Intercorrelations between serum, salivary, and hair cortisol and child-reported estimates of stress in elementary school girls


  • The project was financed by the European Community within the Sixth RTD Framework Program Contract No. 016181 (FOOD) and the research council of Ghent University (Bijzonder Onderzoeksfonds). Barbara Vanaelst, Tineke De Vriendt, and Isabelle Sioen are financially supported by the Research Foundation—Flanders (Grants 1.1.894.11.N.00, 1.1.746.09.N.01, and 1.2.683.11.N.00, respectively). Nathalie Michels is financially supported by the research council of Ghent University (Bijzonder onderzoeksfonds). The authors wish to thank the ChiBS children and their parents who generously volunteered and participated in this project.

Address correspondence to: Barbara Vanaelst, Department of Public Health, Ghent University, University Hospital, Block A, 2nd floor, De Pintelaan 185, B-9000 Ghent, Belgium. E-mail:


To evaluate the impact of stress on children's well-being, it is important to have valid and reliable stress assessment methods. Nevertheless, selection of an appropriate method for a particular research question may not be straightforward, as there is currently no consensus on a reference method to measure stress in children. This article examined to what extent childhood stress can be estimated accurately by stressor questionnaires (i.e., Coddington Life Events Scale) and biological markers (serum, salivary, and hair cortisol) using the Triads (a triangulation) method in 272 elementary school girls. Salivary cortisol was shown to most accurately indicate true childhood stress for short periods in the past (i.e., last 3 months), whereas hair cortisol may be preferred above salivary measurements for periods more distant and thus for chronic stress assessment. However, applicability should be confirmed in larger and more heterogeneous populations.