Do venepuncture procedures induce cortisol responses? A review, study, and synthesis for stress research
Abstract
Venepuncture procedures are frequently employed to continuously monitor humoral stress markers. As such procedures are conceived as "potent psychological and physiological stressors", there is a need to determine whether venepuncture procedures themselves elicit cortisol responses and if so, how to deal with them appropriately. In order to assess the rate of cortisol responses to venepuncture, we conducted a literature review, which suggested that venepuncture procedures induce cortisol responses with a probability of approximately 30%. By utilizing Bayesian analysis, this result was integrated with the cortisol data of 18 healthy men who were exposed to a venepuncture procedure twice (time lag: 1 week). The currently observed response rate of 47% differed substantially from the earlier findings, which we attribute to a self-selective sampling of participants. In addition, participants showing a response to the first venepuncture were highly likely to also show a response to the second one. In this regard, we discuss the presumed conditioning of cortisol responses to venepuncture procedures. To prevent the superposition of venepuncture-induced cortisol responses and responses induced by target stressors, we propose a time- and selection-based strategy: cortisol samples taken about 110min after venepuncture should be virtually adjusted for its superimposing effects. Furthermore, previous experiences of venepuncture were highly predictive for cortisol responsiveness. This association could be utilized in further studies to identify participants who will probably show a cortisol response to venepuncture.
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The computed cortisol-AUC measurement reflects the cortisol response elicited during the entire experimental session, including pain induction and venipuncture procedures preceding the TSST, rather than a specific response to the TSST.
“The computed cortisol-AUC measurement reflects the cortisol response elicited during the entire experimental session, including the pain induction and venipuncture procedures preceding the TSST,(64) rather than a specific response to the TSST.”
The cortisol-AUC results reported here should not be interpreted as reflecting cortisol responses to the TSST, per se, but a more generalized cortisol response to the entire experimental session.
“Therefore, the cortisol-AUC results reported here should not be interpreted as reflecting cortisol responses to the TSST, per se, but a more generalized cortisol response to the entire experimental session.(64)”
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<b>mice</b>: Multivariate Imputation by Chained Equations in<i>R</i>
Buuren, S. V., & Groothuis-Oudshoorn, K. (2011) · Journal of Statistical Software · doi:10.18637/jss.v045.i03 · Cited by 13,870 · see citing works
Neuroendocrine pharmacology of stress
Carrasco, G. A., & Van de Kar, L. D. (2003) · European Journal of Pharmacology · doi:10.1016/s0014-2999(03)01285-8 · Cited by 914 · see citing works
Engert, V., Vogel, S., Efanov, S. I., Duchesne, A., Corbo, V., Ali, N., & Pruessner, J. C. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.02.018 · Cited by 232 · cited 1× · see citing works
“cortisol concentrations from the first to the second sample is assumed to indicate a cortisol response to the first venepuncture experience (Engert et al., 2011).”
BackgroundSalivary cortisone is a potential biomarker for serum free cortisol
Perogamvros, I., Keevil, B. G., Ray, D. W., & Trainer, P. J. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-1215 · Cited by 222 · see citing works
Kirschbaum, C., Wüst, S., Faig, H. G., & Hellhammer, D. H. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.75.6.1464659 · Cited by 195 · see citing works
Self-citationStark, R., Wolf, O. T., Tabbert, K., Kagerer, S., Zimmermann, M., Kirsch, P., Schienle, A., & Vaitl, D. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2006.05.046 · Cited by 167 · see citing works
Cortisol responses to psychological stress and correlations with personality traits
Kirschbaum, C., Bartussek, D., & Strasburger, C. J. (1992) · Personality and Individual Differences · doi:10.1016/0191-8869(92)90181-n · Cited by 115 · see citing works
Self-citationWorking with rather than against macaques during blood collection
Reinhardt, V. (2003) · Journal of Applied Animal Welfare Science · doi:10.1207/s15327604jaws0603_04 · Cited by 96 · see citing works
A Stochastic Differential Equation Model of Diurnal Cortisol Patterns
Brown, E. N., Meehan, P. M., & Dempster, A. P. (2001) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.2001.280.3.e450 · Cited by 61 · see citing works
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Tabak, B. A., Leng, G., Szeto, A., Parker, K. J., Verbalis, J. G., Ziegler, T. E., Lee, M. R., Neumann, I. D., & Mendez, A. J. (2023) · Molecular Psychiatry · doi:10.1038/s41380-022-01719-z · Cited by 170 · see citing works
Fischer, S., Macare, C., & Cleare, A. J. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2017.10.012 · Cited by 70 · see citing works
Wolkow, A., Ferguson, S., Aisbett, B., & Main, L. (2015) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.00227 · Cited by 50 · see citing works
Fingernail cortisol – State of research and future directions
Fischer, S., Schumacher, S., Skoluda, N., & Strahler, J. (2020) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2020.100855 · Cited by 40 · see citing works
(2017) · Journal of the Endocrine Society · doi:10.1210/js.2016-1094 · Cited by 33 · see citing works
Andersen, E., Geiger, P., Schiller, C., Bluth, K., Watkins, L., Zhang, Y., Xia, K., Tauseef, H., Leserman, J., Girdler, S., et al. (2021) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000889 · Cited by 19 · see citing works
Effects of psychosocial work characteristics on hair cortisol – findings from a post-trial study
Herr, R. M., Barrech, A., Gündel, H., Lang, J., Quinete, N. S., Angerer, P., & Li, J. (2017) · Stress · doi:10.1080/10253890.2017.1340452 · Cited by 15 · see citing works
- Authors
- Weckesser, L. J., Plessow, F., Pilhatsch, M., Muehlhan, M., Kirschbaum, C., & Miller, R.
- Affiliations
- Technische Universität Dresden (DE)
- Beth Israel Deaconess Medical Center (US)
- University Hospital Carl Gustav Carus (DE)
- Corresponding author
- Miller, Robert
- ORCID
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 46
- Pages
- 88-99
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2113830094
- Cited by
- 72
- References
- 9
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 4 · 2023: 9 · 2022: 1 · 2021: 8 · 2020: 6 · 2019: 6 · 2018: 8 · 2017: 11 · 2016: 2 · 2015: 4 · 2014: 1
- FWCI
- 2.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- venipuncture, cortisol response, stress response, healthy men
- MeSH terms
- Adolescent, Adult, Depression, Fear, Humans, Hydrocortisone, Male, Personality, Stress, Psychological, Phlebotomy, Young Adult
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