Sex differences in salivary cortisol reactivity to the Trier Social Stress Test (TSST): A meta-analysis

Abstract

Some, but not all studies using the Trier Social Stress Test (TSST) have demonstrated evidence in support of sex differences in salivary cortisol. The aim of the current meta-analysis is to examine sex differences in salivary cortisol following exposure to the TSST. We further explored the effects of modifications to the TSST protocol and procedural variations as potential moderators. We searched articles published from January, 1993 to February, 2016 in MedLine, PsychINFO, and ProQuest Theses and Dissertations. This meta-analysis is based on 34 studies, with a total sample size of 1350 individuals (640 women and 710 men). Using a random effects model, we found significant heterogeneity in salivary cortisol output across sexes, such that men were observed to have higher cortisol values at peak and recovery following the TSST compared to women. Modifications to the sampling trajectory of cortisol (i.e., duration of acclimation, peak sampling time, and duration of recovery) significantly moderated the heterogeneity across both sexes. Further, there are observed sex differences at various time points of the reactive cortisol following the TSST. Lastly, current results suggest that these sex differences can be, at least in part, attributed to variations in methodological considerations across studies. Future research could advance this line of inquiry by using other methods of analyses (e.g., area under the curve; AUC), in order to better understand the effects of methodological variations and their implications for research design.

“N‐of‐1”—Study: A concept of acute and chronic stress research using the example of ballroom dancing

“…This study confirmed ballroom dancing competitions to constitute a major stressor with 3-fold and 2-fold higher sCort and sAA levels, respectively, during tournaments as compared to the daily average of non-competition days. Observed concentrations were considerably high exceeding peak responses to, for example, the Trier Social Stress Test to a large extent [for a recent meta-analysis see 37 ]. Moreover, stress responses were quite variable but we neither saw a trend for increasing nor decreasing peak levels.…”

Impact of a nutritional supplement during gestation and early childhood on child salivary cortisol, hair cortisol, and telomere length at 4–6 years of age: a follow-up of a randomized controlled trial

“…Additionally, cortisol has a diurnal pattern in which cortisol concentrations typically peak 30-40 min after awakening and then decline throughout the day, with lowest concentrations in the evening (Hucklebridge, Hussain, Evans, & Clow, 2005). Previous studies have demonstrated that the regulation of both the stress response and diurnal pattern of cortisol can be impacted by a wide range of factors (Cohen et al, 2006;Danese & McEwen, 2012;Liu et al, 2017), including nutrition (Keenan et al, 2016;Oaks et al, 2016). Recent research suggests that permanent dysregulation of the HPA axis can occur during gestation and early childhood (Alexander et al, 2012).…”

Sex differences in interleukin‐6 stress responses in people with Type 2 diabetes

“…Depressive symptoms did not differ between men and women, though, and IL-6 response differences were sustained despite inclusion of depressive symptoms in the analyses. Furthermore, human studies on sex differences in cortisol responsivity (cortisol is a glucocorticoid [GC] and a known anti-inflammatory factor primarily involved in the acute stress response [Nicolaides, Kyratzi, Lamprokostopoulou, Chrousos, & Charmandari, 2015]) would be informative, but results on sex differences in cortisol responsivity appear inconsistent (Kudielka & Kirschbaum, 2005;Liu et al, 2017;Paris et al, 2010). Interestingly, there is evidence that the sensitivity of immune cells to the anti-inflammatory effects of GCs increases 1 hr after acute stress only in men and not women (Rohleder et al, 2001).…”