Endocrine Abstracts

According to recent research in the field of Psychoneuroendocrinology each stressor appears to have its own neurochemical signature. The present study examined whether keeping a secret stimulates the HPA or the SAM axis as well as cortisol involvement in lying.

Methods: Sixty seven (N=67) healthy young male medical students participated in the study. Students were randomly assigned in 3 groups. All students were informed that they were about to have a 5 min consultation with a 26 year-old woman with non-operable brain tumour. They were also given information about prognosis, treatment and side effects. Group A (disclosure group) was instructed to reveal the information about the diagnosis, prognosis, and treatment. Group B (concealment group) was instructed not to reveal the truth concerning the diagnosis, and prognosis, while students in group C (control group) were instructed to conduct a structured interview concerning dietary habits. Mood, cardiovascular reactivity and salivary cortisol was assessed at baseline (T1), 30 minutes later (T2), and immediately after the task (T3). In addition heart rate was assessed during the consultation using a digital signal extraction pulse oximeter.

Results: Compared to the control group, there was a significant increase in anxiety and negative affect in both experimental groups from T1 to T2 that significantly decreased from T2 to T3 to baseline levels only in the concealment group. In the concealment group there was also a significant decrease of heart rate throughout the consultation (F=5.304, P=0.011). The salivary cortisol significantly changed in all three groups throughout the process (F=5.557, P=0.007).

Conclusions: Results show that performance anxiety is involved in cortisol secretion. However concealment/ secrecy only results in SAM activation. Further research is needed to ascertain the endocrine proceedings taking place and eventually design a strategic plan on training for handling bad news in medical settings.