Cited by 856Stress Responses and CortisolAdrenal Hormones and DisordersCircadian rhythm and melatonin

The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.

The Awakening Cortisol Response: Methodological Issues and Significance

Clow, A., Thorn, L., Evans, P., Hucklebridge, F.·2004·Stress

Open this paper in CoChat — free account

Abstract

The awakening cortisol response (ACR) is a discrete and distinctive part of the cortisol circadian cycle. In healthy adults salivary free cortisol concentrations increase by between 50 and 160% in the first 30 min immediately post-awakening (approximate average increase of 9 nmol/l, range 4-15 nmol/l, estimated to be equivalent to about three secretory episodes). However there are no agreed norms for the absolute concentrations of free cortisol in saliva either immediately post-awakening (range of 4.7-18.5 nmol/l) or 30 min post-awakening (range of 8.6-21.9 nmol/l). This review explores reasons for these discrepancies in normative data including confounding factors such as gender, age, awakening time, light and participant adherence. Although the physiological role of the ACR has not been clearly defined evidence is discussed that suggests it is under a distinct regulatory influence, different from the rest of the diurnal cortisol secretory cycle. Despite the difficulties associated with its measurement a range of studies have demonstrated an association between the ACR and psychosocial variables, stress and health. However it remains unclear whether positive affect and good health are consistently associated with larger or smaller awakening responses. It is early days in the search for the role and significance of the ACR. Its putative role in the regulation of physiological function across the day (e.g. the immune system) and its sensitivity to psychosocial variables make it a prime candidate as an intermediary linking mind and health.

Integrity signals

Registry

Crossref · 10.1080/10253890410001667205

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00108-7 · Cited by 3,638
Salivary Cortisol in Psychobiological Research: An Overview
Kirschbaum, C., & Hellhammer, D. H. (2008) · Neuropsychobiology · doi:10.1159/000118611 · Cited by 1,532
Free Cortisol Levels after Awakening: A Reliable Biological Marker for the Assessment of Adrenocortical Activity
Pruessner, J. C., Wolf, O. T., Hellhammer, D. H., Buske-Kirschbaum, A., von Auer, K., Jobst, S., Kaspers, F., & Kirschbaum, C. (1997) · Life Sciences · doi:10.1016/s0024-3205(97)01008-4 · Cited by 1,450
Diurnal Cortisol Rhythm as a Predictor of Breast Cancer Survival
Sephton, S. E. (2000) · Journal of the National Cancer Institute · doi:10.1093/jnci/92.12.994 · Cited by 1,082
Burnout, Perceived Stress, and Cortisol Responses to Awakening
Pruessner, J. C., Hellhammer, D. H., & Kirschbaum, C. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199903000-00012 · Cited by 822
The cortisol awakening response - normal values and confounds.
Wüst, S., Wolf, J. M., Hellhammer, D. H., Federenko, I. S., Schommer, N. C., & Kirschbaum, C. (2000) · PubMed · Cited by 700
Cortisol regulation in posttraumatic stress disorder and major depression: A chronobiological analysis
Yehuda, R., Teicher, M. H., Trestman, R. L., Levengood, R. A., & Siever, L. J. (1996) · Biological Psychiatry · doi:10.1016/0006-3223(95)00451-3 · Cited by 654
Genetic factors, perceived chronic stress, and the free cortisol response to awakening
Wüst, S., Federenko, I. S., Hellhammer, D. H., & Kirschbaum, C. (2000) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(00)00021-4 · Cited by 642
Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women
Steptoe, A., Owen, N., Kunz-Ebrecht, S. R., & Brydon, L. (2004) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(03)00086-6 · Cited by 620
Compliance With Saliva Sampling Protocols: Electronic Monitoring Reveals Invalid Cortisol Daytime Profiles in Noncompliant Subjects
Kudielka, B. M., Broderick, J. E., & Kirschbaum, C. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000058374.50240.bf · Cited by 489

Show all 55 references

Research works printed but not linked: 7

10.1016/S0306- · DOI
Buijs R.M., 1993, Am. J. Physiol., 264, R1186
Goodyer I.M., 1996, Med, 26, 245
Leproult R., 2001, J. Clin. Endocrinol. Metab., 86, 151
Pruessner J.C., 1995, J. Psychophysiol., 9, 365
Thorn L., 2003, Brain Behav. Immun., 17, 211
Wust S., 2000, Noise Health, 7, 77

Sorted by citations

Items 401–500 of 856

Sex differences in hypothalamic–pituitary–adrenal axis function in patients with chronic pain syndrome
Turner‐Cobb, J. M., Osborn, M., da Silva, L., Keogh, E., & Jessop, D. S. (2010) · Stress · doi:10.3109/10253890903524785 · Cited by 27
The Effect of Psychotherapy Added to Pharmacotherapy on Cortisol Responses in Outpatients With Major Depressive Disorder
Yang, T.-T., Hsiao, F., Wang, K.-C., Ng, S., Ho, R., Chan, C., Lai, Y.-M., & Chen, Y. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181a61594 · Cited by 27
Daily interpersonal coping strategies
Birditt, K. S., Nevitt, M. R., & Almeida, D. M. (2014) · Journal of Social and Personal Relationships · doi:10.1177/0265407514542726 · Cited by 27
Anticipated next‐day demand affects the magnitude of the cortisol awakening response, but not subjective or objective sleep
Elder, G. J., Barclay, N. L., Wetherell, M. A., & Ellis, J. G. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12569 · Cited by 27
The slope of cortisol from awakening to 30 min post-wake in post-institutionalized children and early adolescents
Leneman, K. B., Donzella, B., Desjardins, C. D., Miller, B. S., & Gunnar, M. R. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.06.011 · Cited by 27
Loneliness and Diurnal Salivary Cortisol in Emerging Adults
Lai, J. C. L., Leung, M. O. Y., Lee, D. Y. H., Lam, Y. W., & Berning, K. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19071944 · Cited by 33
The Price of Stress: High Bedtime Salivary Cortisol Levels Are Associated with Brain Atrophy and Cognitive Decline in Stroke Survivors. Results from the TABASCO Prospective Cohort Study
Tene, O., Hallevi, H., Korczyn, A. D., Shopin, L., Molad, J., Kirschbaum, C., Bornstein, N. M., Shenhar‐Tsarfaty, S., Kliper, E., Auriel, E., et al. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180486 · Cited by 26
A review of the effects of acute and chronic cannabinoid exposure on the stress response
Glodosky, N. C., Cuttler, C., & McLaughlin, R. J. (2021) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2021.100945 · Cited by 31
Using saliva to measure endogenous cortisol in nursing home residents with advanced dementia
Woods, D. L., Kovach, C. R., Raff, H., Joosse, L. L., Basmadjian, A., & Hegadoren, K. (2008) · Research in Nursing & Health · doi:10.1002/nur.20254 · Cited by 26
Maternal salivary cortisol levels during pregnancy are positively associated with overweight children
Hohwü, L., Henriksen, T. B., Grønborg, T. K., Hedegaard, M. S., Sørensen, T. I. A., & Obel, C. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.11.006 · Cited by 28
Awakening salivary cortisol levels of children with sleep bruxism.
Castelo, P., Barbosa, T. D. S., Pereira, L. J., Fonseca, F. A., & Gavião, M. (2012) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2012.03.013 · Cited by 25
The Effects of Multivitamin Supplementation on Diurnal Cortisol Secretion and Perceived Stress
Camfield, D., Wetherell, M. A., Scholey, A. B., Cox, K., Fogg, E., White, D., Sarris, J. J., Kras, M., Stough, C. K. K., Sali, A., et al. (2013) · Nutrients · doi:10.3390/nu5114429 · Cited by 25
Correlations between changes in the hypothalamic-pituitary-adrenal axis and neurochemistry of the anterior cingulate gyrus in postpartum depression
de Rezende, M. G., Rosa, C. E., Garcia-Leal, C., de Figueiredo, F. P., Cavalli, R. D. C., Bettiol, H., Salmón, C. E. G., Barbieri, M. A., de Castro, M., dos Santos, A. C., et al. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.07.028 · Cited by 25
High cortisol awakening response in the aftermath of workplace violence exposure moderates the association between acute stress disorder symptoms and PTSD symptoms
Marin, M., Geoffrion, S., Juster, R., Giguère, C., Marchand, A., LUPIEN, S. J., & Guay, S. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.03.006 · Cited by 30
Early life adversity and depressive symptoms predict cortisol in pregnancy
Epstein, C. M., Houfek, J. F., Rice, M. J., Weiss, S. J., French, J. A., Kupzyk, K. A., Hammer, S. J., & Pullen, C. H. (2019) · Archives of Women s Mental Health · doi:10.1007/s00737-019-00983-3 · Cited by 28
Lower diurnal HPA-axis activity in male hypertensive and coronary heart disease patients predicts future CHD risk
Degroote, C., von Känel, R., Thomas, L., Zuccarella‐Hackl, C., Messerli‐Bürgy, N., Saner, H. E., Wiest, R., & Wirtz, P. H. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1080938 · Cited by 28
The association of hypothalamic–pituitary–adrenal axis activity and blood pressure in an Afro-Caribbean population
Boyne, M. S., Woollard, A., Phillips, D. I. W., Taylor‐Bryan, C., Bennett, F. I., Osmond, C., Thomas, T. R., Wilks, R., & Forrester, T. (2009) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2008.12.005 · Cited by 25
Salivary Cortisol in Relation to the Use of Information and Communication Technology (ICT) in School-Aged Children
Wallenius, M., Hirvonen, A., Lindholm, H. J., Rimpelä, A., Nygård, C., Saarni, L. A., & Punamäki, R. (2010) · Psychology · doi:10.4236/psych.2010.12012 · Cited by 29
The Cortisol Awakening Response Mediates the Relationship Between Acculturative Stress and Self-Reported Health in Mexican Americans
García, A. F., Wilborn, K. A., & Mangold, D. L. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-017-9901-5 · Cited by 26
Cortisol as a biomarker of stress
Clow, A. (2004) · WestminsterResearch (University of Westminster) · Cited by 25
Self-citation
Assessment of orofacial dysfunctions, salivary cortisol levels and oral health related quality of life (ORHQoL) in young adults
Strini, P. J. S. A., Strini, P. J. S. A., Barbosa, T. D. S., & Gavião, M. B. D. (2011) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2011.06.009 · Cited by 25
Humor attenuates the cortisol awakening response in healthy older men☆
Lai, J. C. L., Chong, A. M. L., Siu, O. T., Evans, P., Chan, C. L. W., & Ho, R. T. H. (2010) · Biological Psychology · doi:10.1016/j.biopsycho.2010.03.012 · Cited by 24
Self-citation
Early adversity and internalizing symptoms in adolescence: Mediation by individual differences in latent trait cortisol
Stroud, C. B., Chen, F. R., Doane, L. D., & Granger, D. A. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000044 · Cited by 28
Phenotypic spectrum of polycystic ovary syndrome and their relationship to the circadian biomarkers, melatonin and cortisol
Lim, A. J. R., Indran, I. R., Kramer, M. S., & Yong, E. (2019) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.47 · Cited by 24
Hypothalamic–pituitary–adrenal axis activity and upper respiratory tract infection in young children transitioning to primary school
Turner‐Cobb, J. M., Rixon, L., & Jessop, D. S. (2010) · Psychopharmacology · doi:10.1007/s00213-010-1965-x · Cited by 24
Hypothalamic–pituitary–adrenal axis and smoking and drinking onset among adolescents: the longitudinal cohort TRacking Adolescents' Individual Lives Survey (TRAILS)
Huizink, A. C., Greaves‐Lord, K., Oldehinkel, A. J., Ormel, J., & Verhulst, F. C. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02685.x · Cited by 24
Prenatal diurnal cortisol: Normative patterns and associations with affective symptoms and stress
Murphy, H. R., Gu, Y., Wu, Q., Brunner, J., Panisch, L. S., Best, M., Arnold, M. S., Duberstein, Z. T., Putzig, J., Carnahan, J. A., et al. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105856 · Cited by 25
Cortisol awakening response predicts intrinsic functional connectivity of the medial prefrontal cortex in the afternoon of the same day
Wu, J., Zhang, S., Li, W., Qin, S., Yong He, A., Yang, Z., Buchanan, T. W., Liu, C., & Zhang, K. (2015) · NeuroImage · doi:10.1016/j.neuroimage.2015.08.016 · Cited by 25
Daily Work Stress and Awakening Cortisol in Mothers of Individuals with Autism Spectrum Disorders or Fragile X Syndrome
Wong, J. D., Seltzer, M. M., Greenberg, J. S., Hong, J., & Coe, C. L. (2014) · Family Relations · doi:10.1111/fare.12055 · Cited by 25
The cortisol awakening response and the big five personality dimensions
Hill, E. M., Billington, R., & Krägeloh, C. U. (2013) · Personality and Individual Differences · doi:10.1016/j.paid.2013.05.010 · Cited by 23
School start time influences melatonin and cortisol levels in children and adolescents – a community-based study
Carissimi, A., Martins, A. C., Dresch, F., da Silva, L. C., Zeni, C., & Hidalgo, M. P. (2016) · Chronobiology International · doi:10.1080/07420528.2016.1222537 · Cited by 22
A matter of perception: Perceived socio‐economic status and cortisol on the island of Utila, Honduras
García, A. R., Gurven, M., & Blackwell, A. D. (2017) · American Journal of Human Biology · doi:10.1002/ajhb.23031 · Cited by 24
Psychophysiological measures of stress in caregivers of individuals with autism spectrum disorder: a systematic review
Padden, C., Concialdi-McGlynn, C., & Lydon, S. (2018) · Developmental Neurorehabilitation · doi:10.1080/17518423.2018.1460769 · Cited by 26
The effect of acute sleep deprivation on cortisol level: a systematic review and meta-analysis
Chen, Y., Xu, W., Chen, Y., Gong, J., Wu, Y., Chen, S., He, Y. Z., Yu, H., & Xie, L. Y. (2024) · Endocrine Journal · doi:10.1507/endocrj.ej23-0714 · Cited by 31
The hypothalamo–pituitary–adrenal axis and the autonomic nervous system in burnout
Sjörs, A., Jónsdóttir, I. H., & Hansson, C. (2021) · Handbook of clinical neurology · doi:10.1016/b978-0-12-819973-2.00006-x · Cited by 26
Reliability of three versus five saliva sampling times for assessing the cortisol awakening response
Nasser, A., Ozenne, B., Høgsted, E. S., Jensen, P. S., & Frøkjær, V. G. (2022) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2022.105950 · Cited by 21
Diurnal cortisol rhythm: Associated with anxiety and depression, or just an indication of lack of energy?
Harris, A., Rème, S. E., Tangen, T., Hansen, Å. M., Garde, A. H., & Eriksen, H. R. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.04.006 · Cited by 22
Blunted Nocturnal Cortisol Rise is Associated With Higher Carotid Artery Intima-Media Thickness (CIMT) in Overweight African American and Latino Youth
Toledo-Corral, C., Myers, S. J., Li, Y., Hodis, H., Goran, M., & Weigensberg, M. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.01.011 · Cited by 22
Association of Job Strain With Cortisol and Alpha-Amylase Among Shift-Working Health Care Professionals in Laboratory and Field
Karhula, K., Härmä, M., Sallinen, M., Lindholm, H., Hirvonen, A., Elovainio, M., Kivimäki, M., Vahtera, J., & Puttonen, S. (2016) · Biological Research for Nursing · doi:10.1177/1099800415577801 · Cited by 24
Competition Intensity and Fatigue in Elite Fencing
Turner, A. N., Kilduff, L. P., Marshall, G. J. G., Phillips, J. G., Noto, A., Buttigieg, C., Gondek, M. B., Hills, F. A., & Dimitriou, L. (2017) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000001758 · Cited by 30
Personality and Hypothalamic–Pituitary–Adrenal Axis in Older Men and Women
Montoliu, T., Hidalgo, V., & Salvador, A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00983 · Cited by 23
Stress and the hypothalamic–pituitary–adrenal axis: How can the COVID ‐19 pandemic inform our understanding and treatment of acute insomnia?
Elder, G. J., Altena, E., Palagini, L., & Ellis, J. G. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13842 · Cited by 30
Cross-Country Differences in Basal and Stress-Induced Cortisol Secretion in Older Adults
Souza‐Talarico, J. N., Plusquellec, P., LUPIEN, S. J., Fiocco, A. J., & Suchecki, D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0105968 · Cited by 20
The cortisol awakening response and the metabolic syndrome in a population-based sample of middle-aged men and women
Bengtsson, I., Lissner, L., Ljung, T., Rosengren, A., Thelle, D. S., & Währborg, P. (2010) · Metabolism · doi:10.1016/j.metabol.2009.10.024 · Cited by 21
Psychological and physiological effects of caring for patients with treatment-resistant depression
Rane, L. J., Fekadu, A., Papadopoulos, A. S., Wooderson, S. C., Poon, L. C., Markopoulou, K., & Cleare, A. J. (2012) · Psychological Medicine · doi:10.1017/s0033291711003035 · Cited by 22
Diurnal cortisol rhythm is associated with increased risky decision-making in older adults.
Weller, J. A., Buchanan, T. W., Shackleford, C. M., Morganstern, A., Hartman, J. J., Yuska, J. S., & Denburg, N. L. (2014) · Psychology and Aging · doi:10.1037/a0036623 · Cited by 21
Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use
Liu, Y., Almeida, D. M., Rovine, M. J., & Zarit, S. H. (2016) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbw140 · Cited by 21
Free light chains as an emerging biomarker in saliva: Biological variability and comparisons with salivary IgA and steroid hormones
Rapson, A., Collman, E., Faustini, S. E., Yonel, Z., Chapple, I., Drayson, M. T., Richter, A. G., Campbell, J. P., & Heaney, J. L. J. (2019) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2019.09.018 · Cited by 21
The cortisol awakening response—an exploration of intraindividual stability and negative responses
Eek, F., Garde, A. H., Hansen, Å. M., Persson, R., Ørbæk, P., & Karlson, B. (2006) · Lund University Publications (Lund University) · Cited by 21
Effect of flipped classroom methodology on the student performance of gastrointestinal and renal physiology entrants and repeaters
Sánchez, J. C., Zapata, D. F. L., Duque, O. A. P., García, A. M., Morales, M. D., & Henao, S. E. T. (2020) · BMC Medical Education · doi:10.1186/s12909-020-02329-5 · Cited by 20
A Systematic Review and Revised Meta-analysis of the Effort-Reward Imbalance Model of Workplace Stress and Hypothalamic-Pituitary-Adrenal Axis Measures of Stress
Eddy, P. J., Wertheim, E. H., Hale, M. W., & Wright, B. J. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001155 · Cited by 24
Recovery of rescuers from a 24-h shift and its association with aerobic fitness
Lyytikäinen, K., Toivonen, L., Hynynen, E., Lindholm, H. J., & Kyröläinen, H. (2017) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.00720 · Cited by 20
The association between long-term accumulation of temporary employment, the cortisol awakening response and circadian cortisol levels
Gustafsson, P. E., Janlert, U., Virtanen, P., & Hammarström, A. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.09.011 · Cited by 20
Age-related changes in hypothalamic–pituitary–adrenal axis activity in patients with manifest arterial disease
Knoops, A. J. G., van der Graaf, Y., Mali, W. P. T. M., & Geerlings, M. I. (2010) · Endocrine · doi:10.1007/s12020-009-9291-y · Cited by 20
The biological clock modulates the human cortisol response in a multiplicative fashion
van de Werken, M., Booij, S. H., van der Zwan, J. E., Simons, M. J. P., Gordijn, M. C. M., & Beersma, D. G. M. (2013) · Chronobiology International · doi:10.3109/07420528.2013.868472 · Cited by 20
Atypical evening cortisol profile induces visual recognition memory deficit in healthy human subjects
Gilpin, H., Whitcomb, D., & Cho, K. (2008) · Molecular Brain · doi:10.1186/1756-6606-1-4 · Cited by 20
Exercising Caution Upon Waking–Can Exercise Reduce Sleep Inertia?
Kovac, K., Ferguson, S. A., Paterson, J. L., Aisbett, B., Hilditch, C. J., Reynolds, A. C., & Vincent, G. E. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00254 · Cited by 20
Burnout and functioning of the hypothalamus-pituitary-axis—there are no simple answers
Sonnentag, S. (2006) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.1028 · Cited by 21
Heart rate variability and salivary cortisol in very preterm children during school age
Urfer-Maurer, N., Ludyga, S., Stalder, T., Brand, S., Holsboer‐Trachsler, E., Gerber, M., Grob, A., Weber, P., & Lemola, S. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.10.004 · Cited by 20
Rigor and Reproducibility: A Systematic Review of Salivary Cortisol Sampling and Reporting Parameters Used in Cancer Survivorship Research
Hulett, J. M., Fessele, K. L., Clayton, M. F., & Eaton, L. H. (2019) · Biological Research For Nursing · doi:10.1177/1099800419835321 · Cited by 19
Identifying diurnal cortisol profiles among young adults: Physiological signatures of mental health trajectories
Hoyt, L. T., Zeiders, K. H., Chaku, N., Niu, L., & Cook, S. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105204 · Cited by 21
Individual differences in the cortisol-awakening response during the first two years of shift work: A longitudinal study in novice police officers
der Holst, H. M. L., & KERKHOF, G. A. (2015) · Chronobiology International · doi:10.3109/07420528.2015.1064130 · Cited by 20
The cortisol awakening response in caregivers of schizophrenic offspring shows sensitivity to patient status
González‐Bono, E., Andrés-García, S. D., & Moya‐Albiol, L. (2010) · Anxiety Stress & Coping · doi:10.1080/10615806.2010.481792 · Cited by 19
Diurnal patterns and associations among salivary cortisol, DHEA and alpha-amylase in older adults
Wilcox, R. R., Granger, D. A., Szanton, S. L., & Clark, F. A. (2014) · Physiology & Behavior · doi:10.1016/j.physbeh.2014.02.012 · Cited by 19
The impact of post-traumatic stress on first responders: analysis of cortisol, anxiety, depression, sleep impairment and pain
Bergen‐Cico, D., Lane, S. D., Thompson, M. L., Wozny, S., Zajdel, M., Barduhn, M. S., & Noce, J. (2015) · International Paramedic Practice · doi:10.12968/ippr.2015.5.3.78 · Cited by 18
The relationship between the cortisol awakening response and cortisol reactivity to a laboratory stressor
Dienes, K., Gartland, N., & Ferguson, E. (2019) · British Journal of Health Psychology · doi:10.1111/bjhp.12352 · Cited by 19
Daily hassles, loneliness, and diurnal salivary cortisol in emerging adults
Lai, J. C. L., Lee, D. Y. H., Leung, M. O. Y., & Lam, Y. W. (2019) · Hormones and Behavior · doi:10.1016/j.yhbeh.2019.07.006 · Cited by 26
Identity change and the transition to university: Implications for cortisol awakening response, psychological well‐being and academic performance
Griffin, S. M., Lebedová, A., Cruwys, T., McMahon, G., Foran, A., Skrodzka, M., Gallagher, S. M., Ginty, A. T., & Muldoon, O. T. (2024) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12608 · Cited by 25
Salivary Biomarkers (Opiorphin, Cortisol, Amylase, and IgA) Related to Age, Sex, and Stress Perception in a Prospective Cohort of Healthy Schoolchildren
Krahel, A., Paszyńska, E., Otulakowska-Skrzyńska, J., Rzatowski, S., Hernik, A., Słopień, A., Hanć, T., Szcześniewska, P., Bryl, E., Boucher, Y., et al. (2021) · Mediators of Inflammation · doi:10.1155/2021/3639441 · Cited by 18
Association between Altered Cortisol Profiles and Neurobehavioral Impairment after Mild Traumatic Brain Injury in College Students
Villegas, E., Hartsock, M. J., Aben, B. L. L. G., Lenahan, K. N., Hernández, T. D., & Spencer, R. L. (2022) · Journal of Neurotrauma · doi:10.1089/neu.2021.0495 · Cited by 18
Stress in Migrant Farmworkers During Premigration
Clingerman, E. M., & Brown, A. (2011) · Biological Research For Nursing · doi:10.1177/1099800410396703 · Cited by 20
Cognition and HPA axis reactivity in mildly to moderately depressed outpatients. A case–control study
Krogh, J., Videbech, P., Renvillard, S. G., Garde, A. H., Jørgensen, M. B., & Nordentoft, M. (2012) · Nordic Journal of Psychiatry · doi:10.3109/08039488.2012.665081 · Cited by 19
Biological sensitivity to context: Cortisol awakening response moderates the effects of neighbourhood density on the development of adolescent externalizing problem behaviours
Yu, R., Nieuwenhuis, J., Meeus, W., Hooimeijer, P., Koot, H. M., & Branje, S. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.08.004 · Cited by 21
Chronic Stress Is Associated with High Cortisol Levels and Emotional Coping Mechanisms in Amnestic Mild Cognitive Impairment
Souza‐Talarico, J. N., Chaves, E. C., Nitríni, R., & Caramelli, P. (2009) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000259696 · Cited by 18
Effectiveness of mindfulness training on pregnancy stress and the hypothalamic–pituitary–adrenal axis in women in China: A multicenter randomized controlled trial
Shulei, W., Zhang, C., Sun, M., Zhang, D., Luo, Y., Liang, K., Xu, T., Pan, X., Zheng, R., Shangguan, F., et al. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1073494 · Cited by 26
A longitudinal evaluation of the relationship between first morning urinary and salivary cortisol
Sarkar, P. L., Zeng, L., Chen, Y., Salvante, K. G., & Nepomnaschy, P. A. (2013) · American Journal of Human Biology · doi:10.1002/ajhb.22376 · Cited by 18
Poverty and Awakening Cortisol in Adolescence
McFarland, M. J., & Hayward, M. D. (2013) · Society and Mental Health · doi:10.1177/2156869313500278 · Cited by 19
Weak Associations of Morningness-Eveningness and Stability with Skin Temperature and Cortisol Levels
Weidenauer, C., Vollmer, C., Scheiter, K., & Randler, C. (2019) · Journal of Circadian Rhythms · doi:10.5334/jcr.182 · Cited by 17
Work-Fitness Evaluation for Shift Work Disorder
Jang, T. W. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18031294 · Cited by 21
Alterations of postawakening cortisol parameters during a prolonged stress period
Weik, U., & Deinzer, R. (2010) · Hormones and Behavior · doi:10.1016/j.yhbeh.2010.06.001 · Cited by 17
Experimental studies on the effects of nocturnal noise on cortisol awakening response
Griefahn, B., & Robens, S. (2010) · Noise and Health · doi:10.4103/1463-1741.63215 · Cited by 18
Intensive two-day cognitive-behavioral intervention decreases cortisol secretion in soldiers suffering from specific phobia to wear protective mask
Brand, S., Annen, H., Holsboer‐Trachsler, E., & Blaser, A. B. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.04.010 · Cited by 21
The cortisol awakening response is blunted in patients with active Cushing's disease
Roa, S. L. R., Elias, P. C. L., de Castro, M., & Moreira, A. C. (2013) · European Journal of Endocrinology · doi:10.1530/eje-12-0982 · Cited by 17
The Social Psychology of Latin American Happiness
Yamamoto, J. (2015) · Springer eBooks · doi:10.1007/978-94-017-7203-7_3 · Cited by 19
Morning Salivary Cortisol in Young Children: Reference Values and the Effects of Age, Sex, and Acute Bronchiolitis
Rolfsjord, L. B., Bakkeheim, E., Berents, T. L., Alm, J. S., Skjerven, H. O., Carlsen, K., Mowinckel, P., Sjöbeck, A.-C., & Carlsen, K. L. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.01.064 · Cited by 17
Investigating the Role of Salivary Cortisol on Vocal Symptoms
Holmqvist-Jämsén, S., Johansson, A., Santtila, P. O., Westberg, L., von der Pahlen, B., & Simberg, S. (2017) · Journal of Speech Language and Hearing Research · doi:10.1044/2017_jslhr-s-16-0058 · Cited by 19
Cortisol Awakening Response
Steptoe, A. (2007) · Elsevier eBooks · doi:10.1016/b978-012373947-6.00451-7 · Cited by 28
Social Integration and Diurnal Cortisol Decline: The Role of Psychosocial and Behavioral Pathways
Dickman, K. D., Thomas, M. C., Anderson, B. A., Manuck, S. B., & Kamarck, T. W. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000825 · Cited by 17
The impact of prior day sleep and physical activity on the cortisol awakening response
Anderson, T., Corneau, G. M., Wideman, L., Eddington, K. M., & Vrshek‐Schallhorn, S. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105131 · Cited by 20
Cortisol awakening response prompts dynamic reconfiguration of brain networks in emotional and executive functioning
Zeng, Y., Xiong, B., Gao, H., Liu, C., Chen, C., Wu, J., & Qin, S. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2405850121 · Cited by 16
The role of awakening cortisol and psychological distress in diurnal variations in affect: A day reconstruction study.
Daly, M., Delaney, L. D., Doran, P., & MacLachlan, M. (2011) · Emotion · doi:10.1037/a0022590 · Cited by 16
Sampling compliance for cortisol upon awakening in children and adolescents
Rotenberg, S., & McGrath, J. J. (2013) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2013.10.002 · Cited by 18
Psychological reactivity to laboratory stress is associated with hormonal responses in postmenopausal women
Fang, C. Y., Egleston, B. L., Manzur, A. M., Townsend, R. R., Stanczyk, F. Z., Spiegel, D., & Dorgan, J. F. (2014) · Journal of International Medical Research · doi:10.1177/0300060513504696 · Cited by 16
The cortisol awakening response is associated with performance of a serial sequence reaction time task
Hodyl, N. A., Schneider, L. A., Vallence, A., Clow, A., Ridding, M. C., & Pitcher, J. B. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.12.007 · Cited by 16
Self-citation
Interactive effects of early life stress and CACNA1C genotype on cortisol awakening response
Klaus, K., Butler, K., Gutiérrez, H., Durrant, S. J., & Pennington, K. (2018) · Biological Psychology · doi:10.1016/j.biopsycho.2018.05.002 · Cited by 16
Married but lonely. Impact of poor marital quality on diurnal cortisol patterns in older people: findings from the cross-sectional KORA-Age study
Johar, H., Atasoy, S., Bidlingmaier, M., Henningsen, P., & Ladwig, K. (2020) · Stress · doi:10.1080/10253890.2020.1741544 · Cited by 17
The relationship between perceived loneliness and cortisol awakening responses on work days and weekends1
Okamura, H., Tsuda, A., & Matsuishi, T. (2011) · Japanese Psychological Research · doi:10.1111/j.1468-5884.2011.00459.x · Cited by 16
An Exploratory Study of Changes in Salivary Cortisol, Depression, and Pain Intensity After Treatment for Chronic Pain
Evans, K. D., Douglas, B., BRUCE, N. W., & Drummond, P. D. (2008) · Pain Medicine · doi:10.1111/j.1526-4637.2006.00285.x · Cited by 16
Prematurity, Birth Weight, and Socioeconomic Status Are Linked to Atypical Diurnal Hypothalamic–Pituitary–Adrenal Axis Activity in Young Adults
Winchester, S. B., Sullivan, M. C., Roberts, M. B., & Granger, D. A. (2015) · Research in Nursing & Health · doi:10.1002/nur.21707 · Cited by 17
A Heteroscedastic Method for Comparing Regression Lines at Specified Design Points When Using a Robust Regression Estimator
Wilcox, R. R. (2021) · Journal of Data Science · doi:10.6339/jds.2013.11(2).1146 · Cited by 16

Authors: Clow, A., Thorn, L., Evans, P., & Hucklebridge, F.
Affiliations: University of Westminster (GB)
Venue: Stress
Publisher: Informa UK Limited
Published: 2004-03
Volume: 7
Issue: 1
Pages: 29-37
ISSN: 1025-3890 (ISSN-L)
1607-8888
DOI: 10.1080/10253890410001667205
OpenAlex: W1973501977
Cited by: 856
References: 55
Citations by year: 2026: 10 · 2025: 19 · 2024: 14 · 2023: 21 · 2022: 32 · 2021: 34 · 2020: 43 · 2019: 47 · 2018: 31 · 2017: 47 · 2016: 54 · 2015: 51 · 2014: 55 · 2013: 47 · 2012: 47
FWCI: 2.37
Type: journal article
Language: en
Open access: closed
Locations: Stress (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords: cortisol awakening response, diurnal cortisol rhythm, cortisol secretion, reference values, gender differences, age effects, light exposure, participant adherence, positive affect, immune regulation, mind-body problem
MeSH terms: Adrenal Cortex, Arousal, Circadian Rhythm, Humans, Hydrocortisone

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

The Awakening Cortisol Response: Methodological Issues and Significance

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks