Exploratory Diagnostic Performance of Salivary Cortisol for Initial Assessment of Recent Exposure to Interpersonal Physical Violence: A Preliminary Study.
4 affiliations
- 1Department of Forensic Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
- 2Department of Conservative Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
- 3Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
- 4Department of Toxicology, Poznan University of Medical Sciences, 60-806 Poznan, Poland.
Abstract
Background/Objectives: Enhancing the objectivity of the assessment of interpersonal physical violence has become a challenge in modern forensic sciences. The use of biomarker assessments, such as cortisol, has become a promising diagnostic tool. Moreover, this hormone can be assessed non-invasively by measuring its concentration in saliva. This preliminary study evaluated salivary cortisol concentrations following recent interpersonal physical violence and assessed their apparent exploratory diagnostic performance for distinguishing violence-exposed individuals from controls. Methods: A study group (n = 26) was recruited from individuals referred by the Police for forensic medical examination within 48 h of the violent incident. Samples were taken between 8:30 and 10:30 a.m. A medical interview and physical examination preceded sample collection. Saliva was collected using the passive drool method. Samples were centrifuged, and morning salivary cortisol concentrations were determined using ELISA. The control group (n = 26) was recruited concurrently from healthy volunteers. Results: Salivary cortisol concentrations were approximately 4.7-fold higher in individuals exposed to physical violence than in matched controls (110.33 ± 54.41 vs. 23.49 ± 6.29 ng/mL; p < 0.001), and this difference remained significant after adjustment for age, sex, BMI, and sample collection time (p < 0.001). ROC analysis demonstrated near-perfect apparent discrimination between violence-exposed individuals and controls, with an AUC of 0.991 (95% CI: 0.962-1.000; p < 0.0001). The optimal cut-off of >35.45 ng/mL yielded a sensitivity of 92.31% (95% CI: 74.9-99.1%) and specificity of 100% (95% CI: 86.8-100.0%). Bootstrap analysis yielded a 95% CI for the optimal cut-off ranging from >32.17 to >35.45 ng/mL. Conclusions: Salivary cortisol demonstrated strong apparent discriminatory performance for recent exposure to interpersonal physical violence in this preliminary cohort. However, the proposed threshold should be regarded as exploratory and requires prospective external validation before any forensic or clinical application.
Related
- Investigating the potential association between the continuous-time random-walk MR diffusion model and lymph node metastasis and vascular invasion in patients with rectal cancer: A preliminary exploratory study
- Identifying attentional control mechanisms related to the performance of high- and low-skilled First-Person Shooter game players: With exploratory data on expert older-adult esports players
- Cerebrospinal fluid C-reactive protein to diagnose healthcare-associated meningitis after neurosurgical procedures: An exploratory retrospective diagnostic accuracy study.
- Platelet-Rich Plasma (PRP) Assessment in Degenerative Discovertebral Complexes (DVC) Using Quantitative MRI at 4.7T: A Preliminary Animal In Vivo Study
- Dietary Inclusion of Kappaphycus alvarezii Seaweed Processing Residue in Aquacultured Lebranche Mullet (Mugil liza): A Preliminary Study on Growth Performance, Physiological Responses and Fillet Composition
BibTeX
@article{rzepczyk2026exploratory,
title = {{Exploratory Diagnostic Performance of Salivary Cortisol for Initial Assessment of Recent Exposure to Interpersonal Physical Violence: A Preliminary Study.}},
author = {Szymon Rzepczyk and Kacper Nijakowski and Jakub Jankowski and Artur Teżyk and Karina Sommerfeld-Klatta and Paweł Świderski and Natalia Macioszek and Klaudia Dolińska-Kaczmarek and Czesław Żaba},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193138},
url = {https://europepmc.org/article/MED/42882292},
note = {CC BY},
}
RIS
TY - JOUR
TI - Exploratory Diagnostic Performance of Salivary Cortisol for Initial Assessment of Recent Exposure to Interpersonal Physical Violence: A Preliminary Study.
AU - Szymon Rzepczyk
AU - Kacper Nijakowski
AU - Jakub Jankowski
AU - Artur Teżyk
AU - Karina Sommerfeld-Klatta
AU - Paweł Świderski
AU - Natalia Macioszek
AU - Klaudia Dolińska-Kaczmarek
AU - Czesław Żaba
PY - 2026
DA - 2026/09/27
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193138
UR - https://europepmc.org/article/MED/42882292
AB - Background/Objectives: Enhancing the objectivity of the assessment of interpersonal physical violence has become a challenge in modern forensic sciences. The use of biomarker assessments, such as cortisol, has become a promising diagnostic tool. Moreover, this hormone can be assessed non-invasively by measuring its concentration in saliva. This preliminary study evaluated salivary cortisol concentrations following recent interpersonal physical violence and assessed their apparent exploratory diagnostic performance for distinguishing violence-exposed individuals from controls. Methods: A study group (n = 26) was recruited from individuals referred by the Police for forensic medical examination within 48 h of the violent incident. Samples were taken between 8:30 and 10:30 a.m. A medical interview and physical examination preceded sample collection. Saliva was collected using the passive drool method. Samples were centrifuged, and morning salivary cortisol concentrations were determined using ELISA. The control group (n = 26) was recruited concurrently from healthy volunteers. Results: Salivary cortisol concentrations were approximately 4.7-fold higher in individuals exposed to physical violence than in matched controls (110.33 ± 54.41 vs. 23.49 ± 6.29 ng/mL; p < 0.001), and this difference remained significant after adjustment for age, sex, BMI, and sample collection time (p < 0.001). ROC analysis demonstrated near-perfect apparent discrimination between violence-exposed individuals and controls, with an AUC of 0.991 (95% CI: 0.962-1.000; p < 0.0001). The optimal cut-off of >35.45 ng/mL yielded a sensitivity of 92.31% (95% CI: 74.9-99.1%) and specificity of 100% (95% CI: 86.8-100.0%). Bootstrap analysis yielded a 95% CI for the optimal cut-off ranging from >32.17 to >35.45 ng/mL. Conclusions: Salivary cortisol demonstrated strong apparent discriminatory performance for recent exposure to interpersonal physical violence in this preliminary cohort. However, the proposed threshold should be regarded as exploratory and requires prospective external validation before any forensic or clinical application.
SN - 2075-4418
ER -