Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Dec 29:43:100936.
doi: 10.1016/j.bbih.2024.100936. eCollection 2025 Feb.

Measuring salivary cortisol in biobehavioral research: A systematic review and methodological considerations

Fanghong Dong  1 , Justine S Sefcik  2 , Elizabeth Euiler  2 , Nancy A Hodgson  3
Affiliations
Review

Measuring salivary cortisol in biobehavioral research: A systematic review and methodological considerations

Fanghong Dong et al. Brain Behav Immun Health. .

Abstract

The assessment of salivary cortisol in community settings has gained popularity in biobehavioral research due to its noninvasive sampling, ease of handling and storage, and suitability for repeated sampling in short intervals. Ensuring consistent methodological practices for salivary cortisol is essential. This systematic review critically examines salivary cortisol collection procedures, data cleaning, and analysis to better understand its role in biobehavioral research within community populations. Fifty-eight articles met the inclusion criteria. Results indicated significant variability in study designs and cortisol measurement procedures, particularly regarding the biobehavioral role of cortisol, sampling periods, covariate considerations, cortisol analysis parameters, and data analysis plans. The review highlights commonly used and promising study designs while identifying methodological issues in cortisol measurement and analysis that should be addressed to improve comparability in future research.

Keywords: Biobehavioral research; Community setting; Salivary cortisol.

PubMed Disclaimer

Conflict of interest statement

The Author(s) declare(s) that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Prisma Flowchart of studies included in the systematic review.
See this image and copyright information in PMC

References

    1. Abshire M., Bidwell J.T., Page G., Budhathoki C., Davidson P.M., Russell S.D., Han H.R., Desai S., Dennison Himmelfarb C. Physiological and psychological stress in patients living with a left ventricular assist device. Am. Soc. Artif. Intern. Organs J. 2018;64(6):e172–e180. doi: 10.1097/MAT.0000000000000847. [Article] - DOI - PMC - PubMed
    1. Adam E.K., Kumari M. Assessing salivary cortisol in large-scale, epidemiological research. Psychoneuroendocrinology. 2009;34(10):1423–1436. - PubMed
    1. Adam E.K., Quinn M.E., Tavernier R., McQuillan M.T., Dahlke K.A., Gilbert K.E. Diurnal cortisol slopes and mental and physical health outcomes: a systematic review and meta-analysis. Psychoneuroendocrinology. 2017;83:25–41. - PMC - PubMed
    1. Anderson T., Corneau G., Wideman L., Eddington K., Vrshek-Schallhorn S. The impact of prior day sleep and physical activity on the cortisol awakening response. Psychoneuroendocrinology. 2021;126 - PubMed
    1. Armer J.S., Clevenger L., Davis L.Z., Cuneo M., Thaker P.H., Goodheart M.J., Bender D.P., Dahmoush L., Sood A.K., Cole S.W., Slavich G.M., Lutgendorf S.K. Life stress as a risk factor for sustained anxiety and cortisol dysregulation during the first year of survivorship in ovarian cancer. Cancer. 2018;124(16):3401–3408. doi: 10.1002/cncr.31570. [Article] - DOI - PMC - PubMed

References (Included studies references showed in Table 1):

    1. Pruessner J.C., Kirschbaum C., Meinlschmid G., Hellhammer D.H. Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology. 2003;28(7):916–931. - PubMed
    1. Fekedulegn D.B., Andrew M.E., Burchfiel C.M., Violanti J.M., Hartley T.A., Charles L.E., Miller D.B. Area under the curve and other summary indicators of repeated waking cortisol measurements. Psychosom. Med. 2007;69(7):651–659. - PubMed

LinkOut - more resources