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A Small, Exploratory Analysis of Fingernail Cortisol, Psychosocial Well-Being, and Social Support Among Undergraduate Students During the COVID-19 Pandemic

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Abstract

Objectives

College students adjusted to a unique learning environment under the pressures of the COVID-19 pandemic. Living on campus and participating in “hybrid” instruction demands, individuals experienced contexts that were often socially and psychologically demanding, with potential physiological implications. In this exploratory analysis, we tested for correlations between perceived psychosocial stress and potential stress-buffering processes with fingernail cortisol, a relatively new method for measuring cumulative cortisol production in prior months. We specifically drew on data collected from a small sample of university undergraduates living on campus during a pandemic-affected semester.

Methods

We conducted this study in the Spring of 2021 with University of Notre Dame undergraduate students (age 18–21 years, n = 41). We collected data on participants’ cortisol in the 3–5 months prior through sampling of fingernails. We also collected demographic, disposition, and psychosocial data, including participants’ perceived psychosocial stress, social support, sense of school membership, and satisfaction with the university’s COVID-19 response.

Results

We found non-significant positive associations for nail cortisol with recent perceived stress and neuroticism. Students had (non-significantly) lower nail cortisol if they reported greater social support or higher self-compassion. Finally, participants who were more satisfied with the university’s COVID-19 program had significantly lower nail cortisol. The 95% confidence intervals for these findings were wide and generally included zero, indicating imprecision in our data.

Conclusions

In this exploratory study, we found associations between participants’ fingernail cortisol that align in the predicted directions for using nail cortisol as a stress-related biomarker. The effect sizes for our results are small but are generally comparable to those for chronic stress and cortisol measured through other methods. Given the wide confidence intervals for our results, the findings should be considered preliminary. They may highlight the potential of investigating the role of fingernail cortisol as an indicator of chronic stress activation.

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Data Availability

We have attached the data necessary to replicate the analyses in the manuscript as supplementary material in the current submission.

Notes

  1. Our exploratory analyses are potential candidates for adjustment for multiple comparisons. However, the utility of such adjustments in exploratory analyses has been questioned compared to their application in confirmatory analyses, particularly those that are pre-registered (see Rubin, 2017). Given our emphasis on effect sizes and their 95% confidence intervals, we do not think that adjustment for multiple comparisons would substantially improve or affect the interpretation of the results.

References

  • Adam, E. K., Quinn, M. E., Tavernier, R., McQuillan, M. T., Dahlke, K. A., & Gilbert, K. E. (2017). Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysis. Psychoneuroendocrinology, 83, 25–41.

    Article  Google Scholar 

  • Arbona, C., Fan, W., Phang, A., Olvera, N., & Dios, M. (2021). Intolerance of uncertainty, anxiety, and career indecision: A mediation model. Journal of Career Assessment, 29(4), 699–716.

    Article  Google Scholar 

  • Amrhein, V., Korner-Nievergelt, F., & Roth, T. (2017). The earth is flat (p> 0.05): significance thresholds and the crisis of unreplicable research. PeerJ, 5, e3544.

  • Ballonoff Suleiman, A., Till Hoyt, L., & Cohen, A. K. (2022). “It Was Definitely like an Altered Social Scene”: Effects of the COVID-19 Pandemic Restrictions on US Adolescents’ Social Relationships. Youth, 3(1), 18–32.

    Article  Google Scholar 

  • Bovier, P. A., Chamot, E., & Perneger, T. V. (2004). Perceived stress, internal resources, and social support as determinants of mental health among young adults. Quality of Life Research, 13, 161–170.

    Article  Google Scholar 

  • Button, K. S., Ioannidis, J. P., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S., & Munafò, M. R. (2013). Power failure: Why small sample size undermines the reliability of neuroscience. Nature Reviews Neuroscience, 14(5), 365–376.

    Article  Google Scholar 

  • Chao, R. C. L. (2012). Managing perceived stress among college students: The roles of social support and dysfunctional coping. Journal of College Counseling, 15(1), 5–21.

    Article  Google Scholar 

  • Cohen, S., & Janicki-Deverts, D. (2012). Who’s stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006 and 2009. Journal of Applied Social Psychology, 42(6), 1320–1334.

    Article  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 386–396.

    Article  Google Scholar 

  • Cumming, G. (2014). The new statistics: Why and how. Psychological Science, 25(1), 7–29.

    Article  Google Scholar 

  • DeCaro, J. A., & Helfrecht, C. (2022). Applying minimally invasive biomarkers of chronic stress across complex ecological contexts. American Journal of Human Biology, 34(11), e23814.

    Article  Google Scholar 

  • Dev, V., Fernando, A. T., & Consedine, N. S. (2020). Self-compassion as a stress moderator: A cross-sectional study of 1700 doctors, nurses, and medical students. Mindfulness, 11, 1170–1181.

    Article  Google Scholar 

  • Dickerson, S. S., & Kemeny, M. E. (2004). Acute Stressors and Cortisol Responses: A Theoretical Integration and Synthesis of Laboratory Research. Psychological Bulletin, 130(3), 355–391.

    Article  Google Scholar 

  • Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49(1), 71–75.

    Article  Google Scholar 

  • Doan, S. N., DeYoung, G., Fuller-Rowell, T. E., Liu, C., & Meyer, J. (2018). Investigating relations among stress, sleep and nail cortisol and DHEA. Stress, 21(2), 188–193.

    Article  Google Scholar 

  • Erickson, T. M., Jacobson, S. V., Banning, R. L., Quach, C. M., & Reas, H. E. (2021). Big five traits and interpersonal goals during stressors as predictors of hair cortisol. Comprehensive Psychoneuroendocrinology, 8, 100084.

    Article  Google Scholar 

  • Fischer, S., Schumacher, S., Skoluda, N., & Strahler, J. (2020). Fingernail cortisol–state of research and future directions. Frontiers in Neuroendocrinology, 58, 100855.

    Article  Google Scholar 

  • Flinn, M. V., & England, B. G. (1995). Childhood stress and family environment. Current Anthropology, 36(5), 854–866.

    Article  Google Scholar 

  • Flinn, M. V., Nepomnaschy, P. A., Muehlenbein, M. P., & Ponzi, D. (2011). Evolutionary functions of early social modulation of hypothalamic-pituitary adrenal Axis development in humans. Neuroscience and Biobehavioral Reviews, 35(7), 1611–1629.

    Article  Google Scholar 

  • Gelman, A., & Carlin, J. (2014). Beyond power calculations: Assessing type S (sign) and type M (magnitude) errors. Perspectives on Psychological Science, 9(6), 641–651.

    Article  Google Scholar 

  • Gettler, L. T., Lew-Levy, S., Sarma, M. S., Miegakanda, V., Doxsey, M., Meyer, J. S., & Boyette, A. H. (2021). Children’s fingernail cortisol among BaYaka foragers of the Congo Basin: Associations with fathers’ roles. Philosophical Transactions of the Royal Society B, 376(1827), 20200031.

    Article  Google Scholar 

  • Gupta, G. R., Dhruw, V. K., Athawal, B. K., Siddiqui, P., Agrawal, H. K., & Chandra, H. (2005). Human nail growth pattern and medicolegal aspect. Journal of Indian Academy of Forensic Medicine, 27(2), 87–91.

    Google Scholar 

  • Goodenow, C. (1993). The psychological sense of school membership among adolescents: Scale development and educational correlates. Psychology in the Schools, 30(1), 79–90.

    Article  Google Scholar 

  • Hamdan-Mansour, A. M., & Dawani, H. A. (2008). Social support and stress among university students in Jordan. International Journal of Mental Health and Addiction, 6(3), 442–450.

    Article  Google Scholar 

  • Hefner, J., & Eisenberg, D. (2009). Social support and mental health among college students. American Journal of Orthopsychiatry, 79(4), 491–499.

    Article  Google Scholar 

  • Hoyt, L. T., Cohen, A. K., Dull, B., Castro, E. M., & Yazdani, N. (2021). “Constant stress has become the new normal”: Stress and anxiety inequalities among US college students in the time of COVID-19. Journal of Adolescent Health, 68(2), 270–276.

    Article  Google Scholar 

  • Izawa, S., Matsudaira, K., Miki, K., Arisaka, M., & Tsuchiya, M. (2017). Psychosocial correlates of cortisol levels in fingernails among middle-aged workers. Stress, 20(4), 386–389.

    Article  Google Scholar 

  • Izawa, S., Sugaya, N., Ogawa, N., Shirotsuki, K., & Nomura, S. (2021). A validation study on fingernail cortisol: Correlations with one-month cortisol levels estimated by hair and saliva samples. Stress, 24(6), 734–741.

    Article  Google Scholar 

  • Jankovic-Rankovic, J., Oka, R. C., Meyer, J. S., & Gettler, L. T. (2020). Forced migration experiences, mental well-being, and nail cortisol among recently settled refugees in Serbia. Social Science & Medicine, 258, 113070.

    Article  Google Scholar 

  • Jankovic-Rankovic, J., Oka, R. C., Meyer, J. S., Snodgrass, J. J., Eick, G. N., & Gettler, L. T. (2022). Transient refugees’ social support, mental health, and physiological markers: Evidence from Serbian asylum centers. American Journal of Human Biology, 34, e23747.

    Article  Google Scholar 

  • Jeon, H., Lee, K., & Kwon, S. (2016). Investigation of the structural relationships between social support, self-compassion, and subjective well-being in Korean elite student athletes. Psychological Reports, 119(1), 39–54.

    Article  Google Scholar 

  • John, O. P., Donahue, E. M., & Kentle, R. L. (1991). The Big Five Inventory - Versions 4a and 54. Berkeley, CA: University of California, Berkeley, Institute of Personality and Social Research.

    Google Scholar 

  • Li, Y., Jia, W., Yan, N., Hua, Y., Han, T., Yang, J., Ma, L., & Ma, L. (2023). Associations between chronic stress and hair cortisol in children: A systematic review and meta-analysis. Journal of Affective Disorders.

  • Maker Castro, E., Dull, B., Hoyt, L. T., & Cohen, A. K. (2022). Associations between critical consciousness and well-being in a national sample of college students during the COVID-19 pandemic. Journal of Community Psychology, 50(2), 760–777.

    Article  Google Scholar 

  • Meyer, J. S., & Novak, M. A. (2021). Assessment of prenatal stress-related cortisol exposure: Focus on cortisol accumulation in hair and nails. Developmental Psychobiology, 63(3), 409–436.

    Article  Google Scholar 

  • Miller, G. E., Chen, E., & Zhou, E. S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychology Bulletin Journal, 133(1), 25–45.

    Article  Google Scholar 

  • Neely, M. E., Schallert, D. L., Mohammed, S. S., Roberts, R. M., & Chen, Y. J. (2009). Self-kindness when facing stress: The role of self-compassion, goal regulation, and support in college students’ well-being. Motivation and Emotion, 33, 88–97.

    Article  Google Scholar 

  • Neff, K. D. (2003). Development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250.

    Article  Google Scholar 

  • Park, M. J., Paul Mulye, T., Adams, S. H., Brindis, C. D., & Irwin, C. E. (2006). The health status of young adults in the United States. Journal of Adolescent Health, 39(3), 305–317.

    Article  Google Scholar 

  • Pendry, P., & Adam, E. K. (2007). Associations between parents’ marital functioning, maternal parenting quality, maternal emotion and child cortisol levels. International Journal of Behavioral Development, 31(3), 218–231.

    Article  Google Scholar 

  • Rietschel, L., Streit, F., Zhu, G., McAloney, K., Kirschbaum, C., Frank, J., Hansell, N. K., Wright, M. J., McGrath, J. J., Witt, S. H., Rietschel, M., & Martin, N. G. (2016). Hair cortisol and its association with psychological risk factors for psychiatric disorders: A pilot study in adolescent twins. Twin Research and Human Genetics, 19(5), 438–446.

    Article  Google Scholar 

  • Rubin, M. (2017). Do p values lose their meaning in exploratory analyses? It depends how you define the familywise error rate. Review of General Psychology, 21(3), 269–275.

    Article  Google Scholar 

  • Savitsky, B., Findling, Y., Ereli, A., & Hendel, T. (2020). Anxiety and coping strategies among nursing students during the covid-19 pandemic. Nurse Education in Practice, 46, 102809.

    Article  Google Scholar 

  • Shochet, I. M., Dadds, M. R., Ham, D., & Montague, R. (2006). School connectedness is an underemphasized parameter in adolescent mental health: Results of a community prediction study. Journal of Clinical Child & Adolescent Psychology, 35(2), 170–179.

    Article  Google Scholar 

  • Smith, K. J., Rosenberg, D. L., & Timothy Haight, G. (2014). An assessment of the psychometric properties of the perceived stress scale-10 (PSS 10) with business and accounting students. Accounting Perspectives, 13(1), 29–59.

    Article  Google Scholar 

  • Stalder, T., & Kirschbaum, C. (2012). Analysis of cortisol in hair–state of the art and future directions. Brain, Behavior, and Immunity, 26(7), 1019–1029.

    Article  Google Scholar 

  • Stalder, T., Steudte-Schmiedgen, S., Alexander, N., Klucken, T., Vater, A., Wichmann, S., Kirschbaum, C., & Miller, R. (2017). Stress-related and basic determinants of hair cortisol in humans: A meta-analysis. Psychoneuroendocrinology, 77, 261–274.

    Article  Google Scholar 

  • Sundarasen, S., Chinna, K., Kamaludin, K., Nurunnabi, M., Baloch, G. M., Khoshaim, H. B., Hossain, S. F., & Sukayt, A. (2020). Psychological impact of COVID-19 and lockdown among university students in Malaysia: Implications and policy recommendations. International Journal of Environmental Research and Public Health, 17(17), 6206.

    Article  Google Scholar 

  • Uchino, B. N. (2009). Understanding the links between social support and physical health: A life-span perspective with emphasis on the separability of perceived and received support. Perspectives on Psychological Science, 4(3), 236–255.

    Article  Google Scholar 

  • Warnock, F., McElwee, K., Seo, R. J., McIsaac, S., Seim, D., Ramirez-Aponte, T., Macritchie, K. A., & Young, A. H. (2010). Measuring cortisol and DHEA in fingernails: a pilot study. Neuropsychiatric Disease and Treatment, 1–7.

  • Weinstein, L., & Laverghetta, A. (2009). College student stress and satisfaction with life. College Student Journal, 43(4).

  • Wilson, J. M., Weiss, A., & Shook, N. J. (2020). Mindfulness, self-compassion, and savoring: Factors that explain the relation between perceived social support and well-being. Personality and Individual Differences, 152, 109568.

    Article  Google Scholar 

  • World Health Organization. (2022, January 23). Mental health and covid-19. World Health Organization. Retrieved January 6, 2022, from https://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/data-and-resources/mental-health-and-covid-19

  • Wu, H., Zhou, K., Xu, P., Xue, J., Xu, X., & Liu, L. (2018). Associations of perceived stress with the present and subsequent cortisol levels in fingernails among medical students: a prospective pilot study. Psychology research and behavior management, 439–445.

  • Yu, T., & Hu, J. (2022). Extraversion and Neuroticism on College Freshmen's Depressive Symptoms During the COVID-19 Pandemic: The Mediating Role of Social Support. Frontiers in Psychiatry, 13.

  • Zhang, B., Yan, X., Zhao, F., & Yuan, F. (2015). The relationship between perceived stress and adolescent depression: The roles of social support and gender. Social Indicators Research, 123(2), 501–518.

    Article  Google Scholar 

  • Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30–41.

    Article  Google Scholar 

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Acknowledgements

We thank the participants for their commitment of time during the challenging period in which this study took place. We also offer our gratitude to the University of Notre Dame for funding the project as part of EC’s senior undergraduate thesis, including the College of Science.

Funding

The University of Notre Dame’s College of Science provided funding for the project as part of EC’s senior undergraduate thesis.

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Authors and Affiliations

  1. Georgetown University School of Medicine, Washington, DC, 20007, USA

    Emily Y. Chen

  2. Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA

    Emily Y. Chen, Carolyn R. Homolka & Lee T. Gettler

  3. Psychological and Brain Sciences, University of Massachusetts-Amherst, Amherst, MA, USA

    Jerrold S. Meyer

  4. Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA

    Lee T. Gettler

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  1. Emily Y. Chen
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  2. Carolyn R. Homolka
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  4. Lee T. Gettler
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Contributions

E.Y.C.: conceptualization, writing—original draft, writing—reviewing and editing, methodology, investigation, study management; C.R.H.: writing—review and editing, investigation, study management; J.S.M.: writing—review and editing, methodology; L.T.G.: conceptualization, writing—review and editing, methodology, formal analysis, visualization, study management All authors gave final approval for publication.

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Correspondence to Emily Y. Chen.

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The authors declare no competing interests.

Ethical Statement

All participants provided written informed consent before enrolling in the study. The UND IRB approved the study (protocol #21–01-6372), and it was therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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The authors declare no competing interests.

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Chen, E.Y., Homolka, C.R., Meyer, J.S. et al. A Small, Exploratory Analysis of Fingernail Cortisol, Psychosocial Well-Being, and Social Support Among Undergraduate Students During the COVID-19 Pandemic. Adaptive Human Behavior and Physiology 9, 198–215 (2023). https://doi.org/10.1007/s40750-023-00218-x

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