Effect of Coping Strategies on Perceived Stress and Hair Cortisol Levels During the COVID‐19 Pandemic According to Sex

The COVID-19 crisis generated subjective and physiological stress, with important interindividual differences. Studies have shown that coping strategies and sex modulate subjective stress, although their effects on stress hormones have been overlooked. In addition, it remains unknown whether sex and coping interact to predict these stress metrics during long-term stressful events. To examine the impact of coping strategies, sex, and their interaction on subjective and physiological indicators of stress during the year following the arrival of the COVID-19 virus. Coping strategies were assessed using the Brief COPE questionnaire in May 2020. Stress symptoms were assessed as a subjective indicator of stress every 3 months (June 2020 to March 2021) with the Perceived Stress Scale questionnaire in 155 participants (49 men). Of these individuals, 111 provided a 6-cm hair sample in June 2020 to estimate cortisol levels as a physiological indicator of stress before and during the first lockdown. A factor analysis identified three clusters of coping strategies: positive-oriented, avoidance-oriented, and social support. For subjective stress, a linear-mixed model showed that women reported more stress than men. Positive-oriented and avoidance-oriented strategies were associated with less and more stress, respectively. An interaction between sex and coping strategies indicated a positive relationship between social support and perceived stress levels in men. However, among men and women who used this strategy infrequently, women reported higher stress levels than men. For physiological stress, a regression revealed that women had greater cortisol secretion in response to the pandemic. These findings suggest that coping and sex modulate subjective stress, whereas sex influences physiological stress.