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Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge
Abstract
Stress and stress-related health impairments are major problems in human life and elucidating the biological pathways linking stress and disease is of substantial importance. However, the identification of mechanisms underlying a dysregulation of major components of the stress response system is, particularly in humans, a very challenging task. Salivary cortisol responses to diverse acute challenge paradigms show large intra- and interindividual variability. In order to uncover mechanisms mediating stress-related disorders and to potentially develop new therapeutic strategies, an extensive phenotyping of HPA axis stress responses is essential. Such a research agenda depends on substantial knowledge of moderating and intervening variables that affect cortisol responses to different stressors and stimuli. The aim of this report is, therefore, to provide a comprehensive summary of important determinants of, in particular, human salivary cortisol responses to different kinds of laboratory stimuli including acute psychosocial stress as well as pharmacological provocation procedures. This overview demonstrates the role of age and gender, endogenous and exogenous sex steroid levels, pregnancy, lactation and breast-feeding, smoking, coffee and alcohol consumption as well as dietary energy supply in salivary cortisol responses to acute stress. Furthermore, it briefly summarizes current knowledge of the role of genetic factors and methodological issues in terms of habituation to repeated psychosocial stress exposures and time of testing as well as psychological factors, that have been shown to be associated with salivary cortisol responses like early life experiences, social factors, psychological interventions, personality as well as acute subjective-psychological stress responses and finally states of chronic stress and psychopathology.
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“In general, among the studies that used the TSST as a form of mental stress to activate the HPA axis, there seems to be some agreement that when under stress, cortisol increases are greater in the luteal phase relative to the other phases in women who are not taking OC (e.g., Kudielka et al., 2009; Rohleder et al., 2001; Rohleder et al., 2003; Schoof and Wolf, 2009).”
From The relationship between the menstrual cycle and cortisol secretion: Daily and stress-invoked cortisol patterns (2018) · cites this paper as Kudielka et al., 2009
In the citing paper
“In such a model, a decrease in estradiol levels during menopause could cause executive difficulties in women whose genetics or previous life experiences make them susceptible to such a cognitive decline (Culpepper, 2015; Kudielka et al, 2009; Shanmugan and Epperson, 2014) (Figure 1).”
From Lisdexamfetamine Effects on Executive Activation and Neurochemistry in Menopausal Women with Executive Function Difficulties (2017) · cites this paper as Kudielka et al, 2009
In the citing paper
“In public speaking tasks, sex differences in HPA responsivity show an inconsistent pattern; when effects are found, they indicate stronger responses in men, although women show increased cortisol response in the luteal phase of the menstrual cycle (Kajantie and Phillips, 2006; Kudielka and Kirshbaum, 2005; Kudielka et al., 2009)”
From The Adaptive Calibration Model of stress responsivity (2011) · cites this paper as Kudielka et al., 2009
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‘Normal’ cigarette smoking increases free cortisol in habitual smokers
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“Beside nicotine, it has been shown that caffeine intake can potentially activate important components of the pituitaryadrenocortical response in humans during resting states leading to increased plasma as well as salivary cortisol levels (Lovallo et al., 1996, 2005).”
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Self-citationEffects of Fasting and Glucose Load on Free Cortisol Responses to Stress and Nicotine1
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“, 2001), including salivary cortisol responses (Kudielka et al., 1999).”
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Cortisol responses to psychological stress and correlations with personality traits
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Self-citationSex Differences in Neonatal Stress Reactivity
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Feedback from Meal-Related Peaks Determines Diurnal Changes in Cortisol Response to Exercise
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Social hierarchy and adrenocortical stress reactivity in men
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The Pituitary-Adrenal Glucocorticoid Response Is Altered by Gender and Disease
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Decreased adrenal androgen sensitivity to ACTH during aging
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Plasma corticotrophin releasing factor and vasopressin responses to exercise in normal man
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Additive Pressor Effects of Caffeine and Stress in Male Medical Students at Risk for Hypertension
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Metadata
- Authors
- Kudielka, B. M., Hellhammer, D. H., & Wüst, S.
- Affiliations
- Constructor University (DE)
- Universität Trier (DE)
- Central Institute of Mental Health (DE)
- Corresponding author
- Kudielka, Brigitte M.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 34
- Issue
- 1
- Pages
- 2-18
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2057119719
- Cited by
- 963
- References
- 241
- Citations by year
- 2026: 38 · 2025: 38 · 2024: 42 · 2023: 36 · 2022: 50 · 2021: 56 · 2020: 70 · 2019: 61 · 2018: 62 · 2017: 61 · 2016: 67 · 2015: 62 · 2014: 61 · 2013: 62 · 2012: 60
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- salivary cortisol, hypothalamic-pituitary-adrenal axis, acute psychosocial stress, sex steroids, age and gender differences, pregnancy and lactation, smoking, energy intake, genetic factors, early life experience, personality, chronic stress, psychopathology
- MeSH terms
- Age Factors, Animals, Breast Feeding, Nonprescription Drugs, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Lactation, Life Change Events, Male, Personality, Pregnancy, Saliva, Sex Characteristics, Stress, Physiological, Stress, Psychological
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