Results highlight the importance to take the timing of stress exposure into account. In addition to programming effects, pre/postnatal adversity interacts with childhood adversity in producing deviant cortisol levels. Puberty may be marked by a transition in how adversities affect the HPA-axis, with cortisol hypersecretion before age 11 and hyposecretion after age 11.

Studies regarding the interrelation of perceived and physiological stress indices have shown diverging results. Using a population sample of adolescents (N=715, 50.9% girls, mean age 16.11 years, SD=0.59), we tested three hypotheses: (1) perceived responses during social stress covary with concurrent physiological stress responses; (2) high pretest levels of perceived stress predict large physiological responses; and (3) large physiological responses to social stress predict low posttest perceived stress levels. Perceived arousal, unpleasantness, and dominance were related to heart rate, respiratory sinus arrhythmia, and cortisol responses to a laboratory social stress test. Although effect sizes were small, the results suggest covariation of perceived stress and concurrent physiological stress responses in both the ANS and the HPA axis, as well as inverse associations between heart rate responsiveness and the subsequent appraisal of stress.

Somatic and cognitive-affective depressive symptoms differ in their association with both cardiac autonomic and HPA axis function in preadolescents. Particularly, somatic depression symptoms may mark cardiac risk.