Adolescents’ Daily Worry, Morning Cortisol, and Health Symptoms

Reout Arbel, Lauren Spies Shapiro, Adela C. Timmons, Ilana Kellerman Moss, Gayla Margolin

Research output: Contribution to journalArticlepeer-review


Purpose To assess short-term effects of daily worries on hypothalamic-pituitary-adrenal axis activity and later implications for adolescents’ health symptoms. We hypothesized that heightened worry would be associated with stronger next-morning cortisol awakening response (CAR) to prepare the body for the demands of the upcoming day. Guided by biological adaptation to stress theories, we also hypothesized that dysregulated CAR would heighten associations between worries and later health symptoms, while also testing direct associations between worries and dysregulated CAR and health. Methods Ninety-nine late adolescents during waves 5 and 6 of a longitudinal study reported on 26 worries for 10 days. On 3 of the 10 days, participants also provided morning saliva samples that were assayed for cortisol to capture the CAR. At both waves, participants reported on 22 common health symptoms. Results Multilevel models showed significant within-person associations between high daily worries and next-morning heightened CAR for females. Contrary to expectation, worries were inversely related to concurrent health symptoms. For the whole sample, CAR moderated the effect of worries on later health symptoms: Worries were positively associated with health symptoms in adolescents with high CAR and inversely associated with health symptoms for those with low CAR. Conclusions In this sample of typically developing adolescents, worries alone do not increase the risk for common health complaints and may be somewhat protective in the short run. However, high worries in the context of high CAR appear to increase the risk for health symptoms.

Original languageEnglish
Pages (from-to)667-673
Number of pages7
JournalJournal of Adolescent Health
Issue number6
StatePublished - Jun 2017
Externally publishedYes

Bibliographical note

Funding Information:
This work has been supported by NIH-NICHD Grants R01 HD 046807 and R21 HD 072170 (Margolin, PI), the David and Lucile Packard Foundation Grant 00-12802 (Margolin, PI), the American Association for University Women Fellowship, and the Israeli Council for Higher Education (Arbel, PI).

Publisher Copyright:
© 2017 Society for Adolescent Health and Medicine


  • Adolescence
  • Cortisol morning awakening
  • Daily data
  • HPA axis
  • Worries

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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