Work

University Exams and Psychosocial Stress: Effects on Cortisol Rhythmicity in Students

Year: 2025

Type: article

Abstract: BACKGROUND: University exams are recognised as naturalistic stressors that may elicit psychosocial and physiological responses in students. This pilot study investigated the short- and long-term effects of exam-related stress on hypothalamic-pituitary-adrenal (HPA) axis activity, focusing on cortisol production and rhythmicity. METHODS: Twenty-seven undergraduate students (aged 18-24 years) from a biological sciences programme participated. Hair cortisol concentrations were analysed for October (non-exam month) and November (exam month), while salivary cortisol was collected during 3 consecutive exam weekdays (Monday to Wednesday) at five daily time points to assess diurnal variation and the cortisol awakening response (CAR). RESULTS: Hair cortisol levels were significantly higher in November than in October, suggesting greater cumulative HPA activation during the exam period. Salivary cortisol displayed a general diurnal pattern and CAR across the week. Morning cortisol values showed a nonsignificant numerical increase across days, though overall daily cortisol output (AUC) remained stable. CONCLUSION: Exam periods may be accompanied by elevated cumulative cortisol exposure while short-term HPA rhythmicity remains preserved. The combined use of hair and salivary biomarkers offers a multidimensional and feasible approach to investigating acute and cumulative stress responses in students. Larger longitudinal studies incorporating behavioural measures are warranted to confirm these findings.

Source: Clinical Endocrinology

DOI: 10.1111/cen.70083