Effects of mood and rumination on cortisol levels in daily life: An ambulatory assessment study in remitted depressed patients and healthy controls
Abstract
The influence of naturally occurring emotional and cognitive experiences on hypothalamic-pituitary-adrenal axis (HPAA) activity is still underinvestigated, particularly in clinical populations. The present study examined effects of mood and rumination on cortisol levels in daily life in remitted depressed patients with recurrent episodes or a chronic precourse (n=31) and healthy controls (n=32). Ambulatory assessment of subjective variables (valence, calmness, energetic-arousal, ruminative self-focus), daily stressors, and saliva cortisol samples was performed five times a day on two consecutive workdays, whereby cortisol was collected 20min after the subjective assessments. In addition, depressive symptoms and trait rumination (brooding, reflection) were measured retrospectively. Multilevel models revealed that remitted depressed patients showed lower cortisol activity compared to healthy controls. Depressive symptoms and trait rumination did not predict HPAA activity, whereas, by controlling for daily stressors, higher daily means of ruminative self-focus and lower daily means of valence, energetic arousal and calmness were associated with higher daily cortisol levels. Separate analyses per group revealed that mean daily ruminative self-focus predicted higher cortisol in both samples. In contrast, lower daily means of calmness, but also of valence and energetic arousal, were significantly linked to higher cortisol output only in healthy controls, but not in the patient sample. These findings indicate that naturally occurring rumination and low mood are associated with increased activation of the HPAA in daily life. Moreover, our data revealed a potentially reduced mood-cortisol coupling in remitted recurrent depression, possibly indicating that during the course of recurrent depression HPAA activation might become less responsive toward subtle emotional experiences in natural contexts.
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Among remitted MDD patients, reduced cortisol levels throughout the day and a different interaction between affect and cortisol were observed despite remission.
“Finally, interesting outcomes were also observed among remitted MDD patients [44]. Despite remission, patients showed reduced cortisol levels throughout the day and a different interaction between affect and cortisol, thus suggesting a reduction in the HPA axis’ responsiveness as a potential marker of recurrent depression.”
From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [44]
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Stuart, N. C., Zoccola, P. M., & Dickerson, S. S. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107517 · Cited by 4 · see citing works
Rudolph, K. D., Troop‐Gordon, W., Modi, H. H., & Granger, D. A. (2018) · Developmental Psychobiology · doi:10.1002/dev.21600 · Cited by 4 · see citing works
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Personality and Individual Differences
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Social Interaction and Interpersonal Relationships
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A Data‐Driven Closed‐Loop Control Approach to Drive Neural State Transitions for Mechanistic Insight
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Rumination, co-rumination and latent trait cortisol (LTC): the moderating role of depression history
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- Authors
- Huffziger, S., Ebner-Priemer, U., Zamoscik, V., Reinhard, I., Kirsch, P., & Kuehner, C.
- Affiliations
- Heidelberg University (DE)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 38
- Issue
- 10
- Pages
- 2258-2267
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2125934914
- Cited by
- 79
- References
- 49
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 6 · 2020: 21 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 2
- FWCI
- 1.81
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- MADOC (University of Mannheim) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- rumination, mood, cortisol, hypothalamic-pituitary-adrenal axis, remitted depression, recurrent depression, daily hassles, valence, energetic arousal, tranquility, trait rumination, ambulatory assessment, salivary cortisol
- MeSH terms
- Activities of Daily Living, Adolescent, Adult, Affect, Feeding and Eating Disorders, Depression, Female, Health, Humans, Hydrocortisone, Male, Middle Aged, Psychophysiologic Disorders, Remission Induction, Case-Control Studies, Young Adult
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