Skip to main content
Log in

Lifestyle, stress and cortisol response: Review I

Mental stress

  • Review Article
  • Published:
Environmental Health and Preventive Medicine Aims and scope

Abstract

The incidences of diseases related to mental stress are increasing in Japan. Mental stress, unacknowledged for long periods, has been shown to lead to the development of a number of diseases. Thus, an index for mental stress is important to induce awareness of its presence. We focused on the relationship between cortisol and mental stress in this review. We will discuss both the usefulness and problems of cortisol as a mental stress index by summarizing the relationship between cortisol and mental stress. The present findings suggested that cortisol appears to be an adequate index for mental stress. However, there are several problems; the present group clarifies these problems and builds the comprehensive mental stress assessment systems by using saliva samples.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Schaffer MA, Baum A. Adrenal cortical response to stress at Three Mile Island. Psychosom. Med. 1984; 46: 227–237.

    Google Scholar 

  2. Kirschbaum C, Hellhammer DH. Salivary cortisol in psychobiological research: an overview. Neuropsychobiology 1989; 22: 150–169.

    Article  PubMed  CAS  Google Scholar 

  3. Selye H. A syndrome produced by diverse bicuous agents. Nature 1936; 138: 72.

    Article  Google Scholar 

  4. Brien TC. Free cortisol in human plasma. Horm. Metab. Res. 1980; 12: 643–650.

    PubMed  CAS  Google Scholar 

  5. Slaunwhite WR, Lockie GN, Back N, Sandberg AA. Inactivity in vivo of transcortion-bound cortisol. Science 1962; 135: 1062–1063.

    Article  PubMed  CAS  Google Scholar 

  6. Sudo A. Endocrinological test. Clin. Neuroscience 1994; 12: 46–49 (in Japanese).

    Google Scholar 

  7. Kirschbaum C, Prike K-M, Hellhammer DH. The ‘Trier Social Stress Test’—A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 1993; 28: 76–81.

    Article  PubMed  CAS  Google Scholar 

  8. Bohnen N, Houx P, Nicolson N, Jolles J. Cortisol reactivity and cognitive performance in a continuous mental task paradigm. Biol. Psychology 1990; 31: 107–116.

    Article  CAS  Google Scholar 

  9. Fibiger W, Evans O, Singer G. Hormonal responses to a graded mental workload. Eur. J. Appl. Physiol. 1986; 55: 339–343.

    Article  CAS  Google Scholar 

  10. Kemmer FW, Bisping R, Steingrüber HJ, Baar H, Hardtmann F, Schlaghecke R, Berger M. Psychological stress and metabolic control in patients with type I diabetes mellitus. N. Eng. J. Med. 1986; 314: 1078–1084.

    CAS  Google Scholar 

  11. Bolm-Audorff U, Schwämmle J, Ehlenz K, Koop H, Kaffarnik H. Hormonal and cardiovascular variations during a public lecture. Eur. J. Appl. Physiol. 1986; 54: 669–674.

    Article  CAS  Google Scholar 

  12. Schreinicke G, Hinz A, Kratzsch J, Hüber B, Voigt G. Stress-related changes of saliva cortisol in VDU operators. Int. Arch. Occup. Environ. Health 1990; 62: 319–321.

    Article  PubMed  CAS  Google Scholar 

  13. Veltman JA, Gaillard AWK. Indices of mental workload in a complex task environment. Neuropsychobiology 1993; 28: 72–75.

    Article  PubMed  CAS  Google Scholar 

  14. Bernick N, Kling A, Browitz G. Physiologic differentiation of sexual arousal and anxiety. J. Psychosom. Med. 1971; 33: 341–352.

    CAS  Google Scholar 

  15. Francis KT. The relationship between high and low trait psychological stress and serum indicators of stress. Experientia 1981; 37: 1086–1087.

    Article  PubMed  CAS  Google Scholar 

  16. Hubert W, de Jong-Meyer R. Saliva cortisol responses to unpleasant film stimuli differ between high and low trait anxious subjects. Neuropsychobiology 1992; 25: 115–120.

    Article  PubMed  CAS  Google Scholar 

  17. Schedlowski M, Wichert D, Wanger TOF, Tewes U. Acute psychological stress increases plasma levels of cortisol prolactin and TSH. Life Sci. 1992; 7: 1201–1205.

    Article  Google Scholar 

  18. Hennig J, Laschefski U, Opper C. Biopsychological changes after bungee jumping: β-endorphin immunoreactivity as a mediator of euphoria? Neuropsychobiology 1994; 29: 28–32.

    Article  PubMed  CAS  Google Scholar 

  19. Zimmerman U, Loew T, Wildt L. “Stress hormones” and bungee-jumping. Lancet 1992; 340: 428.

    Article  PubMed  CAS  Google Scholar 

  20. Schedlowski M, Wichert D, Wanger TOF, Tewes U. Acute psychological stress increases plasma levels of cortisol prolactin and TSH. Life Sci. 1992; 7: 1201–1205.

    Article  Google Scholar 

  21. Schedlowski M, Jacobs R, Alker J, Pröhl F, Stratmann G, Richter S, Hädicke A, Wagner TOF, Schmidt RE, Tewes U. Psychophysiological, neuroendocrine and cellular immune reactions under psychological stress. Neuropsycobiology 1993; 28: 87–90.

    Article  CAS  Google Scholar 

  22. Levine S. Cortisol change following repeated experiences with parachute training; in Ursin H, Baade E, Levine S (eds). Psychobiology of Stress: A study of coping men. New York, Academic Press, 1978, pp.51–56.

    Google Scholar 

  23. Maillet A, Gunga HC, Gauquelin G, Fortrat JO, Hope A, Røcker L, Kirsch K, Gharib C. Effects of 28-day isolation (ESA-ISEMSI ’90) on blood pressure and blood volume regulating hormones. Aviat. Space Environ. Med. 1993; 64: 287–294.

    PubMed  CAS  Google Scholar 

  24. Jevning R, Wilson Afm Davidson JM. Adrenocortical activity during mediation. Horm. Behav. 1978; 10: 54–60.

    Article  PubMed  CAS  Google Scholar 

  25. DeGood DE, Redgate ES. Interrelationship of plasma cortisol and other activation indices during EMG biofeedback training. J. Behav. Med. 1982; 5: 213–223.

    Article  PubMed  CAS  Google Scholar 

  26. Michaels RR, Parra J, McCann DS, Vander AJ. Renin, cortisol, and aldosterone during transcendental meditation. Psychosom. Med. 1979; 41: 50–54.

    PubMed  CAS  Google Scholar 

  27. McGrady A, Turner JW Jr, Fine TH, Higgins JT Jr. Effects of biobehaviorally-assisted relaxation training on blood pressure, plasma renin, cortisol, and aldosterone levels in borderline essential hypertension. Clin. Biofeed. Health 1987; 10: 16–25.

    Google Scholar 

  28. Jin P. Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress. J. Psychosom. Res. 1992; 36: 361–370.

    Article  PubMed  CAS  Google Scholar 

  29. Turner JW, Fine TH. Restricting environmental stimulation influences levels and variability of plasma cortisol. J. Appl. Physiol. 1991; 70: 2010–2013.

    PubMed  CAS  Google Scholar 

  30. Schulz P, Kaspar C-H. Neuroendocrine and psychological effects of restricted environmental stimulation technique in a flotation tank. Biol. Psychology 1994; 37: 161–175.

    Article  CAS  Google Scholar 

  31. McGrady A, Conran P, Dickey D, Garman D, Farris E, Schumann-Brzezinski C. The effects of biofeedback-assisted relaxation on cell-mediated immunity, cortisol, and white blood cell count in healthy adult subjects. J. Behav. Med. 1992; 15: 343–354.

    Article  PubMed  CAS  Google Scholar 

  32. Michaels RR, Parra J, McCann DS, Vander AJ. Renin, cortisol, and aldosterone during transcendental meditation. Psychosom. Med. 1979; 41: 50–54.

    PubMed  CAS  Google Scholar 

  33. McGrady A, Woener M, Bernal GAA, Higgins JT Jr. Effects of biofeedback-assisted relaxation on blood pressure and cortisol levels in normonetsives and hypertensives. J. Behav. Med. 1987; 10: 301–310.

    Article  PubMed  CAS  Google Scholar 

  34. Riad-Fahmy D, Read GF, Walker RF, Griffiths K. Steroids in saliva for assessing endocrine function. Endocrin. Rev. 1982; 3: 367–395.

    CAS  Google Scholar 

  35. Escber J, Höbmann U, Antbenien L, Dayer E, Bossbard Cb, Gaillard RC. Musik bei der Gastroskopie. Schweiz. Med. Wochenschr. 1993; 123: 1354–1358.

    Google Scholar 

  36. Miluk-Kolasa B, Obminski Z, Stupnicki R, Golec L. Effects of music treatment on salivary cortisol in patients exposed to presurgical stress. Exp. Clin. Endocrinol. 1994; 102: 118–120.

    PubMed  CAS  Google Scholar 

  37. Tarui H, Nakamura A. Hormonal responses of pilots flying high-performance aircraft during seven repetitive flight missions. Aviat. Space Environ. Med. 1991; 62: 1127–1131.

    PubMed  CAS  Google Scholar 

  38. Bourne PG, Rose RM, Mason JW. 17-OHCS levels in combat. Arch. Gen. Psychiat. 1968; 19: 135–140.

    PubMed  CAS  Google Scholar 

  39. Rahe RH, Karson S, Howard NS, Rubin RT, Poland RE. Psychological and physiological assessments on American hostages freed from captivity in Iran. Psychosom. Med. 1990; 52: 1–16.

    PubMed  CAS  Google Scholar 

  40. Pitman RK, Orr SP. Twenty-four hour urinary cortisol and catecholamine excretion in combat-related posttraumatic stress disorder. Biol. Psychiatry 1990; 27: 245–247.

    Article  PubMed  CAS  Google Scholar 

  41. Goenjian AK, Yehuda R, Pynoos RS, Steinberg AM, Tashjian M, Yang RK, Najarian LM. Basal cortisol, dexamethasone suppression of cortisol, and MHPG in adolescents after the 1988 earth-quake in Armenia. Am. J. Psychiatry 1996; 153: 929–934.

    PubMed  CAS  Google Scholar 

  42. Yehuda R, Southwick SM, Nussbaum G, Wahby V, Giller EL, Mason JW. Low urinary cortisol excretion in patients with posttraumatic stress disorder. J. Nerv. Ment. Dis. 1990; 178: 366–369.

    Article  PubMed  CAS  Google Scholar 

  43. Yehuda R, Lowy MT, Southwick SM, Shaffer D, Giller EL Jr. Lymphocyte glucocorticoid receptor number in posttraumatic stress disorder. Am. J. Psychiatry 1991; 148: 499–504.

    PubMed  CAS  Google Scholar 

  44. Yehuda R, Boisoneau D, Mason JW, Giller EL. Glucocorticoid receptor number and cortisol excretion in mood, anxiety, and psychotic disorders. Biol. Psychiatry 1993; 34: 18–25.

    Article  PubMed  CAS  Google Scholar 

  45. Weizman R, Gil-Ad I, Karp L, Laor N, Barber Y, Rehavi M. Platelet imipramine binding and plasma cortisol levels in Israeli civilians during the gulf war. Biol. Psychiatry 1992; 32: 170–178.

    Article  PubMed  CAS  Google Scholar 

  46. Bowler RM, Mergler D, Huel G, Cone JE. Psychological, psychosocial, and psychophysiological sequelae in a community affected by a railroad chemical disaster. J. Traumatic Stress 1994; 7: 601–624.

    CAS  Google Scholar 

  47. Kiecolt-Glaser JK, Malarkey WB, Chee M, Newton T, Cacioppo JT, Mao H, Glaser R. Negative behavior during marital conflict is associated with immunological down-regulation. Psychosom. Med. 1993; 55: 395–409.

    PubMed  CAS  Google Scholar 

  48. Payne RL, Rick JT, Smith GH, Cooper RG. Multiple indicators of stress in an ‘active’ job—cardiothoracic surgery. J. Occup. Med. 1984; 26: 805–808.

    Article  PubMed  CAS  Google Scholar 

  49. VanEck MM, Nicolson NA, Berkhof H, Sulon J. Individual differences in cortisol responses to a laboratory speech task and their relationship to responses to stressful daily events. Biol. Psychol. 1996; 43: 69–84

    Article  CAS  Google Scholar 

  50. Baker GHB, Itani MS, Byrom NA, Wood RI, Hobbs Jr. Brewerton DA. Stress, cortisol concentrations, and lymphocyte subpopulations. BMJ 1985; 290: 1393.

    PubMed  CAS  Google Scholar 

  51. Jemmott JB, Borysenko JZ, Borysenko M, Mcclelland DC, Chapman R, Meyer D, Benson H. Academic stress, power, motivation, and decrease in secretion rate of salivary secretory immunoglobulin A. Lancet 1983; 1: 1400–1402.

    Article  PubMed  CAS  Google Scholar 

  52. Theorell T, Harms-Ringdahl-Harms K, Ahlberg-Hulten G, Westin B. Psychosocial job factors and symptoms from the locomotor system—a multicausal analysis. Scand. J. Rehab. Med. 1991; 23: 165–173.

    CAS  Google Scholar 

  53. Rose RM, Jenkins CD, Hurst M, Kreger BE, Barrett J, Hall RP. Endocrine actibity in air traffic controllers at work. III. Relationship to physical and psychiatric morbidity. Psychoneuroendocrinology 1982; 7: 125–134.

    Article  PubMed  CAS  Google Scholar 

  54. Rose RM, Jenkins CD, Hurst M, Herd JA, Hall RP. Endocrine activity in air traffic controllers at work. II. Biological, psychological and work correlates. Psychoneuroendocrinology 1982; 7: 113–123.

    Article  PubMed  CAS  Google Scholar 

  55. Zeier H, Brauchli P, Joller-Jemelka HI. Effects of work demands on immunoglobulin A and cortisol in air traffic controllers. Biol. Psychol. 1996; 42: 413–423.

    Article  PubMed  CAS  Google Scholar 

  56. Arnetz BB, Brenner S, Levi L, Hjelm R, Petterson I, Wasserman J, Petrini B, Eneroth P, Kallner A, Kvetnansky R, Vigas M. Neuroendocrine and immunologic effects of unemployment and job insecurity. Psychother. Psychosom. 1991; 55: 76–80.

    Article  PubMed  CAS  Google Scholar 

  57. Arnetz BB, Wasserman J, Petrini B, Brenner SO, Levi L, Eneroth P, Salovaara H, Hjelm R, Salovaara L, Theorell T, Petterson IL. Immune function in unemployed woman. Psychosom. Med. 1987; 49: 3–12.

    PubMed  CAS  Google Scholar 

  58. Bengt B, Brenner S-O, Levi L, et al. Nuroendocrine and immunologic effects of unemployment and job insecurity. Psychother. Psychosom. 1991; 55: 76–80.

    Google Scholar 

  59. Van Eck MMM, Nicolson NA, Berkhof H, Sulon J. Individual differences in cortisol responses to a laboratory speech task and their relationship to response to stressful daily events. Biol. Psychology 1996; 43: 69–84.

    Article  Google Scholar 

  60. Turner JR, Ward MM, Gellman MD, Johnston DW, Light KC, van Doornen LJP. The relationship between laboratory and ambulatory cardiovascular activity: current evidence and future directions. Ann. Behav. Med. 1994; 16: 12–23.

    Google Scholar 

  61. Houtman ILD, Bakker FC. Stress in student teachers during real and simulated, standardized lectures. J. Human Stress 1987; 13: 180–187.

    PubMed  CAS  Google Scholar 

  62. Houtman ILD, Bakker FC. Individual differences in reactivity to and coping with the stress of lecturing. J. Psychosom. Res. 1991; 35: 11–24.

    Article  PubMed  CAS  Google Scholar 

  63. Houtman ILD, Bakker FC. Stress and coping in lecturing, and the stability of responses across practice. J. Psychosom. Res. 1991; 35: 323–333.

    Article  PubMed  CAS  Google Scholar 

  64. Burthen B, Russ JJ. Preoperative psychological state and corticosteroid levels of surgical patients. Psychosom. Med. 1965; 27: 309–315.

    Google Scholar 

  65. Salmon P, Evans R, Humphrey DE. Anxiety and endocrine changes in surgical patients. Br. J. Clin. Pyschocl. 1986; 25: 135–141.

    Google Scholar 

  66. Bonhen N, Nicolson N, Sculling J, Jolles J. Coping style, trait anxiety and cortisol reactivity during mental stress. J. Psychosom. Res. 1991; 35: 141–147.

    Article  Google Scholar 

  67. Miller CS, Dembo JB, Falace DA, Kaplan AL. Salivary cortisol response to dental treatment of varying stress. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endoc. 1995; 79: 436–441.

    Article  CAS  Google Scholar 

  68. Hockey GRJ. Changes in operator efficiency as a function of environmental stress, fatigue and circadian rhythms. In K. R. Boff, L. Kaufman & Thomas JP (Eds.), Handbook of perception and human performance (Vol.2, pp.44.1–44.49). New York: Wiley.

  69. Eitzman ED, Fukushima D, Nogeire C, Roffwarg H, Gallagher TF, Hellman L. Twenty-four hour pattern of the episodic secretion of cortisol in normal subjects. J. Clin. Endocr. 1971; 33: 14–22.

    Article  Google Scholar 

  70. Simonsick EM. Personal health habits and mental health in national probability sample. Am. J. Prev. Med. 1991; 7(6): 425–437.

    PubMed  CAS  Google Scholar 

  71. Paffenbarger RS Jr, Lee IM, Leung R. Physical activity and personal characteristics associated with depression and suicide in American college men. Acta. Psychiatr. Scand. 1994; Suppl 377: 16–22.

    Article  Google Scholar 

  72. Ezoe S, Morimoto K. Behavioral lifestyle and mental health status of Japanese factory workers. Preve. Med. 1994; 23: 98–105.

    Article  CAS  Google Scholar 

  73. Marukawa H, Shimomura T, Takahashi K. Salivary substance P, 5-hydroxytryptamine, and gamma-aminobutyric acid levels in migraine and tension-type headache. Headache 1996; 36: 100–104.

    Article  PubMed  CAS  Google Scholar 

  74. Whitson PA, Putcha L, Chen YM, Baker E. Melatonin and cortisol assessment of circadian shifts in astronauts before flight. J. Pineal. Res. 1995; 18: 141–147.

    Article  PubMed  CAS  Google Scholar 

  75. Pikula DL, Harris EF, Desiderio DM, Fridland GH, Lovelace JL. Methionine enkephalin-like, substance P-like, and beta-endorphin-like immunoreactivity in human parotid saliva. Arch. Oral Biol. 1992; 37: 705–709.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fukuda, S., Morimoto, K. Lifestyle, stress and cortisol response: Review I. Environ Health Prev Med 6, 9–14 (2001). https://doi.org/10.1007/BF02897303

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02897303

Key words

Navigation