incorporate electronic monitoring of parental compliance into developmental neuroendocrine research, especially when assessing the CAR.
