The DOI matches its Crossref record; 104 of the 106 references it cites were found in a registry or an index.
The association between adversity and hair cortisol levels in humans: A meta-analysis
Open accessAbstract
Adverse life events are associated with a constellation of negative health outcomes. Theory and research suggest that the hypothalamic-pituitary-adrenal (HPA) axis acts as one mechanism connecting adverse experiences with negative health outcomes. However, this relation is complicated by the potential for adversity to be associated with both hyperactivity and hypoactivity of the HPA axis, as assessed in both animal and human studies. Over the past decade, methodological advances have enabled the sampling of cortisol stored in hair, which provides a marker of HPA axis activity over a several-month period. The present meta-analysis included 28 studies to assess the strength and direction of the relation between adverse experiences and hair cortisol levels. Analyses were conducted using multilevel modeling (MLM) to quantify the magnitude of effects and mixture modeling to identify distinct subgroups of studies. Results of MLM analyses indicated that the overall effect size was small but significant d = 0.213, 95% CI [0.034, 0.397]. There was also significant between-study variance (τ = 0.155, 95% CI [0.065, 0.367]). Mixture modeling to identify distinct classes of studies based on effect size and direction resulted in a 2-class model: The first class included four studies with an overall negative and moderate effect size (d = -0.478, 95% CI [-0.639, -0.318]), and the second class included the remaining 24 studies with an overall positive and significant, albeit small, effect size (d = 0.141, 95% CI [0.084, 0.199]). Moderator analyses indicated that the strength and direction of the association between adversity and hair cortisol were moderated by features of the adversity exposure (e.g., type of adversity, timing of adversity), characteristics of the samples (e.g., clinical status, racial distribution), and features of the publication (e.g., publication type, geographic region of study). The findings refine our understanding of the long-term impact of adversity on dysregulation of the HPA axis, particularly as reflected in hair cortisol measures.
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“Inflammatory factors such as cortisol and C-reactive protein (CRP) are associated with breast cancer progression18 and psychological problems.19”
From The Effect of Mindfulness-Based Stress Reduction Group Counseling on Psychological and Inflammatory Responses of the Women With Breast Cancer (2020) · cites this paper as [19]
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“In humans, a meta-analysis showed adverse life events are associated with a small but significant increase in cortisol stored in hair as a marker of HPA axis activity over several months [37].”
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Iob, E., & Steptoe, A. (2019) · Current Cardiology Reports · doi:10.1007/s11886-019-1208-7 · Cited by 229
The complex neurobiology of resilient functioning after childhood maltreatment
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Daniels, T. E., Olsen, E. M., & Tyrka, A. R. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-082719-104030 · Cited by 157
“Differential patterns of dysregulation appear to be mediated in part by the type of stressor, reported age at the time of stress, and chronicity (Khoury et al. 2019).”
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Lopez, M., Ruiz, M. O., Rovnaghi, C. R., Tam, G. K.-Y., Hiscox, J., Gotlib, I. H., Barr, D. A., Carrión, V. G., & Anand, K. J. S. (2021) · Pediatric Research · doi:10.1038/s41390-020-01264-x · Cited by 200
Metadata
- Authors
- Khoury, J. E., Bosquet Enlow, M., Plamondon, A., & Lyons-Ruth, K.
- Affiliations
- Harvard University (US)
- University of Toronto (CA)
- Corresponding author
- Khoury, Jennifer E.
- ORCID
- Khoury, Jennifer E.
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2019-05
- Volume
- 103
- Pages
- 104-117
- ISSN
- 0306-4530 (ISSN-L)
- PMC
- PMC6450779
- OpenAlex
- W2910167098
- Cited by
- 170
- References
- 106
- Citations by year
- 2026: 15 · 2025: 19 · 2024: 20 · 2023: 26 · 2022: 27 · 2021: 35 · 2020: 23 · 2019: 4
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD079484)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- adversity, life events, hair cortisol, HPA axis dysregulation, hypothalamic-pituitary-adrenal axis, chronic stress, cortisol biomarkers
- MeSH terms
- Adverse Childhood Experiences, Female, Hair, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Male, Pituitary-Adrenal System, Stress, Psychological
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