Beyond a Simple Marker of Stress: A Multiverse Analysis of Biopsychosocial Associations with Hair Cortisol and Cortisone

This study investigates the associations between hair concentrations of cortisol and cortisone and various biopsychosocial factors in young adults, using a multiverse analysis on a large cohort (n=1,002 at age 20 and n=887 at age 24). The findings indicate that hair characteristics, body mass index, hormonal contraception (in women), and sweating intensity (in females) are strongly associated with glucocorticoid levels. Additionally, drug use and testosterone levels consistently correlate with steroid outcomes. Psychosocial factors such as migration background, perceived stress, anxiety/depression symptoms, sports activity, and social exclusion are linked to hair glucocorticoids, with cortisol showing stronger correlations. The study concludes that hair corticosteroids can reflect specific aspects of psychosocial stress when accounting for confounders and sex differences.