Investigating associations between momentary stress and cortisol in daily life: What have we learned so far?

Since cortisol measurement in saliva has been established, it has been used as an indicator of stress-related hypothalamic-pituitary-adrenocortical axis activity. Concurrent development of methodological frameworks such as ambulatory assessment, ecological momentary assessment, and experience sampling have provided opportunities to combine both approaches in daily life research. The current review provides a summary of basic methodological principles and recommendations, as well as abstracts of findings of studies investigating momentary associations between stress and cortisol in daily life with an emphasis on within-subject associations (i.e. average covariance in repeated momentary assessments of stress and cortisol, and individual-specific deviations from the average covariance). Methodological challenges related to stress measurement, sampling principles, and appropriate statistical modeling are discussed, followed by a description of the historical development of studies on within-subject associations between momentary daily life stress and cortisol. The review concludes with a discussion of controversial methodological characteristics of these studies regarding operationalizations of stress, compliance, timing and frequency of stress and cortisol sampling, and reporting of effect sizes. Future research in this area would benefit from automated cortisol assessment, broadening of the scope of stress response measures, use of advanced statistical models that better account for dynamics in the stress process in daily life, and attempts to replicate findings. While previous studies of momentary stress and concurrent cortisol assessments have reliably confirmed some fundamental predictions from stress theory in daily life, future studies should aim at providing progress by testing innovative research questions and utilizing new technological developments.