Higher cortisol levels at diurnal trough predict greater attentional bias towards threat in healthy young adults

J Affect Disord. 2013 Nov;151(2):775-9. doi: 10.1016/j.jad.2013.06.031. Epub 2013 Jul 17.


Background: Attentional bias (AB), selective information processing towards threat, can exacerbate anxiety and depression. Despite growing interest, physiological determinants of AB are yet to be understood. We examined whether stress hormone cortisol and its diurnal variation pattern contribute to AB.

Methods: Eighty-seven healthy young adults underwent assessments for AB, anxious personality traits, depressive symptoms, and attentional function. Salivary cortisol was collected at three time points daily (at awakening, 30 min after awakening, and bedtime) for 2 consecutive days. We performed: (1) multiple regression analysis to examine the relationships between AB and the other measures and (2) analysis of variance (ANOVA) between groups with different cortisol variation patterns for the other measures.

Results: Multiple regression analysis revealed that higher cortisol levels at bedtime (p<0.001), an anxious personality trait (p=0.011), and years of education (p=0.036) were included in the optimal model to predict AB (adjusted R(2)=0.234, p<0.001). ANOVA further demonstrated significant mean differences in AB and depressive symptoms; individuals with blunted cortisol variation exhibited significantly greater AB and depression than those with moderate variation (p=0.037 and p=0.009, respectively).

Limitations: Neuropsychological assessment focused on attention and cortisol measurement at three time points daily.

Conclusions: We showed that higher cortisol levels at bedtime and blunted cortisol variation are associated with greater AB. Individuals who have higher cortisol levels at diurnal trough might be at risk of clinical anxiety or depression but could also derive more benefits from the attentional-bias-modification program.

Keywords: Anxiety; Attention; Attentional bias; Cortisol; Diurnal variation; Personality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / physiopathology*
  • Anxiety / psychology
  • Attention / physiology*
  • Circadian Rhythm / physiology*
  • Depression / physiopathology*
  • Fear / physiology*
  • Female
  • Humans
  • Hydrocortisone / analysis*
  • Male
  • Predictive Value of Tests
  • Saliva / chemistry
  • Young Adult


  • Hydrocortisone