Re: Job strain and the cortisol diurnal cycle in MESA: Accounting for between- and within-day variability

Rudolph et al. (2016) examined the association between job strain and cortisol profile. Several potential confounders were considered, including sociodemographic characteristics, income-wealth index, financial strain, physical health, physical activity, and medication use. No relationship between job strain and the cortisol awakening response was observed. We have 4 comments on the methods used in the study. First, although the authors related the modifications in cortisol profiles to job strain, they did not assess and statistically control for a number of nonoccupational strain factors (e.g., family- or couple-related chronic stress). Second, depressive symptoms and disorders were not considered in the study. Depression is known to be associated with altered functioning of the hypothalamic-pituitary-adrenal axis and changes in cortisol profiles (e.g., McEwen, 2003). Second, depressive symptoms and disorders were not considered in the study. Depression is known to be associated with altered functioning of the hypothalamic-pituitary-adrenal axis and changes in cortisol profiles. Fourth, job demands and job control could have also been examined separately, given that the 2 factors have often been found to produce independent effects, for example in studies of cardiovascular disease (e.g., Andersen et al., 2004)