O estresse crônico ou agudo pode alterar diversas funções relacionadas ao sistema cardiovascular, ocasionando doenças cardíacas. O sistema renina-angiotensina (SRA), importante participante do controle dessas funções, é profundamente afetado em resposta ao estresse. A angiotensina II (Ang II) é reconhecida como hormônio multifuncional que influencia diversos processos celulares importantes para a regulação da função vascular, incluindo regulação do tônus vascular, crescimento celular, dentre outros. Outro componente do SRA é a angiotensina 1-7 (Ang 1-7), suas ações vasculares envolvem aumento na produção de prostanóides vasodilatadores, óxido nítrico e fator hiperpolarizante derivado do endotélio. O objetivo do presente trabalho foi avaliar as conseqüências do estresse, agudo ou crônico, sobre as atividades vasomotoras da Ang II e da Ang 1-7, os mecanismos envolvidos na contração e relaxamento induzidos, respectivamente, por estes peptídeos e as modificações na expressão dos receptores AT1, AT2 e Mas, em carótida de ratos. O estresse crônico levou à diminuição do ganho de peso corpóreo dos animais, promoveu remodelamento das artérias carótidas, com significativo aumento da camada média acompanhada de redução da resposta de relaxamento da Ang 1-7, embora a expressão de seus receptores, do tipo Mas, estivesse aumentada. A maior expressão de receptores de Ang II, AT1 e AT2, desencadeada pelo estresse agudo não alterou a resposta contrátil deste peptídeo. Em carótidas de animais submetidos ao estresse crônico observa-se redução do Emax da Ang II e da Ang 1-7 após incubação com indometacina, sugerindo que prostanóides estão envolvidos na resposta vascular tanto da Ang II quanto da Ang 1-7 em situações de exposição prolongada ao estresse. A maior expressão de nitrotirosina em carótidas de animais expostos tanto ao estresse agudo quanto crônico, demonstra que o óxido nítrico e estresse oxidativo parecem estar relacionados às alterações vasomotoras, em resposta aos peptídeos Ang II e Ang 1-7. Foi evidenciado que o estresse agudo eleva significativamente os níveis plasmáticos de corticosterona e a produção de espécies reativas de oxigênio (EROs). Estes dados sugerem que os estresses agudo e crônico, por imobilização, alteram a expressão de receptores do SRA e a vasoatividade de carótidas em resposta à Ang II e Ang 1-7 em função de diferentes mecanismos celulares. / The chronic or acute stress can alter various functions of the cardiovascular system, causing heart disease. The renin-angiotensin system (RAS), a major participant in control of these functions, is profoundly affected in response to stress. Angiotensin II (Ang II) is recognized as a multifunctional hormone that influences many cellular processes important for the regulation of vascular function, including regulation of vascular tone, cell growth, among others. Another component of the RAS is angiotensin 1-7 (Ang 1-7), their actions involve an increase in vascular production of prostanoid vasodilators, nitric oxide and endothelium-derived hyperpolarizing factor. The aim of this study was to evaluate the consequences of chronic or acute stress on vasomotor activity of Ang II and Ang 1-7, the mechanisms involved in contraction and relaxation induced, respectively, by these peptides and the changes in the expression of AT1, AT2 and Mas in rat carotid artery. Chronic stress has led to decreased body weight gain of animals, promoted remodeling of carotid arteries with a significant increase in the medial layer accompanied by a reduction of the relaxation response to Ang 1-7, although the expression of their receptors (Mas) was increased. The highest expression of Ang II receptors, AT1 and AT2, triggered by acute stress did not alter the contractile response of this peptide. In carotid arteries of animals subjected to chronic stress is observed reduction of Emax of Ang II and Ang 1-7 after incubation with indomethacin, suggesting that prostanoids are involved in the vascular response of both Ang II and Ang 1-7 in exposed situations prolonged stress. The greater expression of nitrotyrosine in carotids from animals exposed to both acute or chronic stress, demonstrates that nitric oxide and oxidative stress appear to be related to vasomotor changes in response to peptides Ang II and Ang 1-7. It was shown that acute stress increases plasma levels of corticosterone and the production of reactive oxygen species (ROS). These data suggest that acute and chronic stress by immobilization, alter the expression of receptors of RAS and vasomotor activity in carotid artery in response to Ang II and Ang 1-7 by different cellular mechanisms.

Die Dissertation beschäftigt sich mit der Frage, ob und wie Feedback-basiertes Lernen durch Stress moduliert wird. Der Zusammenhang zwischen Stress und Kognition sowie die zugrunde liegenden biologischen Mechanismen sind Gegenstand der kognitiven Stressforschung. Während der Einfluss von Stress und Stresshormonen auf andere Lernformen bereits gut etabliert ist, gibt es bisher kaum Studien, die Feedback-basiertes Lernen unter Stress bei Menschen betrachtet haben. In der vorliegenden Arbeit werden daher die Auswirkungen akuten Stresses auf diese Lernform untersucht. Es werden gezielt Auswirkungen auf die generelle Akquisition einer Lernaufgabe mittels Feedback, auf die Nutzung sowohl positiven als auch negativen Feedbacks beim Lernen sowie auf die Fähigkeit der flexiblen Anpassung an sich änderndes Feedback betrachtet. Dafür werden in den experimentellen Untersuchungen der Arbeit Feedback-basierte Aufgaben mit einer vorangestellten Induktion akuten psychosozialen Stresses kombiniert. Die Ergebnisse der vorliegenden Arbeit deuten darauf hin, dass akuter psychosozialer Stress das generelle Erlernen Feedback-basierter Aufgaben nicht beeinflusst, jedoch die Nutzung positiven und negativen Feedbacks beim Lernen verändert. Im Speziellen wird negatives Feedback nach einer Stressinduktion weniger genutzt, während über eine möglicherweise stärkere Nutzung positiven Feedbacks aufgrund der vorliegenden Ergebnisse keine fundierte Aussage getroffen werden kann. Zudem finden sich in der vorliegenden Arbeit Hinweise auf einen positiven Zusammenhang zwischen Cortisolwerten und der Flexibilität in Feedback-basierten Lernaufgaben. Als Erklärungsansätze werden veränderte Aufmerksamkeitsprozesse nach einer Stressinduktion sowie andere psychologische Faktoren wie eine kognitive Nachbeschäftigung mit dem Stresstest und eine geringere Involviertheit in die kognitiven Aufgaben diskutiert. Die berichteten Korrelationen zwischen Cortisolwerten und kognitiven Parametern werden dahingehend interpretiert, dass Cortisol ein vermittelnder Faktor des Stresseffekts auf die Nutzung und neuronale Verarbeitung negativen Feedbacks sein könnte. Zur Integration der Ergebnisse aller Studien wird eine Modulation der dopaminergen Signalübertragung durch Stress und erhöhte Cortisolspiegel und damit verbundene Auswirkung auf Feedback-basiertes Lernen vorgeschlagen. Die vorliegende Arbeit gibt zum ersten Mal Hinweise auf eine veränderte Nutzung und Verarbeitung von Feedback nach psychosozialem Stress und bestätigt frühere Befunde eines Zusammenhangs zwischen Cortisol und der Flexibilität beim Lernen.

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Background The study aimed to investigate the link between burnout symptoms and prosocial behaviour, as well as the role of acute stress and vagally-mediated heart rate variability (vmHRV) on this association. Methods Seventy men were randomly assigned to either the stress or the control condition of the Trier Social Stress Test for Groups (TSST-G). Prosocial behaviour was assessed via a social decision-making paradigm during the respective TSST-G condition. Results Correlation analyses revealed negative correlations between prosocial behaviour and burnout symptoms. Acute stress was also associated with reduced prosocial behaviour, whereas no interaction effects with burnout symptoms could be revealed. Exploratory analyses showed that vmHRV was negatively correlated with burnout symptoms during the social decision-making paradigm but did not mediate the link between burnout and prosocial behaviour. Conclusion In conclusion, we report first experimental evidence that burnout symptoms are negatively associated with prosocial behaviour. Further studies are needed to explore the causal relations.

Features of impulsivity underlie multiple psychological disorders. The body of work examining impulsivity has largely focussed on self-report measurement and has incorporated psychological constructs without reference to the broader biological factors that may influence impulsive behaviour. Two studies were conducted to examine whether environmental stress and genetic status associated with dopaminergic and serotonergic function (DRD2, ANKK1 and 5HT2AR genotypes) were predictive of dimensions of impulsivity and risky behaviour (alcohol use). The two studies used a multi-method approach in a non-clinical community sample of young adults (aged 17-25 years). Dopamine is integral to the two leading theories of impulsive personality, Gray's Reinforcement Sensitivity Theory and Cloninger's Psychobiological model of personality. Dopamine plays a crucial role in reward reinforcement circuits in the brain. The A1 allele of the ANKK1 gene (also referred to as TaqIA of the DRD2 gene region) and the CC genotype of the C957T polymorphism of the DRD2 gene have both been associated with reduced D2 dopamine receptor density in key structures linked to brain reward. In addition, a strong body of evidence implicates their involvement in a number of clinical disorders associated with impulsivity. Serotonin function has also been associated with impulsivity in Cloninger's theory and there is also evidence of associations of two polymorphisms of the 2A serotonin receptor gene (5HT2AR T102C and -1438A/G SNPs) with impulsivity. Acute and chronic forms of stress are also important correlates of impulsive behaviour and the two studies directly examined the relationship between genotype, stress and impulsivity. Study 1 (N=180) utilised a cross-sectional design and examined interactions between these polymorphisms and chronic stress exposure on key impulsivity dimensions of reward sensitivity, Novelty Seeking and rash impulsiveness. Participants completed psychological questionnaires measuring chronic stress, dimensions of impulsivity, mood and substance use and provided mouth swab samples of buccal mucosal cells for DNA analysis. The study confirmed the association between A1 and CC allelic status and chronic stress being associated with harm avoidance and sensitivity to punishment. This suggests a role for both dopamine and background stress in impulsive behaviour. Study 2 (N=73) built upon this questionnaire research in the laboratory by utilising experimental psychological paradigms of impulsive behaviour and experimentally manipulating acute stress. Study 2 employed a mixed experimental design with a sub-sample of those studied in the cross-sectional sample. These behavioural paradigms included pre- and post- stress induction administration of the Card Arranging Reward Responsiveness Objective Test (capturing behavioural approach in the presence of reward cues, presumed to reflect reward sensitivity) and post-induction delay discounting and response inhibition measures. Study 2 confirmed the role of one of the two dopamine-related polymorphisms, with those with A1+ allelic status demonstrating lower reward responsiveness prior to rest or stress induction, which was overcome in the second administration of this task, independent of environment. A1+ allelic individuals also demonstrated significantly poorer response inhibition independent of stress, further confirming the association between A1+ allelic status and impulsivity. Those with CC allelic status showed an increase in reward responsiveness only in the stress induction condition. Together, results from the two studies inform the development of a multidimensional model of impulsivity that captures gene-environment influences on discrete aspects of impulsive personality and behaviour. Further refinement of this model may lead to the development of more effective customised prevention and treatment interventions for clinically disordered impulsivity. The implications of dopaminergic systems and stress in understanding disorders such as ADHD and substance dependence are discussed.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / The fatty acids (FA) are important constituents of brain phospholipid membranes and play important roles in the central nervous system (CNS) may modify the plasticity and fluidity, and act decisively in the development of cognitive and neuropsychiatric disorders. During the last decades, we observed changes in eating habits, which enabled increased consumption of trans fatty acids at the expense of consumption of polyunsaturated fatty acids (PUFA), especially omega-3. Furthermore, frequent situations of stress due to pressure of the outside world may also be associated with the development of diseases involving CNS and changes in metabolic function, particularly in the metabolism of fatty acids. In this study, two sequential generations of rats were supplemented with soybean oil (C-SO), fish oil (FO) and hydrogenated vegetable fat (HVF) during pregnancy and lactation. At 41 days of age, half of the male animals of each group were exposed to acute stress (AE-2h) and evaluated in the open field and elevated plus maze, followed by euthanasia for biochemical analysis. The HVF supplemented group had higher anxiety symptoms, while groups C-SO and FO did not show these behaviors. Among the groups exposed to AE, the HVF showed greater locomotion and symptoms similar to anxiety, but this was not observed in the FO. Biochemical analyzes showed higher levels of lipid peroxidation and reduced cell viability in the cortex of HVF group. Furthermore, the HVF treated rats showed reduced catalase activity in the striatum and hippocampus, and increased generation of reactive species in the striatum, while FO was associated with increased cell viability in the hippocampus. Among the groups exposed to AE, the HVF group showed increased generation of reactive species in the brain, decreased cell viability in the cortex and striatum, and decreased catalase activity in the striatum and hippocampus. The results show that the presence of FA for the development and growth over two generations is capable of modifying parameters of oxidative status and behavior of the brain. Taken together, our data support the idea that regular consumption of a diet rich in monounsaturated fatty acids (MUFA) and PUFA, and particularly low in processed foods, can help prevent the development of emotional disorders, and suggest the influence harmful consumption of trans fat over generations, which is able to increase parameters of emotion and nervousness after stressful situations of everyday life can trigger neurological and neuropsychiatric conditions more severe. / Os ácidos graxos (AG) são constituintes importantes das membranas fosfolipídicas cerebrais e desempenham importantes funções no sistema nervoso central (SNC) podendo modificar a plasticidade e fluidez, além de atuar de forma decisiva no desenvolvimento de patologias cognitivas e neuropsiquiátricas. Durante as últimas décadas, foram observadas mudanças nos hábitos alimentares, as quais possibilitaram o aumento do consumo de ácidos graxos trans, em detrimento do consumo de ácidos graxos poliinsaturados (AGPI), principalmente o ômega-3. Além disso, situações frequentes de estresse devido a pressão do mundo exterior também podem estar associadas com o desenvolvimento de doenças que envolvem o SNC e alterações na função metabólica, particularmente no metabolismo dos ácidos graxos. Neste estudo, duas gerações sequenciais de ratas foram suplementadas com óleo de soja (C-OS), óleo de peixe (OP) e gordura vegetal hidrogenada (GVH) durante a gestação, lactação e após o desmame. Aos 41 dias de idade, parte dos animais machos, da segunda geração, foram expostos ao estresse agudo (EA-2h), enquanto a outra metade foi utilizada como controles, e avaliados em campo aberto e labirinto em cruz elevado, seguido por eutanásia para análises bioquímicas. O grupo suplementado com GVH, não expostos ao estresse, apresentou maiores sintomas de ansiedade, enquanto os grupos C-OS e OP não mostraram esses comportamentos. Entre os grupos expostos ao EA, o GVH mostrou maior locomoção e sintomas semelhantes à ansiedade, mas isso não foi observado no grupo OP. As análises bioquímicas mostraram níveis mais elevados de peroxidação lipídica e menor viabilidade celular no córtex do grupo GVH. Além disso, os ratos tratados com GVH mostraram reduzida atividade da catalase no estriado e hipocampo, bem como aumento da geração de espécies reativas no estriado, ao passo que OP foi associado com aumento da viabilidade celular no hipocampo. Entre os grupos expostos ao EA, o grupo GVH mostrou aumento da geração de espécies reativas no cérebro, diminuição da viabilidade celular no córtex e estriado, e diminuição da atividade da catalase no estriado e hipocampo. Os resultados mostram que a presença de AG durante o desenvolvimento e crescimento ao longo de duas gerações é capaz de modificar parâmetros de comportamento e status oxidativo do cérebro. Tomados em conjunto, nossos dados suportam a ideia de que o consumo regular de uma dieta rica em ácidos graxos monoinsaturados (AGM) e AGPI, e particularmente pobre em alimentos processados, pode ajudar a prevenir o desenvolvimento de distúrbios emocionais, além de sugerir a influência nociva do consumo de gordura trans ao longo de gerações, a qual é capaz de aumentar parâmetros de emocionalidade e ansiedade após situações estressantes da vida cotidiana podendo desencadear condições neurológicas e neuropsiquiátricas mais graves.

Cette thèse a pour visée principale de faire avancer les connaissances de la littérature concernant les différences hommes-femmes dans le trouble de stress aigu (TSA) et le trouble de stress post-traumatique (TSPT), chez une population de victimes d’actes criminels graves (VAC). L’étude comprend deux objectifs principaux. Tout d’abord, l’évaluation de la présence et de l’intensité de réactions péri-traumatiques, soit la dissociation et la détresse. Ensuite, nous avons étudié si ces facteurs étaient associés à la survenue d’un TSA, chez les VAC et s’ils prédisaient différemment le TSA en fonction du genre. Dans le cadre d’un deuxième article et comme objectif secondaire de la thèse, l’impact des réactions péri-traumatiques a aussi été vérifié, mais cette fois sur le développement subséquent d’un TSPT. Également pour cet objectif, nous nous sommes concentrés sur le rôle du genre dans la prédiction de la relation. Des entrevues d’évaluation clinique ont été effectuées auprès de 214 victimes (125 femmes). Plus précisément, le TSA a été évalué, dans le cadre de l’article 1 à l’aide de l’Acute Stress Disorder Interview (ASDI), puis le TSPT à l’aide de l’entrevue semi-structurée du SCID pour une mesure diagnostique catégorielle et avec l’échelle modifiée des symptômes traumatiques (ÉMST), dans l’article 2. Cette échelle produit un score en continu de sévérité et de fréquence des symptômes. Les variables péri-traumatiques ont été évaluées à l’aide de questionnaires auto-rapportés, soit le Questionnaire des expériences dissociatives péri-traumatiques et l’Inventaire de détresse péri-traumatique. Les résultats du premier article démontrent que les femmes vivraient globalement plus de détresse péri-traumatique que les hommes, alors qu’il n’y aurait pas de différence de genre pour les expériences dissociatives. Ces réactions péri-traumatiques seraient toutes deux des prédicteurs d’un TSA tant chez les hommes que les femmes. Des différences de genre seraient présentes dans l’association de la détresse et du TSA lorsque des évènements potentiellement traumatiques passés étaient considérés. Pour les hommes, une présence élevée de détresse péri-traumatique et plusieurs antécédents de potentiels évènements traumatiques les rendraient plus vulnérables au développement d’un TSA. Chez les femmes, de potentiels traumas antérieurs augmenteraient le risque de présenter des symptômes du TSA seulement lorsqu’un niveau élevé de détresse péri-traumatique était présent lors du crime. Le deuxième article de la thèse démontre à nouveau que les réactions péri-traumatiques sont des facteurs de risque, mais cette fois pour le développement d’un TSPT. Cependant, aucune différence de genre n’a été observée concernant la capacité prédictive de ces variables. En effet, quelques mois après l’événement, la dissociation et la détresse péri-traumatiques demeurent des variables d’intérêt à considérer pour prévenir la survenue d’un TSPT, mais ce tant pour les victimes hommes que femmes. Cette deuxième étude a également confirmé l’importance du trouble de stress aigu comme facteur de risque au développement d’un TSPT chez une population de victimes d’actes criminels violents. Ces résultats, les limites de l’étude, des pistes de recherche futures, ainsi que les implications cliniques pour le traitement du TSA et du TSPT seront discutés de manière détaillée dans cette thèse doctorale. / This thesis aimed to contribute to the acute stress disorder (ASD) and post traumatic stress disorder (PTSD) literature in terms of gender differences among crime victims. Precisely, we were interested in the intensity and presence of peritraumatic reactions namely, dissociation and distress, among men and women victims of violent crimes. Two objectives were pursued. First, we evaluated whether peritraumatic dissociation and distress were significant risk factors for ASD development and if these acute stress reactions’ predictive capacity, differed according to gender. A second objective was to investigate if peritraumatic dissociation and distress significantly predicted PTSD development according to gender. Globally, in this research project, we were interested in determining the impact of gender in the prediction of the above-mentioned relationship . Semi-structured interviews; the Acute Stress Disorder Interview (ASDI) in the first article and the Structured Clinical Interview for DSM-IV (SCID) in the second article were conducted with 214 victims (125 women, Mage=39.6yrs) to assess ASD and PTSD respectively. Data on peritraumatic variables were collected through self-report questionnaires, the Peritraumatic Dissociative Experience Questionnaire and the Peritraumatic Distress Inventory. Peritraumatic dissociation and distress were both significant risk factors for ASD in men and women. Women presented higher peritraumatic distress levels compared to men victims. Gender differences were revealed through past potential traumatic experiences, where they have a cumulative impact on ASD risk development for men, but having few past potential traumas could be a protective factor for women. In the second article, findings reveal that acute stress variables were both significantly related to more PTSD symptoms, although no gender differences were identified. An acute stress disorder diagnosis was also confirmed as an important predictor of PTSD in victims of violent crimes. These results, study limitations, directions for future research as well as clinical implications for ASD and PTSD treatment will be discussed.

Summary: Salivary alpha-amylase: More than an enzyme - Investigating confounders of stress-induced and basal amylase activity (Dipl.-Psych. Jana Strahler) The hypothalamus-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS) are two of the major systems playing a role in the adaptation of organisms to developmental changes that threaten homeostasis. The HPA system involves the secretion of glucocorticoids, including cortisol, into the circulatory system. Numerous studies have been published that introduced salivary cortisol to assess HPA axis activity and therefore strengthens its role as an easy obtainable biomarker in stress research that can be monitored easily and frequently. Recent findings suggest a possible surrogate marker of autonomic activity due to autonomic innervation of salivary glands: salivary alpha-amylase (sAA). Up to date, additional methodological research is needed for a better understanding of the advantages and disadvantages of sAA activity in comparison to already established markers of ANS activity. The aim of the present thesis is to further our knowledge of confounders of sAA activity under basal and acute stress conditions and to strengthen the validity of this enzyme as an easy obtainable alternative for ANS testing. After introducing classical and modern stress concepts and stress system physiology (chapter 2), the reader is acquainted with anatomical basics of salivary gland innervation and secretion of salivary proteins, including sAA, due to autonomic innervation (chapter 3 and 4). Afterwards, a more nuanced review of methodological considerations of sAA determination shows gaps of knowledge concerning its usefulness as a marker of ANS activity (chapter 5). Given the fact that the integration of sAA into developmental and aging research is a relative recent phenomenon, several issues have to be addressed before a final conclusion could be drawn. Therefore, we conducted a series of studies incorporating these considerations regarding behavioral correlates of inter- and intraindividual differences in sAA activity with a special emphasis on older adults. Chapter 7 deals with sAA activity under psychological stress conditions in different age groups. Since vulnerability to disease and disease prevalence patterns change with age, it is important to investigate stress reactivity of people in different age groups. We therefore investigated children between 6 and 10 years, because childhood is a sensitive period of growth and development, and thus plays an important role for later life health. Young adults were included to represent the most studied human age group as a reference. Older adults between 59 and 61 years were investigated, because at this age the course is set for the further development of a person’s health in later life, and because autonomic stress responses in older age might be important determinants of cardiovascular and inflammatory aging. Our goal is to test for associations of sAA with more established stress system markers, i.e., salivary cortisol as outcome measurement of HPA reactivity, heart rate (HR) and heart rate variability (HRV) as markers for autonomic reactivity, and to directly compare these responses between different age groups across the life span. Secretion of sAA and cortisol was repeatedly assessed in 62 children, 78 young adults, and 74 older adults after exposure to a standardized psychosocial stressor, the Trier Social Stress Test. In addition, cardiovascular activity was measured in both adult groups. Older adults showed attenuated sAA, HR, and HRV responses. Furthermore, we found higher sAA but lower cortisol at baseline as well as lower sAA and cortisol responses in children. Age by sex interactions were observed only for cortisol with higher responses in older male participants. No associations between the parameters were found. Results in children and young adults confirm previous results. Overall, findings implicate sAA as an alternative or additional autonomic stress marker throughout the life span, with marked and rapid responsiveness to stress in three relevant age groups. The impact of age and chronic stress on basal sAA activity is the center of interest in chapter 8. We therefore assessed diurnal profiles of sAA and salivary cortisol in 27 younger and 31 older competitive ballroom dancers as well as 26 younger and 33 older age- and sex-matched controls. According to the Allostatic Load concept, repeated, non-habituating responses to social-evaluative conditions, which characterize the lives of competitive ballroom dancers, should be associated with stress system dysregulations. Furthermore, we expect to see an increased sympathetic drive associated higher overall alpha-amylase activity in older adults. Analyses revealed an elevated daily overall output of sAA in older adults while there was no effect of age on mean cortisol levels. Alterations of diurnal rhythms were only seen in younger male dancers showing a flattened diurnal profile of sAA and younger dancers and female older dancers showing a blunted diurnal rhythmicity of cortisol. Furthermore, we found a negative correlation between summary indices of basal sAA and the amount of physical activity. In conclusion, higher overall output of sAA in older adults was in line with the phenomenon of a “sympathetic overdrive” with increasing age. Furthermore, a lower output of sAA in people who are more physical active was in line with the hypothesis of an exercise-induced decrease of sympathetic activity. Taken together, results of chapter 7 and 8 show a clear impact of age on sAA activity, either under acute stress or basal conditions. One problem when integrating sAA into developmental and aging research is the use of adrenergic agonists and antagonists what is very common in older adults, i.e. antihypertensive drugs (AD). As well, the previously shown sympathetic overactivity that occurs with normal aging is associated with higher blood pressure (BP). Therefore, chapter 9 deals with a possible impact of high BP and AD on diurnal sAA activity in 79 older adults (33 normotensive adults, 16 medicated vs. 45 hypertensive adults, 34 medicated). Results showed a pronounced rhythm of sAA in all groups. Diurnal profiles differed significantly between men and women with men lacking the typical decrease of sAA in the morning and showing more pronounced alterations throughout the day. An effect of AD on sAA profiles and area under the curve values indicates that subjects not using AD´s show a heightened diurnal profile and a higher total output of sAA. Descriptively, this was also true for hypertensive older adults. Hypertensive subjects and those not using AD showed the highest diurnal output of sAA and the steepest slope. In sum, our results show an impact of antihypertensive medication and a difference between normotensive and hypertensive subjects on characteristics of diurnal sAA activity. Hence, findings are of particular interest in research using sAA as a prognostic indicator of pathological states and processes. Given the fact that hypertension was also shown to be associated with substantial changes of transmitters within the suprachiasmatic nucleus (SCN) - the “biological clock” that receives photic input from retinal glands via the retinohypothalamic pathway - and an altered output from the SCN to the sympathetic nervous system, we broaden the idea of a possible effect of different lighting conditions on morning sAA profiles in chapter 10. In a counterbalanced within-subjects design six men and 16 women of different ages collected sAA morning profiles on two consecutive days with leaving their shutters closed on the one day (= dark) and open their shutters on the other day (= bright). We were able to replicate earlier findings of light-induced changes of salivary cortisol with higher responses during the bright condition. On either day, women showed larger cortisol increases than men. Despite multisynaptic autonomic connections arising from the SCN projecting to multiple organs of the body, we could not find an effect of sunlight on sAA morning profiles. Evidence for circadian clock gene expression in human oral mucosa might account for this result and indicates that peripheral oscillators may act more like integrators of multiple different time cues, e.g. light, food intake, instead of a “master” oscillator (SCN). Results of chapter 7 to 10 provide clear evidence that sAA is heightened in states of autonomic arousal, i.e. stress, aging and hypertension, and that its circadian rhythmicity seems to be regulated rather integrative than directly via efferent input from hypothalamic SCN neurons. In chapter 11 this thesis tries to approach one central question: What is the biological meaning of the findings made? According to this enzyme´s anti-bacterial and digestive action short term changes might not have a biological meaning itself but rather reflect just a small part of multiple coordinated body responses to stressful stimuli. While the sympathetic branch of the ANS mainly stimulates protein secretion, the parasympathetic branch stimulates saliva flow. Acute stress responses might therefore be interpreted as reflecting predominant sympathetic activity together with parasympathetic withdrawal. The same mechanism could also be suitable for the finding of higher diurnal levels of sAA in older adults or hypertensive subjects reflecting a higher peripheral sympathetic tone in these groups. Diurnal profiles of sAA itself may reflect circadian changes in autonomic balance. Circadian rhythms are of great advantage since they enable individuals to anticipate. This pre-adaptation enables the individual to cope with upcoming demands and challenges. Our finding of a relationship between sAA and salivary cortisol what strengthens the relevance of glucocorticoids that were previously shown to be able to phase shift circadian rhythms in cells and tissue. Within a food-related context there is evidence that decreasing levels of sAA in the morning could reflect increases of feeling hungry since sAA systematically increases during food consumption and with the subjective state of satiety. So far, much more research is needed to identify underlying physiological mechanisms of circadian sAA rhythmicity. Taking the next step, future studies will have to focus on the integration of sAA assessment into longitudinal studies and different disease states to prove its applicability as a marker of sympathetic neural functioning in the genesis and prognosis of disease.:Table of Contents 1. Introduction 1 2. Stress 3 2.1. Stress concepts 3 2.1.1. Traditional concepts of stress 3 2.1.2. Allostasis and Allostatic Load 4 2.2. Stress system physiology 6 2.2.1. The hypothalamic-pituitary-adrenal (HPA) axis 6 2.2.1.1. Physiology 6 2.2.1.2. HPA axis activity indicators 6 2.2.2. The autonomic nervous system (ANS) 7 2.2.2.1. Physiology 7 2.2.2.2. ANS activity indicators 8 2.2.3. Relationships between stress systems 10 3. Saliva and salivary glands 11 3.1. Physiology 11 3.1.1. Anatomy, origin, and composition 11 3.1.2. Innervation 12 3.1.3. Salivary gland physiology with aging 13 3.2. Saliva and salivary flow 13 3.3. Protein secretion 14 4. Alpha-amylase in saliva 15 4.1. Chemical characteristics 15 4.2. Secretion of alpha-amylase 15 4.3. Diagnostic value of alpha-amylase 16 5. Methodological considerations of alpha-amylase determination 17 5.1. Collection methods and preparation 17 5.1.1. Saliva collection 17 5.1.2. Impact of flow rate 17 5.1.3. Impact of pH-value 18 5.2. Biochemical determination 18 5.3. Interindividual differences in sAA activity 19 5.3.1. Basal activity 20 5.3.2. Acute responses 20 5.3.3. Age effects 21 5.3.3.1. Basal amylase activity 21 5.3.3.2. Stress-induced amylase activity 21 5.3.4. Sex differences 22 5.3.4.1. Basal amylase activity 22 5.3.4.2. Stress-induced amylase activity 23 5.3.5. Modulating factors influencing amylase (re-)activity 24 5.3.5.1. Impact of smoking 24 5.3.5.2. Impact of alcohol 25 5.3.5.3. Impact of caffeine 25 5.3.5.4. Impact of high body fat and obesity 26 5.3.5.5. Impact of food intake 26 5.3.5.6. Impact of physical exercise 27 5.3.5.7. Impact of somatic and psychiatric diseases 27 5.3.5.8. Impact of medical drugs 29 5.3.5.9. Impact of sunlight on diurnal amylase 29 6. Aims and outline of the present work 31 7. Salivary alpha-amylase stress reactivity across different age groups 32 7.1. Introduction 32 7.2. Methods 35 7.2.1. Participants 35 7.2.2. Study Protocol 35 7.2.3. Measures 36 7.2.3.1. Saliva sampling 36 7.2.3.2. Heart rate and heart rate variability 36 7.2.3.3. Biochemical analyses 37 7.2.3.4. Psychometrical analyses 37 7.2.4. Statistical analyses 38 7.3. Results 38 7.3.1. Sample characteristic 38 7.3.2. Subjective stress response 39 7.3.3. Physiological stress response 39 7.3.3.1. Salivary alpha-amylase 39 7.3.3.2. Salivary cortisol 40 7.3.3.3. Heart rate 42 7.3.3.4. Heart rate variability 43 7.3.3.5. Determinants of the salivary alpha-amylase stress response 45 7.4. Discussion 45 7.5. Conclusion 48 8. Aging diurnal rhythms and chronic stress: Distinct alteration of diurnal rhythmicity of salivary alpha-amylase and cortisol 49 8.1. Introduction 49 8.2. Methods 52 8.2.1. Participants 52 8.2.2. Study protocol 53 8.2.3. Measures 53 8.2.3.1. Saliva sampling 53 8.2.3.2. Biochemical parameters 54 8.2.3.3. Psychological parameters 54 8.2.4. Statistical analyses 54 8.2.4.1. Preliminary analyses 54 8.2.4.2. Diurnal course of salivary alpha-amylase 55 8.3. Results 56 8.3.1. Sample characteristic 56 8.3.2. Preliminary analyses: impact of oral contraceptives, blood pressure, and lipid lowering medication on diurnal profiles 56 8.3.3. Diurnal course of salivary alpha-amylase 57 8.3.3.1. Salivary alpha-amylase over the day 57 8.3.3.2. Salivary alpha-amylase after awakening 58 8.3.4. Diurnal course of salivary cortisol 59 8.3.4.1. Salivary cortisol over the day 59 8.3.4.2. Salivary cortisol after awakening 60 8.3.5. Diurnal course of salivary biomarkers: associations and determinants 61 8.4. Discussion 62 8.5. Conclusion 65 9. Impact of blood pressure and antihypertensive drugs on diurnal alpha-amylase activity: A novel marker of sympathetic drive 67 9.1. Introduction 67 9.2. Methods 68 9.2.1. Participants 68 9.2.2. Study protocol 69 9.2.3. Measures 69 9.2.3.1. Saliva sampling 69 9.2.3.2. Biochemical parameters 69 9.2.3.3. Blood pressure assessment 70 9.2.4. Statistical analyses 70 9.3. Results 70 9.3.1. Participants 70 9.3.2. Salivary alpha-amylase 71 9.3.2.1. Salivary alpha-amylase over the day 71 9.3.2.2. Salivary alpha-amylase after awakening 74 9.4. Discussion 75 9.5. Perspectives 76 10. Light affects morning salivary cortisol, but not salivary alpha-amylase 77 10.1. Introduction 77 10.2 Methods 79 10.2.1. Participants 79 10.2.2. Study protocol 80 10.2.3. Measures 80 10.2.3.1. Saliva sampling 80 10.2.3.2. Biochemical parameters 81 10.2.4. Statistical analyses 81 10.3. Results 82 10.3.1. Sociodemographics 82 10.3.2. Salivary alpha-amylase 82 10.3.3. Salivary cortisol 84 10.3.4. Associations between biochemical parameters 85 10.4. Discussion 86 10.5. Conclusion 89 11. General discussion 90 11.1. Summary of the results 90 11.1.1. Salivary alpha-amylase stress reactivity across different age groups 91 11.1.2. Aging diurnal rhythms and chronic stress: Distinct alteration of diurnal rhythmicity of salivary alpha-amylase and cortisol 91 11.1.3. Impact of blood pressure and antihypertensive drugs on diurnal alpha-amylase activity: A novel marker of sympathetic drive 92 11.1.4. Light affects salivary morning cortisol, but not salivary alpha-amylase 93 11.2. Integration of main findings 93 11.3. Stress-induced amylase activity, basal rhythm, and its biological meaning 95 11.4. Methodological consequences 97 11.4.1. Circadian variation 97 11.4.2. Longitudinal variation 98 11.4.3. Short-term variation and stability 98 11.4.4. Long-term change 99 11.5. Outlook 100 12. References 102

Violent cnme is among the most prominent distinguishing characteristics of South African society, it has a severely traumatising effect on the populations concerned. Based on research :findings and existing literature, this study explores traumatic effects of violent crime on the most intimate associate of the victim (the partner). Accordingly, this study deals with the much-neglected topic of secondary trauma, by focusing on the following aspects of or conditions associated with violent crime and the secondary victim: cognitive, emotional and relational effects the experience of trauma, loss, vulnerability, depression and acute stress. It reveals that, depending on the severity of the incident, its consequences for the partner of the victim may range from post-traumatic stress to acute stress or secondary traumatic stress. From the similar results returned for primary and secondary victims, it is apparent that in the future, both victim and supporter should have their needs addressed with equal emphasis. / Educational Studies / M.Ed. (Specialisation in Guidance and Councelling)

Violent cnme is among the most prominent distinguishing characteristics of South African society, it has a severely traumatising effect on the populations concerned. Based on research :findings and existing literature, this study explores traumatic effects of violent crime on the most intimate associate of the victim (the partner). Accordingly, this study deals with the much-neglected topic of secondary trauma, by focusing on the following aspects of or conditions associated with violent crime and the secondary victim: cognitive, emotional and relational effects the experience of trauma, loss, vulnerability, depression and acute stress. It reveals that, depending on the severity of the incident, its consequences for the partner of the victim may range from post-traumatic stress to acute stress or secondary traumatic stress. From the similar results returned for primary and secondary victims, it is apparent that in the future, both victim and supporter should have their needs addressed with equal emphasis. / Educational Studies / M.Ed. (Specialisation in Guidance and Councelling)