Table 2.
Synthesis of primary findings reporting an association between stress and cortisol levels.
| Developmental period | Measure of cortisol | Findings | Evidence |
|---|---|---|---|
|
| |||
| Childhood stress | Diurnal | (a) Greater cortisol awakening response (n = 5) (b) Increasing cortisol awakening response across pregnancy (n = 1) (c) Less flattening of the diurnal cortisol slope across pregnancy (n = 2) |
(a) Epstein et al. (2020);Stephens et al. (2021);Thomas et al. (2018a);Thomas et al. (2018b); Thomas-Argyriou et al. (2021) (b) Bublitz and Stroud (2012) (c) Thomas et al. (2018b);Stephens et al. (2021) |
| Tonic: Saliva | (a) Lower waking cortisol levels (n = 1) (b) Higher wake + 30 cortisol levels (n = 1) (c) Higher evening cortisol levels (n = 1) |
(a) Shea et al. (2007) (b) Thomas et al. (2018b) (c) Jairaj et al. (2020) |
|
| Tonic: Hair | (a) Higher hair cortisol concentrations (n = 1)a (b) Lower hair cortisol concentrations (n = 2) |
(a) Schreier et al. (2015a) (b) Bowers et al. (2018);Nyström-Hansen et al. (2019) |
|
| Proximal preconception and/or pregnancy stress | Diurnal | (a) Greater cortisol awakening response (n = 1) (b) Lower cortisol awakening response (n = 1) (c) Flatter slope (n = 2)a |
(a) Urizar et al. (2019) (b) Simon et al. (2016) (c) Suglia et al. (2010);Smew et al. (2018) |
| Tonic: Saliva | (a) Lower morning cortisol levels (n = 2) (b) Higher afternoon cortisol levels (n = 1) (c) Higher evening cortisol levels (n = 1) (d) Higher momentary cortisol levels and daily cortisol output (n = 1)b |
(a) Suglia et al. (2010);Smew et al. (2018) (b) Valladares et al. (2009) (c) Obel et al. (2005) (d) Lazarides et al. (2020) |
|
| Tonic: Hair | (a) Higher hair cortisol concentrations (n = 3)b | (a) Kalra et al. (2007);King et al. (2022);Hoffman et al. (2016) | |
| Lifetime stress | Diurnal | — | — |
| Tonic: Saliva | (a) Higher morning cortisol (n = 1) (b) Higher afternoon cortisol (n = 1) s |
(a) Ghosn et al. (2019) (b) Campbell et al. (2019) |
|
| Tonic: Hair | (a) Higher hair cortisol (n = 1)a | (a) Schreier et al. (2016) | |
| Moderated effects | Diurnal | (a) Adulthood stress associated with a flatter cortisol sleep among individuals who experienced low childhood stress but associated with a steeper cortisol slope among individuals who experienced higher stress in childhood (n = 1) (b) A more severe history of childhood sexual abuse and poorer family functioning in pregnancy predicted increases cortisol awakening response from the second to the third trimester compared to individuals with a less severe childhood sexual abuse history and better family functioning (n = 1) (c) More adverse childhood experiences were associated with a steeper cortisol slope among individuals who reported low levels of social support but not among those who reported high levels of social support (n = 1) |
(a) Epstein et al. (2020) (b) Bublitz et al. (2014) (c) Thomas et al. (2018a) |
| Tonic: Saliva | (a) Stress in pregnancy associated with higher levels of wake + 30 cortisol levels among individuals who had experienced childhood sexual abuse, but not those who had not (n = 1) (b) Momentary stress associated with higher levels of cortisol among individuals without a history of childhood maltreatment but associated with lower levels of cortisol among individuals with a history of childhood maltreatment (n = 1) (c) Stressful life events associated with a blunted cortisol awakening response among individuals who with high mercury levels but not low mercury levels (n = 1) |
(a) Bublitz and Stroud (2013) (b) Bublitz et al. (2016) (c) Schreier et al. (2015b) |
|
| Tonic: Hair | (a) Adulthood and pregnancy stress was more strongly, positively associated with hair cortisol among individuals who had experienced higher levels of childhood stress (n = 2) | (a) Bowers et al. (2018);Swales et al. (2018) | |
Note. Table summarizes studies reporting associations between stress and measures of cortisol; null results are presented in Table 3 in further detail. No studies evaluated associations of lifetime stress with diurnal cortisol indices.
a
In stratified analyses, the association between stress and cortisol was only significant among Black participants.
b
Stress was associated with cortisol at the within-persons, but not between-persons level.