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281.
  • Aardal-Eriksson, Elisabeth (författare)
  • Salivary cortisol and posttraumatic stress reactions : methodological and applied studies before and after trauma
  • 2002
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The field of psychotraumatology has its roots in ancient history. During the past decades, the surveillance of the psychobiological background of reactions to and consequences of traumatic stress has made great progress and the complexity of the human stress response system stands out. The hypothalamic-pituitary-adrenocortical axis activity, modulated by various neuroimmunological substances, seems to play a major role in the stress response. However, there are still inconsistencies in explanations of relationships between biological and psychological changes following traumatic stress. Moreover, the matter of predictive factors for the development of posttraumatic morbidity is still in a speculative phase.The aims of the present thesis were to further develop a commercial serum cortisol radioimmunoassay (RIA) for determination of cortisol in saliva and to test its reliability, specificity and sensitivity as a biochemical assay. The saliva sampling procedures and sample storage stability were also to be tested. Further issues were to investigate determinations of salivary cortisol and serum prolactin in relation to selfratings of posttraumatic psychological distress and general psychological health. Possible predictive and concurrent validity of salivary cortisol as a biochemical marker for posttraumatic psychological distress were to be tested.Cortisol is present in saliva mainly in non-protein form, representing the free, biologically active fraction of the total plasma cortisol concentration. In a first phase of the present thesis, the commercial serum cortisol RIA was modified for determination of cortisol in saliva. The relation between salivary and serum cortisol concentrations was tested. Reference ranges at 8 AM and 10 PM for the salivary cortisol assay were established from 195 healthy subjects. Salivary cortisol concentrations were tested in relation to serum cortisol in estimating adrenocortical function during endocrine dynamic function tests in 37 patients and 13 healthy controls. In testing salivary cortisol as a marker for stress for fieldwork use, a screening study was performed on 66 male rescue workers. Salivary cortisol at 8 AM and 10 PM and serum prolactin were determined and general psychological health and posttraumatic psychological distress were estimated with the self-rating scales General Health Questionnaire, Impact of Event Scale and Posttraumatic Symptom Scale. These scales were used in the second phase of the thesis. Three applied follow-up studies were performed with sampling of salivary cortisol and self-ratings: (a) a study of 31 UN-soldiers five days, two and nine months after a mine accident; (b) a study of 145 UN-soldiers before, at return, and two and six month after a six month mission. (c) a study of 101 UN-soldiers six and twelve months after a six month mission with severe combat exposure.The results from the present thesis indicate that the modified method of salivary cortisol determination possesses sufficient precision, accuracy, sample storage stability and procedural advantages for laboratory, clinical and field application. Moreover, it possesses moderate predictive information and moderate to high concurrent validity as a biochemical marker for posttraumatic psychological distress.
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282.
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283.
  • Aardal-Eriksson, Elisabeth, et al. (författare)
  • Salivary cortisol and serum prolactin in relation to stress rating scales in a group of rescue workers
  • 1999
  • Ingår i: Biological Psychiatry. - 0006-3223 .- 1873-2402. ; 46:6, s. 850-855
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Rescue service personnel are often exposed to traumatic events as part of their occupation, and higher prevalence rates of psychiatric illness have been found among this group.Methods: In 65 rescue workers, salivary cortisol at 8 am and 10 pm and serum prolactin at 8 am were related to the psychiatric self-rating scale General Health Questionnaire (GHQ-28) measuring psychiatric health, and the Impact of Events Scale (IES) and Post Traumatic Symptom Scale (PTSS) measuring posttraumatic symptoms.Results: Seventeen percent of the study population scored above the GHQ-28 cut-off limit but none scored beyond the cut-off limit in the IES and PTSS questionnaires. Salivary cortisol concentration at 10 pm correlated with statistical significance to anxiety (p < .005) and depressive symptoms (p < .01) measured with GHQ-28, as well as to posttraumatic symptoms, with avoidance behavior measured with IES (p < .01) and PTSS (p < .005). Two of the rescue workers were followed over time with the same sampling procedure after a major rescue commission.Conclusions: The correlation between evening salivary cortisol and anxiety, depressiveness, and posttraumatic avoidance symptoms indicates that these parameters can be used in screening and follow-up after traumatic stress events.
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284.
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285.
  • Aardal-Eriksson, Elisabeth, et al. (författare)
  • Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up
  • 2001
  • Ingår i: Biological Psychiatry. - 0006-3223 .- 1873-2402. ; 50:12, s. 986-993
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Because traumatic events are unpredictable, there are few studies of psychobiological states immediately following such events. Our study aimed to determine the relation of salivary cortisol to psychologic distress immediately after a traumatic event and then during follow-up.Methods: Measurement of morning and evening salivary cortisol and ratings of psychologic distress (using the Impact of Events Scale [IES], the Post Traumatic Symptom Scale, and the General Health Questionnaire) were performed with 31 United Nations soldiers at three time points—5 days and 2 and 9 months—following a mine accident in Lebanon.Results: Five days after the accident, 15 subjects reported substantial posttraumatic distress according to the IES, as well as significantly lower morning and higher evening cortisol levels compared with the low-impact group. Within 9 months, the posttraumatic distress of the high-impact group was reduced, accompanied by an increase in morning and a decrease in evening cortisol levels. There were significant relationships between evening cortisol and all rating scales at the first and third time points.Conclusions: Subclinical posttraumatic stress following an adverse event can be measured biologically via salivary cortisol levels soon after the event.
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286.
  • Aardal, Karen, et al. (författare)
  • Decomposition principles applied to the dynamic production and work-force scheduling problem
  • 1987
  • Ingår i: Engineering Costs and Production Economics. - 0167-188X .- 1878-4011. ; 12:1-4, s. 39-49
  • Tidskriftsartikel (refereegranskat)abstract
    • One of the most important problems in the production and inventory planning field, is the scheduling of production and work force in a dynamic environment. Although this problem can be formulated as a linear program, it is often quite difficult to solve directly, due to its large scale. Instead, it might be fruitful to use a decomposition approach. Decomposition, in general, means decomposing a difficult problem into several easier, or a sequence of easier problems which are later coordinated to reconstruct the original problem.In this report we discuss several possibilities of applying the most common decomposition principles, namely Benders (primal) and Datnzig-Wolfe (dual), as well as a relatively new decomposition method, called cross decomposition, to the dynamic, multiproduct production and employment planning problem. A number of special cases are also presented.
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287.
  • Aardal, Karen, et al. (författare)
  • On the resemblance between the Kornai-Liptak and cross decomposition techniques for block-angular linear programs
  • 1990
  • Ingår i: European Journal of Operational Research. - : Elsevier BV. - 0377-2217 .- 1872-6860. ; 46:3, s. 393-398
  • Tidskriftsartikel (refereegranskat)abstract
    • In this paper the resemblance is demonstrated between the master- and subproblems generated by the Kornai-Liptak algorithm and the subproblems obtained by using the cross decomposition method on linear optimization problems with block-angular structure. The significance of the similarity between these two algorithms becomes apparent considering the main disadvantage attributed to cross decomposition. In cross decomposition a master problem has to be solved from time to time since the subproblems alone do not always give a converging sequence of primal and dual solutions. But if the cross decomposition algorithm is modified in such a way that the successive primal and dual subproblem solutions are taken into consideration with equal weights, this results in the Kornai-Liptak algorithm for which convergence is guaranteed
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288.
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289.
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290.
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