The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol

M van Eck, H Berkhof, N Nicolson, J Sulon

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469 Citations (Scopus)


This study examined the effects of perceived stress and related individual characteristics, mood states, and stressful daily events on salivary cortisol levels. Forty-one "high stress" and 46 "low stress" subjects were selected on the basis of Perceived Stress Scale scores from a sample of male, white collar workers. Subjects completed Experience Sampling self-reports and collected saliva samples 10 times a day over 5 consecutive days. Multilevel analysis revealed that trait anxiety and depression, but not perceived stress, were associated with small but statistically significant cortisol elevation. No effects on cortisol were found for recent life events, chronic difficulties, trait anger, or psychosomatic symptoms. Distress, as reflected by the mood states Negative Affect and Agitation, was associated with higher cortisol levels, whereas Positive Affect had no statistically significant effect. Stressful daily events were associated with increased cortisol secretion, the magnitude of the effect depending on whether the event was still ongoing and on how frequently a similar kind of event had occurred previously. Although perceived stress, anxiety, and depression did not increase cortisol reactivity to daily events, we found evidence for reduced habituation to recurrent events in subjects scoring high on these traits. Mood appeared to play a mediating role in the relationship between stressful events and cortisol secretion. These results suggest that negative affectivity is not just a confounder but is related to elevated cortisol secretion during normal daily activities. The finding that even minor events and fluctuations in mood states were associated with increased adrenocortical activity points to a possible mechanism linking subjective experience to health outcomes.

Original languageEnglish
Pages (from-to)447-58
Number of pages12
JournalPsychosomatic medicine
Issue number5
Publication statusPublished - 1 Sept 1996


  • Adult
  • Affect/physiology
  • Anxiety/physiopathology
  • Bayes Theorem
  • Confounding Factors, Epidemiologic
  • Cross-Sectional Studies
  • Depression/physiopathology
  • Humans
  • Hydrocortisone/metabolism
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neurotic Disorders/physiopathology
  • Periodicity
  • Saliva/metabolism
  • Sampling Studies
  • Self-Assessment
  • Severity of Illness Index
  • Stress, Psychological/physiopathology
  • Time Factors

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