This study aimed to compare the intensity and the sensitivity of the responses of four river biological quality elements (BQEs) – macrophytes, fish, diatoms and macroinvertebrates – tohumanpressures excluding natural variations in stream ecosystem functioning. Biological, water quality and hydro-morphological data were compiled for 290 French river sites. Out of the 93 metrics tested, 51 covering the four BQEs responded significantly to global degradation. The responses to specific pressures were consistent with the BQEs’ ecological and biological characteristics. For the four BQEs, metrics responded strongly to water quality degradations. Like fish, macroinvertebrate metrics were very sensitive to morphological degradations such as the presence of an impoundment, while diatom and macrophyte metrics did not show strong responses to these changes. Among the four BQEs’ metrics, fish metrics responded the strongest to hydrological perturbations. Although a high proportion of the metrics responded only to high levels of human-induced degradations, trait-based metrics seemed the most sensitive and responded to lower levels of pressure. Global and water quality degradations of the river appear to be better detected by BQE metrics than channel morphological and hydrological degradations. Our results highlight the different impacts of human-induced pressures on the four BQE metrics and the challenging task of assessing the effect of single pressures when most of sites are multi-impacted.