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Due to physical hindrance and time spent in hospital, a cancer diagnosis can lead to disturbance of personally important goals. Goal disturbance in cancer patients has been related to poorer psychological well-being. However, the relation with physiological measures is yet unknown. The purpose of the current study is to examine the impact of goal disturbance on cortisol as a measure of response to stress over time, and a possibly moderating role of a DNA genotype associated with HPA-axis functioning, Catechol-O-Methyl transferase (COMT). We examined the predictive value of goal disturbance on Cortisol Awakening Response (CAR) and Diurnal Cortisol Slope (DCS) over two periods: 1-7 and 7-18 months post-diagnosis, and the moderating role of COMT during these periods. Hierarchical regression analyses showed that goal disturbance 7 months post-diagnosis significantly predicted a steeper CAR a year later. During that period, the slow COMT variant moderated the relation, in that patients reporting high goal disturbance and had the Met/Met variant, had a more flattened CAR. No other significant effects were found. As steeper CARs have been related to adverse health outcomes, and COMT genotype may modify this risk, these results indicate that goal disturbance and genotype may be important factors to consider in maintaining better psychological and physical health in the already vulnerable population of cancer patients.

ObjectivesAssociations between biological stress markers and depression are inconsistent across studies. We assessed whether inter- and intra-individual variability explain these inconsistencies.MethodsPair-matched depressed and non-depressed participants (N = 30) collected saliva thrice a day for 30 days, resulting in 90 measurements per individual. The relationships between measures of stress-system function and depression were examined at the group level by means of mixed model analyses, and at the individual level by means of pair-matched comparisons. The analyses were repeated after adjusting for time-varying lifestyle factors by means of time-series regression analyses.ResultsCortisol and α-amylase levels were higher, the α-amylase/cortisol ratio larger, and the daily cortisol slope steeper in the depressed compared to the non-depressed group. Adjusting for lifestyle factors and antidepressant use reduced the associations under study. In 40%-60% of the matched comparisons, depressed individuals had higher cortisol and α-amylase levels, a larger α-amylase/cortisol ratio, and a steeper daily slope than their non-depressed match, regardless of adjustment.ConclusionsOur group-level findings were mostly in line with the literature but generalization to individuals appeared troublesome. Findings of studies on this topic should be interpreted with care, because in clinical practice the focus is on individuals instead of groups.