Plasma Cortisol Concentrations and Perceived ...

Physiology & Biochemistry

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Plasma Cortisol Concentrations and Perceived Anxiety in Response to On-Sight Rock Climbing

Affiliations

Key words ▶ rock climbing ● ▶ plasma cortisol ● concentration ▶ psychophysiology ● ▶ lead climbing ● ▶ top-roping ●

N. Draper1, T. Dickson1, S. Fryer1, G. Blackwell1, D. Winter1, C. Scarrott2, G. Ellis1 1 2

School of Sciences and Physical Education, University of Canterbury, Christchurch, New Zealand Department of Maths and Statistics, University of Canterbury, Christchurch, New Zealand

Abstract ▼ Previous research suggested plasma cortisol concentrations in response to rock climbing have a cubic relationship with state anxiety and selfconfidence. This research, however, was conducted in a situation where the climbers had previously climbed the route. The purpose of our study was to examine this relationship in response to on-sight climbing. Nineteen (13 male, 6 female) intermediate climbers volunteered to attend anthropometric and baseline testing sessions, prior to an on-sight ascent (lead climb or top-rope) of the test climb (grade 19 Ewbank/6a sport/5.10b YDS). Data recorded included state

Introduction ▼ accepted after revision June 24, 2011 Bibliography DOI http://dx.doi.org/ 10.1055/s-0031-1284348 Published online: October 7, 2011 Int J Sports Med 2012; 33: 13–17 © Georg Thieme Verlag KG Stuttgart · New York ISSN 0172-4622 Correspondence Dr. Nick Draper University of Canterbury School of Sciences and Physical Education Private Bag 4800 8140 Christchurch New Zealand Tel.: +64/3/364 2987 Ext.: 4193 Fax: +64/3/345 8381 [email protected]

Rock climbing is an increasingly popular recreational and competitive adventure sport that places sometimes extreme demands upon the performer [8–10, 15, 18, 20, 22, 24, 26]. Goddard and Neumann [12] suggested that co-ordination and technique, tactical considerations, physical fitness, psychological aspects, external conditions and background conditions interact to determine performance in rock climbing. In a review of the rock climbing research to that point Watts [26] indicated that these factors and their interaction continued to require investigation as to their relative importance to performance in rock climbing. While much of the published research in the area of rock climbing continues to be discipline specific, more recently a number of researchers have begun to investigate the interaction of the components of climbing performance suggested by Goddard and Neumann [8, 9, 12, 15, 16, 19, 21, 23, 24]. While there is clearly a need for continued discipline specific research, through investigation of the interaction between components, and their relative effect on performance, it will be possible to develop a more

anxiety, self-confidence and cortisol concentrations prior to completing the climb. Results indicated that there were no significant differences in state anxiety, self-confidence and plasma cortisol concentration regardless of the style of ascent (lead climb or top-rope) in an on-sight sport climbing context. Regression analysis indicated there was a significant linear relationship between plasma cortisol concentrations and selfconfidence (r = − 0.52, R2 = 0.267, p = 0.024), cognitive (r = 0.5, R2 = 0.253, p = 0.028), and somatic anxieties (r = 0.46, R2 = 0.210, p = 0.049). In an onsight condition the relationships between plasma cortisol concentrations with anxiety (cognitive and somatic) and self-confidence were linear.

complete understanding of the sport and its performance dynamics [8, 26]. A number of recent publications have investigated the interaction between physiological and psychological aspects of climbing and linked with this the changes in key hormone levels in response to climbing [8, 9, 15, 24]. In other contexts it has been demonstrated that plasma cortisol concentration rises in response to physiological and psychological stress [1, 2, 11, 14, 15, 24]. As such, it has become a popular measure, in conjunction with psychological tools such as the Revised Competitive State Anxiety Inventory-2 (CSAI-2R), for assessing psychological stress in a rock climbing context [6, 15]. Hodgson et al. [15] reported that plasma cortisol concentrations were significantly related to anxiety (somatic and cognitive) and self-confidence as measured by the CSAI-2R in a sport climbing context. Rock climbing has a number of different disciplines, of which sport climbing is a popular choice for many climbers. With the exception of bouldering routes, virtually all other indoor climbing comprises of sport routes and many outdoor areas are bolted for sport climbing. On a sport climbing route a lead climber (protected from a ground fall

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Materials and Methods ▼ Participants Nineteen (13 male, 6 female) rock climbers volunteered and completed the study (mean ± SD; age 26.6 ± 6 years, height 1.76 ± 0.09 m, mass 74.8 ± 14.1 kg, body fat, males 16.7 ± 4.3 %, females 20.9 ± 2.1 %, VO2max 51.8 ± 8.7 ml∙kg-1∙min-1). Characteris▶ Table 1. tics of the lead climb and top-rope groups are shown in ● Participants were classified as intermediate level climbers based on having (within the last 12 months) a self-reported redpoint climbing grade of 18–21 Ewbank/5+ – 6b sport/5.10a – 5.10d YDS, (mean ± SD; 20. 74 ± 1.055, Range; 19–23 Ewbank) and an on-sight ability grade of (mean ± SD) 18.4 ± 0.5, Range; 18–19 Ewbank. The climbers had (mean ± SD) 4.9 ± 5.7 years involvement in the sport and lead climbing experience of 4.74 ± 5.77 years. They were actively involved in the sport, climbing at least once a week on both artificial surfaces and natural rock. The participants were fully acquainted with the nature of the study and were informed they could leave at any stage. All participants completed a medical health history questionnaire and gave informed consent prior to taking part in the study. Ethical approval for the study was obtained from the institutional human ethics committee. The study was completed in accordance with the ethical standards required for the International Journal of Sports Medicine [13].

Procedure Each participant attended 3 sessions for their involvement in the study. The first was based at the University of Canterbury exercise physiology laboratory where anthropometric data were collected and a VO2max assessment completed using the athlete led protocol [7]. In this protocol, conducted on a treadmill, after initial increases in belt speed (every 60 s), each climber indicated when he or she had reached their maximum cadence, from which point the gradient was increased by 1 % every 60 s until exhaustion. The second and third sessions were held at an indoor climbing wall. For comparative purposes the same K4b2 (Cosmed, Rome Italy) worn by participants in the climbing trials was used for the VO2max assessment. During the second session a baseline capillary blood sample was withdrawn to assess cortisol concentration and each climber completed a familiarisation climb wearing the portable gas analysis equipment. During the final testing session climbers undertook an on-sight climb of the study route using either a lead climb or top rope safety protocol (randomly assigned after matching for age and redpoint climbing ability. The total number of climbers, number in each group ▶ Table 1, was affected by and age match, as can be seen from ● the withdrawal of 3 climbers due to injury, after randomisation [N = 22 at the time of randomisation], but prior to starting in the study). The second and third sessions (at the climbing wall) were completed at the same time of day to accommodate the normal diurnal variation in physiological functioning, but particularly in the case of cortisol concentrations. Participants were asked to refrain from exercise 24 h prior to all testing sessions and to avoid consuming food within 2 h of testing. A minimum of 2 days separated the sessions. Each climber completed a standardised warm-up which consisted of 3 distinct phases; (a) 5 min of light jogging, (b) mobilising/stretching exercises and (c) a top rope ascent of a route of their choice was at least 2 difficulty grades below the designated test route. Post climb a 15 min passive recovery period was observed, during which the climbers remained seated and continued to wear the portable gas analyzer. The study route was set on a Sheer Adventure® (Sheer Adventure, Christchurch, Canterbury, NZ) indoor artificial wall using modular climbing holds (Uprising Ventures Ltd, Canterbury, NZ). Climbers were permitted to use hands and feet on the holds and also to smear their feet on the wall during the ascent. The route was 12.15 m and confirmed by expert climbers prior to the study and post climb by the participants at grade 19 Ewbank (6a sport/5.10b YDS). After the initial clip at 2.85 m, the distance between the next 5 clips was 1.0–1.40 m and the distance to the final (top) anchor was 1.95 m. With the route set at this difficulty it was near to the limits of the climbers in the study and as such failure to complete Table 1 Characteristics of the lead climb (N = 8) and top-rope (N = 11) groups shown as mean (± SD).


age (years) height (m) mass (kg) body fat ( %) VO2max (ml∙kḡ1∙min̄1) highest on-sight (Ewbank) highest redpoint (Ewbank)

Lead climb

Top-rope

31.1 ± 5.7 1.75 ± 0.11 75. 8 ± 17.1 18.1 ± 4.8 49.8 ± 6.8 18.6 ± 0.52 21.4 ± 1.2

23.3 ± 3.8* 1.77 ± 0.07 74.0 ± 12.2 17.9 ± 4.0 53.2 ± 9.92 18.3 ± 0.47 20.3 ± 0.6

*significant difference detected (p < 0.05). Grade 18 Ewbank = 5+ sport or 5.10a YDS, grade 19 Ewbank = 6a sport or 5.10b YDS, grade 20 Ewbank = 6a+ sport or 5.10c YDS, Grade 21 Ewbank = 6b sport or 5.10d YDS


by a rope and belayer) will clip bolts that have been pre-drilled and set into the rock or artificial wall surface during the ascent. A sport route can be climbed as a lead climb or can be top-roped (with an anchor at the top of the climb to protect the climber). If a climber falls during a lead climb they would fall double the distance from their last anchor (plus any stretch in the rope). During a top-rope climb, given a responsive belayer, the climber would fall only as far as the stretch in the rope allows. In this context toproping can be seen as a safer and therefore less psychologically stressful situation. Typically top-roping is used for group sessions with beginners and by more experienced climbers when they are practicing a route and wish to make repeat attempts on a particular move. Hodgson et al. [15] studied responses to ascent of a sport climbing route that had been previously climbed by each of the 12 participants. In a randomised order the climbers ascended the route, sport grade 6a (19 Ewbank, YDS 5.10b), on 3 separate occasions using differing safety rope protocols. The researchers found that lead climbing was the most stressful situation, as measured by subjective anxiety (somatic and cognitive) and change in plasma cortisol concentration, with top-roping being the least stressful style of ascent. With regard to the relationship between the CSAI-2R measures and plasma cortisol concentration in each case (somatic and cognitive anxiety and self-confidence) this was found to be cubic. To date however, it appears that no research has been conducted to examine whether such relationships hold for on-sight climbing which generally climbers and coaches agree is the most stressful style of ascent (in an on-sight, the ascent is made without the climber having previously practiced the climb, having watched someone climb it, or having any gained information about the route). In addition, it would be of interest to identify whether such a relationship was maintained in a single trial randomised design. Therefore the purpose of our study was to investigate the relationship between subjective anxiety (cognitive and somatic), self-confidence and plasma cortisol concentration for an on-sight lead or top-rope climb.


State anxiety and self-confidence assessment The CSAI-2R, as revised by Cox et al. [6], was used to assess each individuals feelings of anxiety (somatic and cognitive) and selfconfidence before the climb. The CSAI-2R was completed by the climber immediately pre-climb after preclimb blood sampling was completed and the climber had tied into the rope. Each of the 17 items on the CSAI-2R was scored on a Likert scale from 1 to 4. The scores were combined to give a final score on 3 subscales; somatic anxiety, cognitive anxiety and self-confidence.

Blood sampling and analysis The first (big) toe was selected for capillary blood sampling to minimise the impact on the participant’s climbing performance. The first (big) toe was prepared using a non-alcoholic medical wipe (TYCO Healthcare, UK) before sampling, and Haemolance plus (Haemedic, Poland) lances were used to puncture (1.6 mm depth) the skin. Blood samples (300 μl) were collected using lithium heparin CB300LH Microvettes (Sarstedt Aktiengesellschaft & Co, Numbrecht, Germany). All blood samples were stored on ice until centrifugation (cr2000, Centurion Scientific, West Sussex, England). The separated plasma samples were placed in Eppendorf microtubes (Starsledt Aktiengesellschaft & Co, Numbrecht, Germany) and stored at − 20 °C for later analysis. The plasma samples were analysed for cortisol using an Enzyme-Linked Immunosorbent Assay (ELISA) Kit (Dept. of Clinical Biochemistry, Christchurch Hospital, Christchurch, New Zealand) as described and validated by Lewis and Elder [17]. All standards and samples were analysed in duplicate. Intra assay coefficients of variation were < 10 %. A single participants plasma cortisol samples were analysed in entirety in an attempt to minimise within-subject variability. Cortisol values were given in nmol/l and subsequently converted to μg/dl and ng/ml with a factor of 27.59 [25].

Statistical analysis Prior to any further analysis all variables were examined for normality of distribution using the one-sample Kolmogorov-Smirnov goodness-of-fit tests. The results of these tests indicated that all variables displayed normal distributions. As is shown

▶ Table 1, the withdrawal of 3 participants led to a significant in ● difference (P < 0.05) in age for the climbers in the lead and toprope groups. To ensure this variable did not affect subsequent regression modelling analysis of covariance (ANCOVA) were calculated to potentially correct for age as a covariate on pre-climb cortisol levels, anxiety (cognitive and somatic) and self-confidence. Despite the significant difference between the covariate (age) in the groups (top rope and lead climb), data suggested age did not have an effect on the pre-climb cortical concentrations, anxiety or self-confidence. As a result, further statistical analysis and modelling was completed. Four independent sample t-tests, with Bonferroni correction, were calculated to examine differences in anxiety (cognitive and somatic), self-confidence and plasma cortisol concentrations between the 2 groups (lead climb or top rope). Following this, regression analyses were calculated to assess whether there was a relationship between each of the CSAI-2R measures and plasma cortisol concentrations. All analyses were conducted using the Statistical Package for the Social Sciences (Statistics 19) for Windows software (IBM, Armonk, USA).

Results ▼ The means (± SD) for the lead climbing (N = 8) and top-roping (N = 11) groups for state anxiety (cognitive and somatic), selfconfidence and plasma cortisol concentration are shown ▶ Table 2. Results of the independent sample t-tests indicated in ● that there were no significant differences between the groups for any of the variables. Regression analysis indicated that there was a significant negative linear relationship between self-confidence and plasma cortisol concentration (r = − 0.52, R2 = 0.267, ▶ Fig. 1. The relationp = 0.024). This relationship is shown in ● ship between cognitive anxiety and plasma cortisol concentra▶ Fig. 2, was also linear (r = 0.5, R2 = 0.253, tion, shown in ● ▶ Fig. 3, results of regression p = 0.028). Finally, as shown in ● analysis revealed there was a significant linear relationship between subjective somatic anxiety and plasma cortisol concentration (r = 0.46, R2 = 0.210, p = 0.049).

Discussion ▼ Previous research findings have identified a significant difference in plasma cortisol concentrations between lead climbing and top-roping and cubic relationships between pre-climb plasma cortisol concentrations and state anxiety (cognitive and somatic) and self-confidence as measured using the CSAI-2R Table 2 Mean (± SD) anxiety, self confidence ratings and plasma cortisol concentrations for on-site lead climbing and top roping.

somatic anxiety (Pts) cognitive anxiety (Pts) self confidence (Pts) baseline plasma cortisol concentration (ng · ml−1) pre-climb plasma cortisol concentration (ng · ml−1) change in plasma cortisol concentration (ng · ml−1) CSAI-2 R

Lead climb

Top-rope

16.6 ± 4.1 17.8 ± 4.8 29.3 ± 5.5 113.8 ± 36.5

18.6 ± 5.3 18.6 ± 8.7 27.1 ± 8.2 138.8 ± 46.8

139.5 ± 31.5

156.5 ± 60.4

25.7 ± 32.0

17.7 ± 77.6

Change refers to the difference between baseline and pre-climb plasma cortisol concentrations



the route was a realistic possibility for the climbers. The participants were asked to complete the route without weighting the rope and to climb at their normal climbing pace. Upon arrival at the climbing wall for the baseline testing (second) session each climber was seated for a capillary blood sample to be collected from the first (big) toe of their left foot. After this climbers completed a familiarisation climb whilst wearing the K4b2 (Cosmed, Rome Italy). To facilitate climbing the harness was modified such that both the battery and analyser unit were worn on the climbers back (total weight 0.7 kg). This was done in order to minimise interference with movement whilst climbing. Climbers were then asked to climb a route of their choice on top rope. Upon arrival at the third session participants were informed of the study route, their style of ascent (top-rope or lead climb) and the grade of the climb. Climbers then completed the standardised study warm up and were fitted with a Polar FS1 (Polar Electro, Oy, Kempele, Finland) heart rate monitor and the K4b2 portable gas analyser. 30 min after being informed about the climbing route, but prior to ascent, a capillary blood sample was taken from the left first toe to assay for cortisol concentration. The participants then completed the CSAI-2R questionnaire prior to commencing the climb. During the climbing trial climb time, heart rate and oxygen consumption were recorded.

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Plasma cortisol concentration (ng·ml–1)


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Fig. 1 Relationship between plasma cortical concentration and subjective self confidence.

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Fig. 3 Relationship between plasma cortical concentration and subjective somatic anxiety.


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Fig. 2 Relationship between plasma cortical concentration and subjective cognitive anxiety.

[15]. The cubic nature of the relationships between these variables occurred however, in a situation where the climbing route was known to the climbers. The purpose of our study was to examine differences in anxiety and plasma cortisol concentrations for lead climbing and top-roping, and then to identify whether the cubic nature of the relationships was maintained, regardless of safety rope protocol in an on-sight (first) ascent ▶ Table 2, indicated that situation. Our results, as shown in ● while mean plasma cortisol concentration increments were higher for those undertaking a lead climb ascent, mean anxiety was higher and self-confidence lower for the top-rope climbers, but without statistical differences. Regression analysis results indicated that in an on-sight climbing context the relationships between plasma cortisol concentrations and subjective anxiety and self-confidence were linear rather than cubic. For an onsight climb, the higher the feelings of anxiety and the lower the

self-confidence prior to climbing the greater the plasma cortisol concentration, regardless of the style of ascent. Despite data being collected in New Zealand and UK, for intermediate climbers on a similar grade of climb (Ewbank 19/6a sport/5.10b YDS) the levels of subjective anxiety and self-confidence found in our study are similar to those reported by Draper et al. [9] for an on-sight lead climb and subsequent lead climb, Hodgson et al. [15] (lead climb, top-rope climb and lead on a toprope) and Draper et al. [8] (top-rope and lead climb). Taken together, these findings suggest that the CSAI-2R is a robust instrument for reporting subjective anxiety for intermediate level climbers. The data published to date, taken with the findings from this study, suggest when intermediate climbers have knowledge of a route from prior practice, lead climbing generally appears to stimulate higher levels of anxiety (cognitive and somatic) than top-roping [15]. An on-sight lead climb tends to generate higher subjective anxiety levels than a subsequent lead climb, however, in an on-sight climbing situation subjective anxiety is similar for top-roping and lead climbing. Results from plasma cortisol concentrations responses appear to support the CSAI-2R anxiety data. Findings to date suggest that lead climbing stimulates a higher cortisol concentration response than toproping in a situation where the climbers have current knowledge of the route. If, however, intermediate climbers are making an ascent in an on-sight style the type of safety protocol does not matter. In this context there are no significant differences between leading climbing or top-roping. With regard to areas for future research, to date there appears to be no data published for higher level (advanced and elite) level climbers or lower grade climbers focusing on state anxiety, self-confidence or plasma cortisol concentrations in response to different safety protocols (lead climb or top-rope) or styles of ascent (on-sight or previously climbed route). Unlike the findings of Hodgson et al. [15], the findings from our study, for plasma cortisol concentrations, state anxiety and selfconfidence, suggest the relationship between these variables is



Somatic anxiety


further understand the relationship between anxiety and plasma cortisol concentration responses in rock climbing.

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linear when the climb is an on-sight ascent. Hodgson and coworkers [15] suggested that when a route had been previously climbed a subsequent ascent was open to subjective interpretation by the climber. It could be perceived as inducing somatic and cognitive anxiety and result in higher plasma cortisol concentrations or conversely could be perceived more positively and result in feelings of higher self-confidence and also promote relatively higher cortisol concentrations. Whereas, when perceived as moderately anxiety provoking or, when climbers felt moderately self confident, the cortisol concentration response was relatively lower. Support for this duality, with regard to rises in plasma cortisol concentrations, can be found from the work of Brown et al. [5] who found rises in levels in response to both sadness and elation inducing emotional stresses. The results of our findings, however, suggest that for an on-sight climbing ascent the relationship between plasma cortisol concentrations and the CSAI-2R variables is linear rather than cubic. As such, the spectrum of anxiety and self-confidence responses that the authors suggested could be induced naturally for climbing in the context of their study might not apply when the climb is an on-sight ascent. Researchers interested in topics in the fields of psychophysiology or psychoneuroendocrinology would need to bear this in mind if selecting rock climbing as a stress inducing context for their research. It appears that for intermediate climbers the duality in emotional response to climbing is evident only when the route has been previously successfully climbed. The anxiety and self-confidence spectrum response might also be subject to the climb being at or close to the ability level of the climbers being studied so that despite previous success it would continue to present a challenge to the climber where failure (a fall) remained a possibility [15]. It might be that when a climber was on a route several grades below their ability level that the climbing encountered would fail to stimulate a spectrum response in a group of climbers. This point however, requires further investigation, as does the possibility that this response exists for higher (advanced and elite) and lower grade climbers. The grade of the climb (19 Ewbank/6a sport/5.10b YDS) was set such that falling was a realistic possibility for all climbers taking part in the study, given the range of their previous highest onsight climbs (18–19 Ewbank). While not the main focus of our study it was of interest to note that 12 of the 19 climbers went on to successfully complete the route, 5 as a lead climb and 7 on top-rope (the ascent of the route being made after having completed the CSAI-2R and having provided their pre-climb blood sample which represented the main focus of the study). Previous studies have tended to focus on results for climbers who successfully complete a route [3, 4, 15, 23]. To further develop knowledge in the field, it may perhaps be useful for researchers to examine psychological and physiological differences between those who successfully complete and those who fall during the ascent of an on-sight climb. On-sight lead climbing and top roping appear to produce similar levels of anxiety (cognitive and somatic), self-confidence and plasma cortisol concentration responses and the relationships between the variables seem to be linear in this climbing context. The meaningfulness of these relationships (R2 ranging from 0.210–0.267) indicates that around 21–25 % of the variance in plasma cortisol concentrations is explained by responses to the CSAI-2R. This would need to be born in mind when interpreting the results from this study. Continued research, with different methodologies and variables, would be beneficial in helping to

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