Afternoon salivary cortisol shows no association with same-day state anxiety in community-dwelling older adults during the COVID-19 pandemic

Stress-related salivary biomarkers - cortisol, dehydroepiandrosterone, alpha amylase, and suicidal ideation among young women living in Kampala's informal settlements.

Suicidal ideation was common, and square root-transformed morning cortisol-to-DHEA ratios were independently associated with suicidal ideation, and these findings highlight the importance of understanding suicidality through integrated biological, psychological, and social perspectives.

Adverse childhood experiences and prospective changes in diurnal cortisol activity during the transition to adolescence: Moderation by daily coping and adolescent sex.

By observing coping as a moderator between ACEs and cortisol patterns, this study demonstrates that associations between ACEs and diurnal cortisol differ across adolescents' coping use and coping variability.

Blunted Diurnal Cortisol Slope as a Risk Marker for 9-Year Executive Function Decline: Amplification by Daily Stress and Worry Severity.

OBJECTIVES Cortisol dysregulation, reflective of hypothalamic-pituitary-adrenal (HPA) axis dysregulation, has been linked to executive functioning (EF) decline. However, substantial effect-size heterogeneity across studies highlights the potential role of psychosocial moderators. We investigated whether the severity of perceived daily stressors and chronic worry moderated the relationships between baseline cortisol dysregulation and 9-year EF. METHODS Community adults (N = 1,617) completed four-day, four-times-daily salivary cortisol sampling and an eight-day interview-driven daily diary at baseline. Three cortisol metrics were computed: area under the curve (AUC), cortisol awakening response (CAR), and diurnal cortisol slope (DCS). Linear mixed models determined whether daily stressor or chronic worry severity moderated associations between baseline cortisol metrics and 9-year EF, adjusting for baseline EF. RESULTS Daily stressor severity significantly moderated the relationship between DCS-but not AUC or CAR-and 9-year EF (Cohen's d = 0.113). Flatter DCS was associated with poorer EF across all stressor severity levels, although the observed numerical attenuation at higher severity was not statistically confirmed. Chronic worry severity was significantly associated with lower 9-year EF across all cortisol metrics and significantly moderated the CAR-to-EF relationship (d = -0.176). Exploratory analyses suggested that a flatter DCS was associated with worse EF at higher worry severity, but this interaction was not significant. DISCUSSION These outcomes broadly align with moderation, not mediation, suggesting that psychosocial stress and worry can amplify, rather than yield, cortisol-linked relationships with EF. Pending replication, HPA-axis circadian modulation and chronic worry severity can indicate viable targets for prevention research.

AD03 DASS-21 stress severity is associated with altered diurnal salivary cortisol ratio in Greek endocrinology patients: a pilot study

Psychological stress is common in clinical practice; however, its association with biological stress markers remains incompletely characterized. The Depression Anxiety Stress Scales-21 (DASS-21) questionnaire assesses depression, anxiety, and stress, while salivary cortisol is an established marker of hypothalamic–pituitary–adrenal axis activity. This pilot study evaluated whether DASS-21 Stress scale severity is associated with alterations in the diurnal salivary cortisol rhythm in endocrinology patients. To investigate the association between DASS-21 Stress scale severity and the diurnal salivary cortisol profile in adult endocrinology patients. This pilot study included 33 Greek endocrinology patients aged 18–65 years with paired salivary cortisol measurements. Participants completed the DASS-21 questionnaire and provided saliva samples at 08:00 and 20:00. Morning cortisol, evening cortisol, and the morning-to-evening cortisol ratio were assessed. Patients were categorized according to DASS-21 Stress severity and compared using the Mann–Whitney U test. DASS-21 Stress scale severity was significantly associated with the diurnal cortisol ratio. Patients with moderate-to-extremely severe stress had a lower morning-to-evening cortisol ratio than those with normal-to-mild stress (median 1.40, interquartile range [IQR] 0.74–2.83 vs. median 4.14, IQR 2.46–6.29; Mann–Whitney U = 64.0, P = 0.016), suggesting a flatter diurnal cortisol rhythm in patients with higher perceived stress severity. In this pilot cohort of Greek endocrinology patients, higher DASS-21 Stress scale severity was associated with a flatter diurnal cortisol rhythm. These preliminary findings suggest that perceived stress severity may correspond to biological alterations in cortisol regulation. Larger studies are warranted to confirm these observations and to explore the clinical utility of combining psychometric stress assessment with salivary cortisol measurements in endocrine populations.

From allostasis to addiction: Cortisol dysregulation, daily stress and relations with 9-year alcohol and substance use disorder severity in community adults.

Nonlinear interactions between cortisol indices and daily stressor severity appear to predict 9-year alcohol use disorder and substance use disorder severity, with cortisol area under the curve emerging as the most robust indicator.

Changes in salivary brain-derived neurotrophic factor following a standardized eating task in community-dwelling older adults: a cross-sectional study.