The DOI matches its Crossref record; 153 of the 154 references it cites were found in a registry or an index.
Stress-related and basic determinants of hair cortisol in humans: A meta-analysis
Abstract
The analysis of hair cortisol concentrations (HCC) is a relatively new strategy to measure long-term cumulative cortisol levels, which is increasingly used in psychoneuroendocrinological research. Here, we conduct a first comprehensive meta-analysis of HCC research based on aggregated data from a total of 124 (sub)samples (66 independent studies; total N=10,289). We seek to answer two central questions: (i) Which covariates and basic features of HCC need to be considered in future research? (ii) What are the main determinants of HCC in terms of chronic stress exposure and mental health? Concerning basic characteristics, our findings identify several covariates to be considered (age, sex, hair washing frequency, hair treatment, oral contraceptive use), confirm a decline of HCC from the first to the second proximal 3cm hair segment, and show positive associations between HCC and short-term salivary cortisol measures. Regarding chronic stress, we show that stress-exposed groups on a whole exhibit 22% increased HCC. This long-term cortisol hypersecretion emerges particularly when stress is still ongoing at the time of study (+43% HCC) but is not present in conditions of past/absent stress (-9% HCC, n.s.). We also report evidence for 17%-reduced HCC in anxiety disorders, such as PTSD. Interestingly, no consistent associations with mood disorders and self-reports of perceived stress, depressiveness or social support are found. However, our findings reveal positive associations of HCC with stress-related anthropometric (body mass index, waist-to-hip ratio) and hemodynamic measures (systolic blood pressure). These meta-analytic results are discussed in the light of their practical implications and important areas for future inquiry are outlined.
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“Meta-analytic and descriptive reviews show that chronic stress is associated with elevated long-term cortisol secretion (Stalder et al., 2017; Staufenbiel et al., 2013), with stressor duration and recency since stressor onset being important factors in shaping basal cortisol levels (Miller et al., 2007).”
From More than a feeling: A unified view of stress measurement for population science (2018) · cites this paper as Stalder et al., 2017
In the citing paper
“Elevated hair cortisol levels in stressed populations have previously been found (reviewed in Stalder et al., 2017; Staufenbiel et al., 2013).”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Stalder et al., 2017
In the citing paper
“However, the first meta-analytic review, which included primarily cross-sectional studies, did not show consistent links with self-reported depressiveness (Stalder et al., 2017).”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Stalder et al., 2017
In the citing paper
“Cross-sectional studies have shown elevated hair cortisol in stressed populations (Stalder et al., 2017; Staufenbiel et al., 2013)”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Stalder et al., 2017
In the citing paper
“Our results are consistent with a recent meta-analysis that found no clear relationships between hair cortisol and self-reported depressiveness (Stalder et al., 2017).”
From Chronic Stress, Hair Cortisol and Depression: A Prospective and Longitudinal Study of Medical Internship (2018) · cites this paper as Stalder et al., 2017
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Lehto, R., Lehto, E., Saha, M., Moazami-Goodarzi, A., Sääksjärvi, K., Leppänen, M. H., Vepsäläinen, H., Nissinen, K., Erkkola, M., & Sajaniemi, N. K. (2022) · Early Years Journal of International Research and Development · doi:10.1080/09575146.2022.2130879 · Cited by 3
“In recent years, hair cortisol concentration (HCC) has also been used as a measure of cumulative cortisol accumulation and possibly long-term stress among adults (Stalder et al. 2017) and children (Bates, Salsberry, and Ford 2017; Gray et al. 2018; Liu and Doan 2019).”
MethodTsai, M.-L., Cheng, T., Yang, Y. K., & Wang, C. (2021) · Healthcare · doi:10.3390/healthcare9101319 · Cited by 6
“HCC is a stress indicator and mental health-related variable that can be significantly influenced by age, sex, hair treatment, body mass index (BMI), and major life events [24,31].”
BackgroundKim, W. J., Park, K., Park, J. T., Seo, E., Bang, M., An, S. K., Park, H. Y., & Lee, E. M. (2021) · Psychiatry Investigation · doi:10.30773/pi.2021.0256 · Cited by 3
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“In contrast, a recent meta-analysis including studies in adult subjects concluded that HCC had a positive relation to age [54], which could probably explain the difference in cortisol concentration between minors and adults.”
ResultMayer, S. E. (2017) · Deep Blue (University of Michigan) · Cited by 4
Mood swings in cows : Cognitive and physiological assessments
Kremer, L. (2022) · doi:10.18174/562024 · Cited by 3
Valk, S. L., Engert, V., Puhlmann, L. M. C., Linz, R., Caldairou, B., Bernasconi, A., Bernasconi, N., Bernhardt, B. C., & Singer, T. (2023) · eLife · doi:10.7554/elife.87634.1 · Cited by 3
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Dyadic Comparison of Pain and Stress in Alzheimer's Disease and Caregivers
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“Nonetheless, multiple influencing factors of cortisol in hair (HairF) have been identified, for example age, sex, body mass index, frequency of hair washing and medication (Psarraki et al., 2021; Stalder et al., 2017).”
Self-citationSporniak, B., & Szewczuk-Bogusławska, M. (2025) · Brain Sciences · doi:10.3390/brainsci15030287 · Cited by 3
“This method is painless, quick, and can be performed in various settings without special preparation, making it highly convenient for both participants and researchers [59].”
Tovo‐Rodrigues, L., Goularte, L. M., Bierhals, I. O., Santos, I. S., Martins‐Silva, T., Rohde, L. A., Oliveira, I. O., Gonzalez, A., Matijasevich, A., & Murray, J. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02693-x · Cited by 2
“The primary regulator of this axis, but also its end product, cortisol, a steroid hormone, is often associated with mental health problems [9, 10].”
Soomro, M. H., England-Mason, G., Giesbrecht, G. F., Letourneau, N. L., Reardon, A. J. F., MacDonald, A. M., Kinniburgh, D. W., Martin, J. W., & Dewey, D. (2025) · Environmental Research · doi:10.1016/j.envres.2025.122379 · Cited by 2
“A flattened or blunted CAR may be indicative of dysregulation of the HPA axis (Chida and Steptoe, 2009; Clow et al., 2010; Stalder et al., 2017).”
Work-related stress and burnout: Is epigenetic aging the missing link?
Eder, J., David, F. S., Illius, S., Rothe, N., Wekenborg, M., Walther, A., Penz, M. S., Jylhävä, J., Miller, R. E., Kirschbaum, C., et al. (2025) · Clinical Epigenetics · doi:10.1186/s13148-025-01968-z · Cited by 3
“Additionally, participants completed a standardized hair protocol assessing the number of hair washes per week and hair treatments (e.g., coloration, tinting, permanent wave), which are considered potential confounders of hair glucocorticoid levels [67].”
Self-citationTrépanier, M., Deschênes, A.-A., Marin, M., & Gendron, A. (2025) · Journal of Workplace Behavioral Health · doi:10.1080/15555240.2025.2579032 · Cited by 2
“Stalder et al. (2017) also consider the notion of temporality.”
Lipka, R., Kreuzpointner, L., Bärtl, C., Giglberger, M., Konzok, J., Peter, H. L., Speicher, N., Waller, L., Kudielka, B. M., Wüst, S., et al. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-04140-0 · Cited by 2
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Dopico, J., Schäffer, B., Brink, M., Vienneau, D., Röösli, M., Binz, T. M., Tobias, S., Bauer, N., & Wunderli, J. M. (2026) · Urban forestry & urban greening · doi:10.1016/j.ufug.2026.129291 · Cited by 3
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Gianaros, P. J., Wan, L., DeCataldo, M. K., Molina‐Hidalgo, C., Scudder, M. R., Grove, G., Shell, A., Kang, C. R., Wu‐Chung, E. L., Marsland, A. L., et al. (2026) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2026.101135 · Cited by 2
“68 Importantly, though, cross-sectional meta-analytic evidence indicates that hair cortisol concentrations relate to components of the metabolic syndrome and other markers of cardiovascular disease risk.”
Wang, J., Liao, X., Kuang, Y., Gu, Y., Zhu, T., Hu, Y. G., Li, C., Zeng, X., Xuan, C., Zhu, T., et al. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.121757 · Cited by 2
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“With 22 to 43% elevated cortisol levels under present and ongoing stress exposure 36 , HCC proved to be a sensitive parameter to capture longitudinal cortisol secretion.”
ATLAS—a psychobiological model of teacher stress in classroom interactions
Wettstein, A., Schneider, I., Jenni, G., & LUPIEN, S. J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1869744 · Cited by 2
“Previous studies indicate that a person’s psychological and biological systems have only weak connections (Stalder et al., 2017).”
Hair cortisol concentrations in decedents with severe mental illness – An autopsy-based cohort study
Busch, J. R., Wang, X., Lynnerup, N., Jacobsen, C., Jørgensen, M. B., Línnet, K., Johansen, S. S., & Banner, J. (2021) · Forensic Science International Reports · doi:10.1016/j.fsir.2021.100173 · Cited by 2
Hair Cortisol Concentrations Are Associated with Dental Anxiety during Pregnancy
Viitaniemi, H., Suominen, A., Karlsson, L., Mustonen, P., Kortesluoma, S., Rantavuori, K., Rodrigues, A. J., Coimbra, B., Karlsson, H., & Lahti, S. M. (2021) · Dentistry Journal · doi:10.3390/dj9040042 · Cited by 2
“Depressive symptoms, general anxiety symptoms, maternal age at delivery, maternal educational level, BMI before pregnancy, use of selective serotonin and/or noradrenalin reuptake inhibitors (SSRI/SNRI), and smoking during pregnancy were considered potential covariates based on prior literature [27,32,40,41].”
MethodElevated levels of hair cortisol concentrations in professional dementia caregivers
Rippon, D., McDonnell, A., Bristow, M., Smith, M., McCreadie, M., & Wetherell, M. A. (2021) · Stress · doi:10.1080/10253890.2021.1968821 · Cited by 3
“While these results do suggest that staff in higher education and students do experience high levels of stress, there is not always an association between levels of HCC and self-reported stress (Stalder et al., 2017).”
BackgroundResultA matter of habit? Stressful life events and cognitive flexibility in 15-month-olds
Tisborn, K., Kumsta, R., Zmyj, N., & Seehagen, S. (2023) · Infant Behavior and Development · doi:10.1016/j.infbeh.2023.101810 · Cited by 2
Sami, A., Elimairi, I., Ryan, C. A., Ross, R. P., & Stanton, C. (2023) · Steroids · doi:10.1016/j.steroids.2023.109189 · Cited by 4
Depressive-Like Effects of Foreclosing: A Cross-Sectional Study of Hair Cortisol Concentration
Portella, M. J., González-González, I., Jubero, M., Trujols, J., & Pérez, V. (2023) · Psychopathology · doi:10.1159/000530706 · Cited by 2
“The fi ndings are consistent with ours and also with a previous meta-analysis that suggests increments in HPA activity under chronic stress [38].”
ResultMonitoring Social Determinants of Health Assessing Patients and Communities
Morelli, V., & Heizelman, R. (2023) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2023.04.005 · Cited by 2
Torrecilla, P., & Neus Barrantes-vidal, A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1150142 · Cited by 3
“org function and psychopathology but that probably the effects are not as devastating as we would expect them to be in a clinical or functionally impaired sample, whereas stronger or persistent negative experiences might be needed to capture the effects in a nonclinical sample of functional young adults (Stalder et al…”
BackgroundValk, S. L., Engert, V., Puhlmann, L. M. C., Linz, R., Caldairou, B., Bernasconi, A., Bernasconi, N., Bernhardt, B. C., & Singer, T. (2023) · eLife · doi:10.7554/elife.87634 · Cited by 3
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Emal, L. M., Tamminga, S. J., Schaafsma, F. G., Jakaša, I., Peremin, I., Kirschbaum, C., van der Molen, H. F., & Kežić, S. (2024) · Health Science Reports · doi:10.1002/hsr2.1710 · Cited by 2
“32 In a recent large study conducted in occupational settings, no associations was found between PD and hair cortisol levels in the overall sample, but, a positive association was observed in a subgroup with high perceived PD, suggesting that alterations in the HPA ‐ axis become apparent beyond a…”
BackgroundMethodInfluentialSelf-citationAssessment of salivary cortisol dynamics in an infantry training exercise: a pilot study
Gifford, R. M., Taylor, N., Carroll, A., Sweeting, J., Parsons, I., Stacey, M. J., Homer, N. Z. M., Tsanas, A., Woods, D. R., & Reynolds, R. M. (2024) · BMJ Military Health · doi:10.1136/military-2023-002622 · Cited by 2
“35 This interpretation is corroborated by variation in sampling compliance and low day- to-day stability.”
BackgroundRamacciotti, M. C. C., Soares, R. D. S., Sato, J. R., & Gualtieri, M. (2024) · Developmental Neuroscience · doi:10.1159/000539023 · Cited by 4
Ip, K. I., Wen, W., Sim, L., Chen, S., & Kim, S. Y. (2024) · Developmental Psychobiology · doi:10.1002/dev.22519 · Cited by 2
“HCC serves as a physiological index of chronic stress response in the HPA axis (Russell et al. 2012; Stalder et al. 2017).”
BackgroundInfluentialProlonged perceived stress predicts fingernail cortisol increase: A longitudinal study
Moriishi, C., Izawa, S., Maeda, S., & Shimada, H. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.08.034 · Cited by 7
Kuckuck, S., van der Valk, E. S., Lengton, R., März, J., Hillegers, M. H. J., Penninx, B. W. J. H., Kavousi, M., Boon, M. R., van den Berg, S. A. A., & van Rossum, E. F. C. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107224 · Cited by 3
“…between continuous self-reported measures of psychological stress and hair glucocorticoid levels have been reported to be inconsistent before (Stalder et al., 2017), while more objective stressors like e.g. shift work are associated with higher levels of hair glucocorticoids (Manenschijn et…”
BackgroundCentral neurophysiological mechanisms of stress resistance in post-traumatic stress disorder
Kondashevskaya, M. V., Artemyeva, К. А., & Алексанкина, В. В. (2024) · Журнал высшей нервной деятельности им И П Павлова · doi:10.31857/s0044467724050032 · Cited by 2
Plettenberg, L., Kräplin, A., Voß, C., Beesdo‐Baum, K., & Kische, H. (2025) · Addiction Biology · doi:10.1111/adb.70018 · Cited by 2
Shkreli, L., Woud, M. L., Bergunde, L., Schindler‐Gmelch, L., Blackwell, S. E., Kirschbaum, C., Kessler, H., & Steudte‐Schmiedgen, S. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2457295 · Cited by 2
“Since only two men remained eligible, we decided to exclude them due to the relevance of sex for steroid secretion (Stalder et al., 2017).”
InfluentialSelf-citationKhoury, J. E., Jambon, M. M., González, A., & Atkinson, L. R. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107556 · Cited by 2
The Potential of Hair Matrix for Biomarker Analysis in Schizophrenia
Rubio-Contreras, E., Guasch-Capella, N., Martínez-Pinteño, A., Olivares-Berjaga, D., & Morén, C. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26178718 · Cited by 2
“Accordingly, elevated serum cortisol levels [55,111] have been described in individuals with SCZ, although inconsistent findings that have emerged from hair analysis have been reported [112–114].”
Busch, J. R., Lundemose, S. B., Lynnerup, N., Jacobsen, C., Jørgensen, M. B., & Banner, J. (2019) · Stress · doi:10.1080/10253890.2019.1641485 · Cited by 2
“It is hypothesized that psychological stress leads to increased activity in the HPA-axis, which leads to physiologic hypercortisolemia (Findling & Raff, 2017; Stalder et al., 2017).”
BackgroundBertrams, A., & Minkley, N. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00580 · Cited by 2
Sääksjärvi, K., Lehto, E., Lehto, R., Suhonen, E., Leppänen, M. H., Michels, N., Saha, M., Ray, C., Vepsäläinen, H., Pajulahti, R., et al. (2021) · Hormones and Behavior · doi:10.1016/j.yhbeh.2021.105042 · Cited by 2
“The association of the diurnal sCort level and HCC has been examined in many studies among adults, and although significant positive correlations have been found, many times the effect sizes have been modest (Stalder et al., 2017).”
Economic Stress and Body Weight During the COVID-19 Pandemic
Mathieu‐Bolh, N. (2021) · Studies in Microeconomics · doi:10.1177/23210222211053915 · Cited by 2
“The meta-analysis by Stalder et al. (2017) shows that a 9.8% increase of cortisol results in a 2.5 point increase in Body Mass Index.”
InfluentialCosan, A. S., Schloß, S., Becker, K., Skoluda, N., Nater, U. M., & Pauli‐Pott, U. (2022) · Journal of Neural Transmission · doi:10.1007/s00702-022-02463-y · Cited by 2
“The hair cortisol concentration (HCC), which reflects the cumulative long-term activity of the HPAA, has been suggested to represent a biological marker of chronic stress in healthy adults (Khoury et al. 2019; Stalder et al. 2017).”
BackgroundHaugen, T., Halvorsen, J. Ø., Friborg, O., Simpson, M. R., Mork, P. J., Mikkelsen, G., Elklit, A., Rothbaum, B. O., Schei, B., & Hagemann, C. T. (2023) · Trials · doi:10.1186/s13063-023-07147-w · Cited by 4
“The hair samples are additionally collected as these measurements provide a retrospective indication of the cumulative cortisol secretion over an extended period, which represents a good proxy indicator of the intraindividual stability regarding cortisol levels [66].”
BackgroundWillingness to wait covaries with endogenous variation in cortisol
Lukinova, E., & Erlich, J. C. (2021) · bioRxiv · doi:10.3389/fpsyg.2025.1565274 · Cited by 3
Cosan, A. S., Schloß, S., Vasen, Z., Hausner, M., Christiansen, H., Becker, K., Skoluda, N., Nater, U. M., & Pauli‐Pott, U. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105279 · Cited by 2
Shinrin-yoku, yoga and other strategies in the fight against COVID-19
Pasieka, J. L. (2021) · Surgery · doi:10.1016/j.surg.2021.07.044 · Cited by 2
A social and physical stressor increases later punishment in healthy malesPreprint
Deza-Araujo, Y. I., Rimmele, U., Gyger, L., Aguirre, C., Sander, D., & Klimecki, O. (2021) · doi:10.31234/osf.io/4d6g3 · Cited by 2
Fathers, families, and physiology: Exploring the psychobiological context of fathering
Gettler, L. T., & Barr, R. (2022) · Developmental Psychobiology · doi:10.1002/dev.22267 · Cited by 1
Fatores de estresse psicológico e cortisol salivar em alunos de enfermagem ao longo da formação
Mendes, S. S., Martino, M. M. F. D., Borghi, F., Rocha-Teles, C. M., de Souza, A. L., & Kassisse, D. M. G. (2022) · Revista da Escola de Enfermagem da USP · doi:10.1590/1980-220x-reeusp-2022-0078pt · Cited by 1
Estimation of Hair Cortisol Levels as a Biomarker of Chronic Stress in Psoriasis: A Pilot Study
Budamakuntla, L., Loganathan, E., Ramesh, H., Karagaiah, P., Somashekhar, S., & Venkatarayaraju, S. K. (2023) · Clinical Dermatology Review · doi:10.4103/cdr.cdr_27_22 · Cited by 1
Life-course stress, cognition, and diurnal cortisol in memory clinic patients without dementia
Holleman, J., Kåreholt, I., Aspö, M., Hagman, G., Udeh‐Momoh, C. T., Kivipelto, M., Solomon, A., & Sindi, S. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105316 · Cited by 2
Fenech, A. L., Soriano, E. C., Asok, A., Siegel, S. D., Morreale, M. T., Brownlee, H. A., & Laurenceau, J. (2024) · Journal of Cancer Survivorship · doi:10.1007/s11764-024-01631-1 · Cited by 3
“…extraction; however, the study was limited on variables that may affect cortisol concentrations in hair such as hair treatments, personal hygiene, medications, or health behaviors as well as medical illnesses that affect cortisol output such as Cushing syndrome or Addison’s disease [28, 56].”
Age and Hair Cortisol Levels as Predictors of SARS-CoV-2 Infection
Fiedler, N. L., Ohman‐Strickland, P., Shen, J. D., Black, K., Horton, D. B., Panettieri, R. A., Blaser, M. J., Carson, J. L., Bendinskas, K. G., Cheng, H., et al. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21091166 · Cited by 2
“Because the hair cortisol level declines with greater distance from the scalp, we matched the hair segment used for controls with the segment used for cases [33].”
BackgroundMethodResultInfluentialHair cortisol and psychiatric symptomatology in children; outcomes of group CBT
Barron-Linnankoski, S. T. A., Raaska, H. K., Bergman, P., Laasonen, M. R., & Elovainio, M. J. (2024) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2024.100263 · Cited by 1
“For example, liquid chromatography-based analyses, used in our study, have yielded lower HCC concentrations than immunoassay protocols [59], which have so far been more commonly used in studies involving children [27].”
BackgroundMethodProsocial reputation and stress among contemporary hunter-gatherers: the Hadza case
Fedurek, P., Aktipis, A., Cronk, L., Danel, D. P., Lacroix, L. P., Lehmann, J., Mabulla, I. A., Makambi, J. E., & Berbesque, J. C. (2024) · Scientific Reports · doi:10.1038/s41598-024-72238-w · Cited by 1
“…hair cortisol concentration (HCC) is not necessarily a synonym of stress per se 1–4 , it is heightened among individuals experiencing ongoing chronic stress 66 , among children brought up in high-risk environments 67 , and among people with dementia exhibiting low levels of social engagement 68 .”
BackgroundArchibald, P., Daniels, K., Massenburg, R., Simms, E., & Thorpe, R. J. (2024) · Ethnicity & Disease · doi:10.18865/ethndis-2023-88 · Cited by 3
Raymond, C., Bilodeau-Houle, A., Arcand, M., Peyrot, C., & Marin, M. (2024) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2024.107233 · Cited by 2
Kosmas, N., Simitsis, P., Alevyzakis, E., Rizos, E. N., Zapantiotis, D., & Rallidis, L. S. (2024) · Coronary Artery Disease · doi:10.1097/mca.0000000000001468 · Cited by 2
“A positive association was also found between HCC and BMI, as well as systolic blood pressure [38].”
Associations of reproductive hormones and stress-related factors with menopausal symptoms
Brimienė, I., Šiaudinytė, M., Ilkevič, E., Mazgelytė, E., Karčiauskaitė, D., Songailienė, J., Kaminskas, A., Petrėnas, T., Utkus, A., Burokas, A., et al. (2024) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000002463 · Cited by 1
Verlinden, S., Wynen, J., Doninck, D. V., Roosens, L., Block, C. E. M. D., & Boon, J. (2025) · Review of Public Personnel Administration · doi:10.1177/0734371x241310418 · Cited by 1
“For a critical review of HCC analysis, we refer to Stalder et al. (2017).”
Machulsky, N. F., Colla, J., González, D., Fortuna, F., Ibar, C., Jamardo, J., Gagliardi, J., Fabre, B. R., & Berg, G. A. (2025) · Heart and Mind · doi:10.4103/hm.hm-d-24-00099 · Cited by 1
Advanced capabilities for in vitro stress diagnostics: a review
Pekhova, Y. G., Александровна, К. А., & Marchenkova, L. (2025) · Bulletin of Rehabilitation Medicine · doi:10.38025/2078-1962-2025-24-1-67-74 · Cited by 1
Schmalbach, I., Steudte‐Schmiedgen, S., Renner, V., Drees, P., & Petrowski, K. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03295-6 · Cited by 1
“In light of past evidence, hair cortisol concentrations (HCC) allow a view on long-term cortisol secretion [11, 12], potentially delivering insight regarding HPA dysregulation in PTSD.”
InfluentialSelf-citationMeyer, J. S., Markham, J., Scott, L., Valdez, L. A., Robinson, D. E., & Buchanan, D. R. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1526636 · Cited by 1
Zerroug, Y., Marin, M., Brendgen, M. R., Beauchamp, M. H., Séguin, J. R., Côté, S. M., & Herba, C. M. (2025) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2025.100311 · Cited by 1
“Previous research has indicated that these variables could influence glucocorticoid concentrations, hence their consideration [14,36].”
InfluentialRubeis, V. D., Wang, E., Joshi, D., Catherine, N. L. A., MacMillan, H. L., Waddell, C., Boyle, M., Tonmyr, L., Atkinson, L. R., Jack, S. M., et al. (2025) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2025.107602 · Cited by 1
Doninck, D. V., Wynen, J., Boon, J., Roosens, L., & Block, C. E. M. D. (2025) · Review of Managerial Science · doi:10.1007/s11846-025-00907-9 · Cited by 2
Associations among prenatal stress, socioeconomic status, and infant epigenetic aging
Sperber, J. F., Hart, E. R., Troller‐Renfree, S. V., Watts, T. W., Miller, M., Bellatin, A., Meyer, J. S., Dettmer, A. M., Champagne, F. A., & Noble, K. G. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107575 · Cited by 1
“Indeed, our study finds no correlation between perceived stress and hair cortisol, which aligns with the results from several meta-analyses (Kim et al., 2020; Stalder et al., 2017).”
de la Rosa, R., Steinmaus, C., Nardone, A., Keller, A., Acevedo, J., Catterina Ferreccio, R., Smith, M. T., & Sillé, F. C. M. (2026) · Environmental Health · doi:10.1186/s12940-026-01304-9 · Cited by 1
“This sex difference in cortisol is consistent with previous studies that reported men had higher levels of morning serum cortisol [24] and hair cortisol concentrations [49] than women.”
Tormos‐Pons, P., Cano‐López, I., Catalán‐Aguilar, J., Lozano‐García, A., Hampel, K. G., Hidalgo, V., Salvador, A., Villanueva, V., & González‐Bono, E. (2025) · Physiology & Behavior · doi:10.1016/j.physbeh.2025.115118 · Cited by 1
Jaramillo, I., Mamo-Wilhelmy, J., Bergunde, L., Karl, M., Weidner, K., Garthus‐Niegel, S., & Steudte‐Schmiedgen, S. (2025) · Hormones and Behavior · doi:10.1016/j.yhbeh.2025.105838 · Cited by 1
Self-citationMorf, R., Kernwein, C., Jaeger, J., Reicherzer, L., Degenfellner, J., & Boendermaker, S. H. (2025) · Frontiers in Pain Research · doi:10.3389/fpain.2025.1686389 · Cited by 2
“The findings revealed weak correlations between objective and subjective stress measures, which adds to the existing body of inconsistent research (12, 13, 58).”
InfluentialSwart, A. C., Heyns, B., Kidd, M., Pieters, R., & Atkin, S. L. (2025) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2025.112719 · Cited by 1
Rodrigues, K. L., da Silva, A., Pereira, E. N. G. D. S., Castilho, C., Schmidt, M. I., da Fonseca, M. D. J. M., Griep, R. H., & Daliry, A. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.121061 · Cited by 1
Skinner, A. T., Павлова, Ю., Godwin, J. W., Reilly, E. B., & Georgiades, A. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107761 · Cited by 1
Kim, N., Stuifbergen, A. M., Becker, H., Swift‐Scanlan, T., Osier, N. S., & Buxhoeveden, S. (2026) · Western Journal of Nursing Research · doi:10.1177/01939459251405618 · Cited by 1
“17 The relatively low perceived stress in our sample (median = 12 out of a total maximum score of 40) may have contributed to this lack of a significant relationship.”
InfluentialNon-invasive physiological indicators of welfare in dairy cows
Kremer, L., van Reenen, K., Kok, A., Bokkers, E. A. M., Gort, G., Engel, J., van der Werf, J. T. N., & Webb, L. E. (2026) · Animal Welfare · doi:10.1017/awf.2026.10063 · Cited by 1
“It has been shown to increase in humans in response to chronic stress (Stalder et al. 2017) and psychiatric disorders (Wosu et al. 2013).”
Abelson, J. L., Clark, S. L., Sánchez, B. N., Mayer, S. E., Tobias Stalder, A., Liberzon, G., Briggs, H., Rajaram, N., & Liberzon, I. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107778 · Cited by 1
Zhang, Y., Luo, Z., Kirschbaum, C., & Gao, W. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107781 · Cited by 1
Self-citationStrack, J., Hansen, M., Jacobs, L., Turner, A., Bulson, V., Bendinskas, K. G., Wiltshire, C. A., Gavin, W. J., Davies, P. L., & Merz, E. C. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107796 · Cited by 2
Bergunde, L., Jaramillo, I., Rihm, L., Gao, W., Weidner, K., von Soest, T., Steudte‐Schmiedgen, S., & Garthus‐Niegel, S. (2026) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2026.111649 · Cited by 1
Self-citationThe adrenal is doing what it’s supposed to do, you just don't understand it
Cantave, C. Y., & Gunnar, M. R. (2026) · Neurobiology of Stress · doi:10.1016/j.ynstr.2026.100792 · Cited by 2
“Alternatively, urine and hair samples provide integrated measures of long-term cortisol secretion, ranging from 12 h or 24h (urine) to months (hair; Levine et al., 2007; Nicolson, 2008; Stalder et al., 2017).”
From lifetime stressor exposure to daily stress experience: Associations with hair cortisol
Huthsteiner, K., Finke, J. B., Planert, J., Slavich, G. M., Klucken, T., & Stalder, T. (2026) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2026.100348 · Cited by 1
“By contrast, associations between hair cortisol and self-reported stress perception, as measured with brief questionnaires such as the Perceived Stress Scale (PSS) or the Trier Inventory for Chronic Stress (TICS), tend to be weak or absent [8,10 – 12].”
InfluentialSelf-citationSuriya-Arunroj, L., Huntula, T., Chimngam, M., Suttisan, N., Kongsombat, N., & Suwannachat, P. (2026) · International Journal of Primatology · doi:10.1007/s10764-026-00557-y · Cited by 1
“…provides a retrospective index of basal or chronic HPA activity accumulated over weeks to months (Davenport et al. , 2006; Meyer & Novak, 2012; Stalder et al. , 2017; Linden et al. , 2018; Dettmer et al. , 2023; Pritchard et al. , 2023; Bendinskas et al. , 2024) and, unlike blood or saliva,…”
Mariño-Narváez, C., Romero‐Gonzalez, B., Puertas‐Gonzalez, J. A., González-Pérez, R., Nacarino-Palma, C., & Peralta‐Ramírez, M. I. (2026) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2026.2662664 · Cited by 1
Li, Y., Li, F., Wei, Q., Li, Q., Gu, B., Liu, X., & Qianlong, Z. (2026) · Gene Reports · doi:10.1016/j.genrep.2026.102516 · Cited by 2
Fortuna, F., Lanno, A., Magrin, D., LOCATELLI, A., González, D., Jacobsen, D., Jamardo, J., Fabre, B. R., Passoni, A., & Bagnati, R. (2026) · Journal of Endocrinological Investigation · doi:10.1007/s40618-026-02933-0 · Cited by 1
“For instance, in terms of sex differences, several studies reported higher HCC in men compared to women [ 40–42].”
Shkreli, L., Morse, L., Scaife, J. C., Browning, M. D., Murphy, S. E., Kirschbaum, C., & Reinecke, A. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107944 · Cited by 1
Self-citationLiedtke, C., Schaefer, M., & Enge, S. (2026) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2026.100361 · Cited by 1
“…systems, including the hypothalamic – pituitary – adrenal (HPA) axis as the primary neuroendocrine stress system [21], with cortisol as established marker measurable in saliva to capture acute stress responses [22], while hair cortisol concentrations (HCC) reflect long-term or chronic stress [23].”
Janousch, C., Eggenberger, L., Johnson‐Ferguson, L., Voegel, C. D., Baumgartner, M. R., Ribeaud, D., Eisner, M., Binz, T. M., Shanahan, L., & Quednow, B. B. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107953 · Cited by 1
Galatoula, P., Pipelias, P., Mantikas, V., Papadopoulou, A., Chrousos, G. P., Bacopoulou, F., Mykoniatis, M., & Darviri, C. (2026) · Nutrients · doi:10.3390/nu18152501 · Cited by 1
“Elevated HCC has been associated with chronic stress, obesity, metabolic syndrome, and adverse health outcomes, supporting its utility as a marker of long-term stress exposure [53,54].”
Norlin, A. (2020) · Linköping University medical dissertations · doi:10.3384/diss.diva-170320 · Cited by 1
Metadata
- Authors
- Stalder, T., Steudte-Schmiedgen, S., Alexander, N., Klucken, T., Vater, A., Wichmann, S., Kirschbaum, C., & Miller, R.
- Affiliations
- Universität Hamburg (DE)
- University of Siegen (DE)
- Technische Universität Dresden (DE)
- MSB Medical School Berlin (DE)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 77
- Pages
- 261-274
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2512922965
- Semantic Scholar
- 78b482bd463a2e29e2aae66b9cf8e24a66b06fe6
- Cited by
- 855
- References
- 154
- Citations by year
- 2026: 83 · 2025: 100 · 2024: 123 · 2023: 101 · 2022: 88 · 2021: 111 · 2020: 95 · 2019: 74 · 2018: 56 · 2017: 23
- FWCI
- 5.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- German Research Foundation (1213/5-1, 940/2)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Behavior and Welfare Studies
- Keywords
- hair cortisol, chronic stress, cortisol hypersecretion, salivary cortisol, anxiety disorders, post-traumatic stress disorder, mood disorders, perceived stress, body mass index, waist-to-hip ratio, systolic blood pressure, hair treatment, oral contraceptive use
- MeSH terms
- Hair, Hemodynamics, Humans, Hydrocortisone, Stress, Psychological
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