Perceived Stress, Anxiety, and Fatigue: What Does Cortisol Map Onto?

• In Event: Timing matters: Implications of Early-life and concurrent adversity for HPA axis activity across multiple timescales

Abstract

While stressors reliably activate the hypothalamic-pituitary-adrenal (HPA) axis, previous research reveals inconsistent associations between HPA activity and self-reported stress or exposure to life stressors in pre-adolescent children (Gray et al., 2018; Gunnar et al., 2009). Cortisol, a glucocorticoid hormone produced by the HPA axis, supports metabolic processes that provide the body with energy across the day and during stressors (Hostinar & Gunnar, 2018; Gunnar et al., 2016), but it is unclear which psychological processes are most closely associated with various aspects of HPA functioning.

Method: This study examined the association between HPA activity and self-reported perceived stress, state and trait anxiety, and fatigue in a sample of 181 9-to 11-year-old children (M = 9.90, SD = .58; 50% female). Some participants (n = 119) completed the modified Trier Social Stress Test (TSST-M). HPA activity was measured in the laboratory via baseline salivary cortisol, salivary cortisol reactivity, and hair cortisol concentration (HCC) from a 3-cm hair sample, reflecting cortisol output over the preceding 3 months. Participants reported perceived stress and state anxiety following the TSST-M. Parents completed the Child Life Events Scale and reported on children’s health using the MacArthur HBQ-P. Participants were re-contacted to participate in a follow-up study (n = 86) during the COVID-19 pandemic (October 2020-March 2021), and provided another hair sample for HCC assays (mean age at follow-up = 11.9 years; 63% female).

Results: At time 1, baseline salivary cortisol was significantly correlated with HCC (r = .20, p = .01). Salivary cortisol reactivity to the TSST-M was marginally correlated with state anxiety (r = .18, p = .052). Children’s self-reports of how stressful the TSST-M was did not correlate with cortisol reactivity to the stressor (p = .32). Trait anxiety was significantly correlated with baseline cortisol (r = .21, p = .02) and state anxiety (r = .43, p < .001), but not cortisol reactivity (p = .09). HCC was related to state anxiety (r = .28, p = .006), even controlling for age and sex. However, HCC was not related to the number or perceived negative impact of stressful child life events (p’s > .26). As shown in Figure 1, HCC was negatively correlated with parent-reported items reflecting fatigue/tiredness (r= -.19, p = .02), which remained significant after controlling for age, sex, and BMI. During the pandemic, HCC was not correlated with perceived stress (p = .59) or child life events (p’s > .11). While stressful child life events increased during the pandemic (p = .004), this increase was not correlated with changes in HCC.

Discussion: While cortisol reactivity and HCC were associated with state anxiety, cortisol reactivity was not associated with perceived stress. HCC was not associated with child life events before and during the pandemic. Interestingly, low HCC was associated with child fatigue and overtiredness. Thus, HCC may map onto energy levels more than stressful events. This study suggests that cortisol is more strongly associated with state anxiety and fatigue than with perceived stress or exposure to stressful life events.

Authors

• Anna Parenteau, University of California - Davis
  Presenting Author

• Geneva Jost, University of California - Davis

• Sally Hang, University of California - Davis

• Sydney C. Yi

• Camelia E Hostinar, University of California - Davis