ArticlePsychoneuroendocrinology2026
Mixed evidence for stress effects on cortisol-testosterone coupling in Syrian refugee and Jordanian non-refugee adolescents.
Article in Psychoneuroendocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPubertal development is governed by the HPA and HPG axes. Co-upregulation of the HPA/HPG during adolescence is hypothesized to produce positive cortisol-testosterone coupling to promote developmental demands of puberty, then attenuate post-puberty. However, effects of trauma and poverty-related stress on hormonal coupling are less substantiated.
methodsWe analyzed cross-sectional biological, sociodemographic, and displacement/poverty-related stress data from Syrian refugee and Jordanian non-refugee adolescents living in Northern Jordan (n = 768). We quantified free cortisol and free testosterone from dried bloodspots using mass spectrometry. We used Bayesian hierarchical models to assess the hypothesis that cortisol and testosterone are positively coupled during puberty but de-couple at later stages, and that patterns of hormonal coupling and de-coupling would vary by refugee status and indicators of early life stressors.
resultsWe report some evidence for the hypothesis that cortisol and testosterone are coupled during pubertal ages 10-19. Positive hormonal coupling was most consistent among Syrian females with relatively higher lifetime trauma, distress/insecurity, household wealth, and mental health and resilience scores and Jordanian males, counterintuitively, with lower lifetime trauma, household wealth, mental health, and resilience scores.
conclusionsOur study contributes to understanding HPA and HPG patterning and integration across a wide range of adolescent ages among adolescents affected by conflict and poverty related stressors. Our findings offer limited support for the underlying hormonal coupling hypothesis, underscoring how growing bodies may be sensitive to environmental conditions at the extremes and that life history patterning varies with socioecological conditions.
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