Bibian van der Voorn

177 GENDER-SPECIFIC HPA AXIS REACTIVITY IN CHILDHOOD TABLE 5. Summary of articles describing sex differences in miscellaneous stress tests ( Continued) Author (year) Sample size Age Study protocol Sampling points Results ≥7 years old Psychological stress Daughters (2013) 82 132 16.1±1.0 years Behavioral Indicator of Resiliency to Distress 4x, 1 before, 3 after Saliva Boys: higher baseline, greater peak. No sex differences in AUCg. Hackman (2012) 79 180 12-14 years Parent-Adolescent Conflict Discusison 3x (2 before, 1 after) Saliva No sex differences; pubertal status not assessed Minkley (2012) 83 93 Examination challenge (reproduction of knowledge, or transfer and problem-solving) 2x, 1 before, 1 after Saliva Not statistically significant, but higher increases in boys. More in reproduction of knowledge group, but also greater in transfer and problem-solving group. Zijlmans (2013) 80 52 12.5±1.21 years Social Evaluative Stress Test 7x, 1 before, 6 after Saliva Higher reactivity in boys Physical stress Allen (2009) 84 235 12.7±2.9 years Laboratory Pain Tasks Saliva: 3x, 1 before, 2 after Blood: 2x (after) Saliva / blood No sex differences; pubertal status not associated with reactivity Chiodo (2011) 90 16 Boys: 14±0 years, girls: 13±1 years Taekwondo competition 5x (2 before, 3 after) Saliva Lower overall values in girls, but higher peak. ≥7 years old Physical stress Covelli (2012) 85 106 15.3±1.1 years Cold water hand 2x, 1 before, 1 after Saliva No sex differences; pubertal immersion status not assessed Frias (2000) 92 48 13-17 years Acute alcohol intoxication 1x (after); controls as reference Blood More pronounced increase in girls Gecgelen (2012) 86 40 10.9-14.7 years Rapid maxillary expansion 13x, 1 before, 3 after, and 9 during a period of treatment Saliva No sex differences; pubertal status not assessed Khilnani (1993) 87 98 2-20 years Elective surgery 2x, 1 before, 1 after Blood No sex differences; pubertal status not assessed Kuhlman (2015) 38 121 12.8±2.3 years Socially evaluated cold pressor test 7x (2 before, 5 after) Saliva No sex differences; pubertal status not assessed Lopez-Duran (2015) 89 115 12.79±2.26 years Socially evaluated cold pressor test 8x (2 before, 6 after) Saliva No sex differences; pubertal status not assessed Stupnicki (1995) 91 29 Boys: 17.3±0.8, girls 16.4±0.6 years Exercise 2x, 1 before, 1 after Blood Boys decrease in cortisol, girls increase in cortisol after exercise Yfanti (2014) 88 97 89.73±15 months Dental treatment 5x, 1 before, 4 after Saliva No sex differences; pubertal status not assessed CAR Eighteen studies (with the data of 3,549 subjects) described the CAR in children. Nine studies did not find differences between boys and girls, 15-18,21,26,27,38,40 although four of these 15-18 studied the CAR as part of the diurnal rhythm, and did not perform separate analyses for the CAR, with therefore limited data available on the CAR. Additionally, Michels et al. (2012) 18 (n=385, age: 5-10 years) and Vanaelst et al. (2014) 21 (n=355, age: 5-10 years) reported on the same cohort, and Osika et al. (2007) 15 (n=84, age: 9.9±0.55 years) only took samples between 0 and 15 minutes after awakening. Nine studies found significant differences in CAR between sexes, of which eight found a higher CAR in girls. Martikainen et al. (2013) 29 (n=252, age: 8.1±0.3 years) found a higher peak after awakening in girls, as well as a higher AUCg. However, the awakening