Editors: Margareta Kristenson, Peter Garvin, Ulf Lundberg

The Role of Saliva Cortisol Measurement in Health and Disease

Special Offer (PDF + Printed Copy): US $119
Printed Copy: US $119
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.


This book is based on a combination of fascination and frustration; fascination on the wish to use saliva cortisol measurement because of its many advantages but frustrations over opposing results in the literature. Several discussions at different meetings led to the development of a network of researchers from Sweden, funded by the Swedish National Research Council. This network was soon expanded to also include colleagues from Norway and Denmark. Thus, this was a Scandinavian network working on measurement of Cortisol and the name ScanCort was taken.

The main aim of the group was to try to understand the results from different studies on saliva cortisol measurement and thereby better understand how and when saliva cortisol assessment best could be made. A hypothesis was that, seemingly, divergent findings could be effects of differences in the theoretic assumptions made and methods used.

This led over to a decision to perform a literature review focusing on if the many different ways of evaluating the levels and dynamics of salivary cortisol especially with regard to time points of assessment and analyses of data affect the interpretation of cortisol measurement in various contexts.

The literature review was, of course, more work than expected but it was also a very exciting learning experience! We are grateful for the economic support given by Swedish National Research Council. We thank Gary W. Evans for being insightful, constructive and generous by reviewing all chapters and Lorna O'Brien for skillful language control. As editors we thank all colleagues in the ScanCort group for an unforgettable time together, for stimulating discussions and hard work. My specific thanks goes to my two co-editors professor Ulf Lundberg and PhD Peter Garvin for their work, enthusiasm and friendship.

We do hope that this book will be of use for all those who are involved in the challenging but fascinating field of stress research and want to use saliva cortisol measurement. We do believe that this can be a useful biomarker in many settings, if caution is taken in the choice of methods used.

Margareta Kristenson
Professor of Social Medicine and Public Health Science,
Department of Medical and Health Sciences,
Linköping University,


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