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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In the citing paper
“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
Citations
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Protective and Damaging Effects of Stress Mediators
McEwen, B. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801153380307 · Cited by 6,733 · cited 2×
“…with more severe stress (e.g. caregiving stress, trauma exposure) where patterns of worrying and ruminating pervade individuals’ lives, thus inducing cumulative burden that eventually exhausts the regulatory capacities of the HPA axis and manifests in long-term endocrine changes (McEwen, 1998).”
Dickerson, S. S., & Kemeny, M. E. (2004) · Psychological Bulletin · doi:10.1037/0033-2909.130.3.355 · Cited by 5,881
Stress and disorders of the stress system
Chrousos, G. P. (2009) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2009.106 · Cited by 3,215
Cited by
Sorted by citations
More than a feeling: A unified view of stress measurement for population science
Epel, E. S., Crosswell, A. D., Mayer, S. E., Prather, A. A., Slavich, G. M., Puterman, E., & Mendes, W. B. (2018) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2018.03.001 · Cited by 1,077
“elevated long-term cortisol secretion (Stalder et al., 2017; Staufenbiel, Penninx, Spijker, Elzinga, & van Rossum, 2013), with stressor duration and recency since stressor onset being important factors in shaping basal cortisol levels (Miller, Chen, & Zhou, 2007).”
BackgroundStress and Health: A Review of Psychobiological Processes
O'Connor, D. B., Thayer, J. F., & Vedhara, K. (2021) · Annual Review of Psychology · doi:10.1146/annurev-psych-062520-122331 · Cited by 948
“undergoing in vitro fertilisation and cardiometabolic risk factors for cardiovascular disease (CVD) such as high blood pressure, diabetes, and adiposity (e.g., Lob & Steptoe, 2019; Massey et al., 2016; Stalder et al., 2017; Wright, Hickman, Laudenslager, 2015).”
BackgroundStress and Obesity: Are There More Susceptible Individuals?
van der Valk, E. S., Savas, M., & van Rossum, E. F. C. (2018) · Current Obesity Reports · doi:10.1007/s13679-018-0306-y · Cited by 402
The use of hair cortisol for the assessment of stress in animals
Heimbürge, S., Kanitz, E., & Otten, W. (2018) · General and Comparative Endocrinology · doi:10.1016/j.ygcen.2018.09.016 · Cited by 329
The multiple roles of life stress in metabolic disorders
Mika Kivimaki, B., Bartolomucci, A., & Kawachi, I. I. (2022) · Nature Reviews Endocrinology · doi:10.1038/s41574-022-00746-8 · Cited by 357
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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