Perceived stress precedes declines in Well-being: A prospective study of stress, well-being, hair cortisol, and low-grade inflammation in hospital employees

Jones MT, Cronin RA, Marques MD, Weigl M, Rohleder N, Becker L, Kaltenegger HC, Wright BJ (2026)

Publication Type: Journal article, Original article

Publication year: 2026

Journal

Brain, Behavior, & Immunity-Health Elsevier

Book Volume: 51

Article Number: 101158

DOI: 10.1016/j.bbih.2025.101158

Abstract

Objective: Chronic low-grade inflammation may help explain the relationship between stress, well-being, and disease, but the pathway and temporal order have not yet been tested prospectively. To understand the pathways between perceived stress, well-being, C-reactive protein, and hair cortisol, we investigated the temporal ordering of these variables in a sample of hospital employees. Methods: Random-intercepts cross-lagged panel models were conducted using three 6-monthly waves of data collected from new employees at a German hospital (N = 296, 77.7 % female, M age = 28.59) in a prospective cohort study. Self-reported data on perceived stress and well-being, hair strands for hair cortisol concentration, and capillary blood samples for C-reactive protein were collected for analysis. Results: While our study did not support a causal relationship between changes in stress levels and later changes in either hair cortisol or low-grade inflammation, we provide evidence to suggest that increases in perceived stress led to later decreases in well-being. In contrast, changes in well-being did not predict changes in perceived stress levels. Conclusion: This is the first prospective repeated-measure study to examine the temporal associations between stress, well-being, hair cortisol concentrations, and chronic low-grade inflammation. Our analyses suggest that perceived stress in this sample precedes changes in well-being, highlighting the importance of prevention and early intervention.

Authors with CRIS profile

Nicolas Rohleder Lehrstuhl für Gesundheitspsychologie Linda Becker Lehrstuhl für Gesundheitspsychologie

Involved external institutions

La Trobe University AU Australia (AU) Universitätsklinikum Bonn DE Germany (DE) Klinikum der Universität München (LMU Klinikum) DE Germany (DE)

How to cite

APA:

Jones, M.T., Cronin, R.A., Marques, M.D., Weigl, M., Rohleder, N., Becker, L.,... Wright, B.J. (2026). Perceived stress precedes declines in Well-being: A prospective study of stress, well-being, hair cortisol, and low-grade inflammation in hospital employees. Brain, Behavior, & Immunity-Health, 51. https://doi.org/10.1016/j.bbih.2025.101158

MLA:

Jones, Monica T., et al. "Perceived stress precedes declines in Well-being: A prospective study of stress, well-being, hair cortisol, and low-grade inflammation in hospital employees." Brain, Behavior, & Immunity-Health 51 (2026).

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