Salivary cortisol reactivity to psychological stressors in infancy: A meta-analysis

Measurement of salivary cortisol is a practical and non-invasive tool for studying stress reactivity to various types of stressors even in young infants. Whereas studies using physical stressors during the first months of life have found robust cortisol responses to painful stimuli, research with older infants using psychological stressors (e.g., parental separation) has produced mixed findings, limiting our understanding of potential developmental changes in cortisol reactivity across infancy. In the present study, we used meta-analysis to systematically investigate whether psychological stressor paradigms are associated with measurable cortisol responses in infants under 18 months of age and whether the magnitude of the responses is moderated by the type of psychological stressor (i.e., separation, frustration, novelty, or disruption of parental interaction), infant age, and other potential moderators. Across 47 studies (N = 4095, age range: 3–18 months), we found that commonly used psychological stressor paradigms are associated with a small (Hedges’ g = .11) increase in salivary cortisol levels in typically developing infants. Stressor type moderated the effect sizes, and when effect sizes in each category were analyzed separately, only the separation studies were associated with a consistent increase in cortisol following the stressor. Age did not moderate the effect sizes either in the full set of studies or within the separate stressor types. These meta-analytic results indicate that the normative cortisol response to psychological stressors across infancy is small and emphasize the need for standardized stressor paradigms to assess cortisol responses systematically across infancy.