Editors: Margareta Kristenson, Peter Garvin, Ulf Lundberg

The Role of Saliva Cortisol Measurement in Health and Disease

Special Offer (PDF + Printed Copy): US $131
Printed Copy: US $131
ISBN: 978-1-60805-071-0 (Print)
ISBN: 978-1-60805-342-1 (Online)
Year of Publication: 2012
DOI: 10.2174/97816080534211120101


This e-book is based on a critical evaluation of existing literature on salivary cortisol, aiming to evaluate the utility of salivary cortisol as a biomarker in various settings. It focuses on how different ways of evaluating levels of salivary cortisol may have an impact on the interpretation of cortisol measurements in various contexts.

This e-book focuses on salivary cortisol in relation to the following topics: psychosocial work environment (effort reward imbalance and job demand vs control model), psychosocial resources (mastery, perceived control, sense of coherence), psychosocial risk factors (perceived stress, depression, vital exhaustion, burn-out), sleep quality, biological markers (bodily factors, cardiovascular risk factors, inflammation and metabolism) and somatic outcome.

This ebook should serve as a reference for studies planned to adopt cortisol as an assessment tool.


The ability to assess the biomarker cortisol as an index of Hypothalamic Pituitary Adrenal (HPA) axis activity has provided enormous insights about the relations between psychosocial and physical environmental characteristics and the human stress response. Having a reliable and valid index of stress has also proven invaluable in examining the role of stress in mental and physical health. The ability to assess cortisol in saliva samples has opened up vast new areas of scientific exploration, particularly at the borders of social science with public health and medicine. The collection of salivary cortisol is a relatively unobtrusive procedure that can then be analyzed at low cost. It is remarkable that this book on salivary cortisol as a human stress biomarker is authored by a group of scientists from Scandinavia since, along with some prestigious scientists in Germany, much of the pioneering work on neuroendocrine biomarkers of stress has emanated from Sweden and Norway.

This volume arrives at an opportune moment with exponential growth in the use of salivary cortisol as a biomarker of stress coupled with remarkable interdisciplinary research on the borders of the social sciences and health. Thus we can ask two key questions about salivary cortisol and scientific research: What have we learned about the utility of salivary cortisol as a biomarker of stress? How should we use this tool to assess emerging scientific questions? Reading this book provides in depth answers to these questions.

This book provides a balanced, careful, and thorough review of literally hundreds of studies relating salivary cortisol indices to sociodemographic background characteristics of individuals such as socioeconomic status and gender, psychosocial working conditions (e.g., job control), perceived stress, and psychological resources such as social support. Studies of associations between salivary cortisol and biomarkers of cardiovascular and immune function as well as sleep processes are reviewed along with work on the relations between salivary cortisol and major health outcomes (e.g. cardiovascular disease, breast cancer) as well as mental health (e.g., depression). The authors identified all potentially relevant articles then applied systematic conceptual and methodological inclusion criteria to filter out irrelevant or sloppily conducted studies. They then systematically analyzed the remaining studies, tabling results in a manner that is easy to read and understand. Each table is organized by methods of saliva collection according to variables of interest (e.g., sociodemographic background, disease outcomes). The results of hundreds of studies are then discussed within each topic area taking into account the patterns of findings and implications for measurement and theory. As the reader will be able to see herein, the quality of data and the clarity of conclusions about salivary cortisol as a stress biomarker vary considerably because of measurement protocols, statistical and methodological controls, and important conceptual issues having to do with static versus dynamic measures and inter versus intra person comparisons.

The authors have done all of us who are interested in the interplay among environment, personal background, stress, and disease, a marvelous favor. They have extensively and accurately reviewed what we know about salivary cortisol as an index of human stress. The authors have provided direction as well for how future research on salivary cortisol as a biomarker of stress should proceed.

Gary W. Evans
Elizabeth Lee Vincent Professor of Human Ecology,
Cornell University,


.Nanoscience Applications in Diabetes Treatment.
.Frontiers in Clinical Drug Research – Diabetes and Obesity.
.Diabesity: A Multidisciplinary Approach.
.Pharmacological and Molecular Perspectives on Diabetes.