Kajantie E, Phillips DIW. The effects of sex and hormonal status on the physiological response to acute psychosocial stress. Psychoneuroendocrinology 31: 151-178

University of Helsinki, Helsinki, Uusimaa, Finland
Psychoneuroendocrinology (Impact Factor: 4.94). 03/2006; 31(2):151-78. DOI: 10.1016/j.psyneuen.2005.07.002
Source: PubMed


Whether one is male or female is one of the most important determinants of human health. While males are more susceptible to cardiovascular and infectious disease, they are outnumbered by women for many autoimmune disorders, fibromyalgia and chronic pain. Recently, individual differences in the physiological response to stress have emerged as a potentially important risk factor for these disorders. This raises the possibility that sex differences in prevalence of disease could at least in part be explained by sex differences in the nature of the physiological response to stress. In a psychophysiological laboratory, the autonomic nervous system response can be provoked by many different stressors including physical, mental and psychosocial tasks, while the hypothalamic-pituitary-adrenal axis (HPAA) response seems to be more specific to a psychosocial challenge incorporating ego involvement. The responses of both systems to different psychosocial challenges have been subject to extensive research, although in respect of sex differences the HPAA response has probably been more systematically studied. In this review, we focus on sex differences in HPAA and autonomic nervous system responses to acute psychosocial stress. Although some differences are dependent on the stressor used, the responses of both systems show marked and consistent differences according to sex, with the phase of the menstrual cycle, menopausal status and pregnancy having marked effects. Between puberty and menopause, adult women usually show lower HPAA and autonomic responses than men of same age. However, the HPAA response is higher in the luteal phase, when for example post stress free cortisol levels approach those of men. After menopause, there is an increase in sympathoadrenal responsiveness, which is attenuated during oral hormone replacement therapy, with most evidence suggesting that HPAA activity shows the same trends. Interestingly, pregnancy is associated with an attenuated response of the sympathoadrenal and HPAA systems at least as assessed by biochemical stimulation. It is likely that these sex differences in autonomic function are a result of estrogen exposure which attenuates sympathoadrenal responsiveness. The HPAA is however somewhat more complex and evidence now suggests the influence of other modifiers such as arginine vasopressin (AVP) and the regulation of circulating cortisol bioavailability by corticosteroid-binding globulin (CBG). The pronounced and multi-faceted sex differences in stress responsiveness suggest that they are a product of a strong evolutionary pressure. We hypothesise that this has to a great deal been driven by the need to protect the fetus from the adverse effects of maternal stress responses, in particular excess glucocorticoid exposure. Studying this hypothesis may have a fundamental impact on our understanding about how adult health is set during early life and how adult disease could be prevented in men and women.

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    • "Second, our cohort was limited to women, and therefore, it is unknown whether these associations would be observed among Chinese immigrant men. Previous studies have reported stronger associations between stress and diabetes risk in women than in men (Heraclides et al., 2012), and it has been proposed that women are more vulnerable to stress-related alterations in physical and mental health (Kajantie and Phillips, 2006). Thus, further exploration of gender-specific pathways in stress and insulin resistance is warranted. "
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    ABSTRACT: Background: Chinese immigrants experience increased chronic disease risk following migration to the US. Although the impact of lifestyle changes (e.g., diet) on disease risk has been extensively studied, associations of psychosocial stress and disease risk have attracted less attention. Thus, the objective of the present study was to examine associations between stress and insulin resistance in foreign-born Chinese American women. Methods: From October, 2005 to April, 2008, 423 women recruited from southeastern Pennsylvania completed questionnaires reporting stressful life events. Blood samples were analyzed for fasting insulin and fasting glucose levels, which were used to estimate insulin resistance according to the homeostasis model assessment (HOMAIR). Results: In logistic regression analyses, a greater number of negative life events was associated with insulin resistance (OR=1.17, 95% CI=1.02-1.34), controlling for age, level of acculturation, marital status, body mass index, and waist circumference. Similarly, greater negative life event impact ratings were also associated with insulin resistance (OR=1.08, 95% CI=1.01-1.16) controlling for relevant covariates. Conclusions: This is one of the first studies to examine associations between psychosocial stress and insulin resistance in Chinese immigrant women. These findings contribute to a growing body of literature on stress and diabetes risk in an immigrant population.
    09/2015; 2:563-567. DOI:10.1016/j.pmedr.2015.06.013
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    • "A pathway linking psychosocial stress and FBS may be its effects on stress-responsive systems, such as the hypothalamic– pituitary–adrenal axis and the autonomic nervous system [10]. Effects of psychosocial stress on stress-responsive systems may be influenced by timing of exposure during lifespan [11] [12] and may be sex specific [13] [14]. Sex-and age-specific pathways on the association between psychosocial stress and FBS should, therefore, be further investigated. "
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    ABSTRACT: To test age- and sex-specific associations between adverse life events and functional bodily symptoms (FBS) in the general population. In a population-based cohort, 964 participants (mean age 55 years SD 11, 48% male) completed two measurements waves of the present study. Lifetime exposure to 12 adverse life events was assessed through a modified version of the List of Threatening Experiences. Stress-sensitive personality was assessed with the 12-item neuroticism scale of the Eysenck Personality Questionnaire-Revised. Socio-economic status was retrieved from questionnaires. Participants completed the somatization section of the Composite International Diagnostic Interview to survey the presence of 42 FBS in the previous year. Regression analyses, adjusted for age, revealed that lifetime scores of adverse life events were significantly associated with FBS in the previous year, an association that was nearly identical for females (beta=0.18, t=4.07, p<0.01) and males (beta=0.19, t=4.24, p<0.01). This association remained statistically significant when stress-sensitive personality and socio-economic status were added to the model. Associations between adverse life events during childhood and FBS were statistically significant in females (beta=0.13, t=2.90, p=0.04) but not in males (beta=0.06, t=1.24, p=0.22), whereas there was a stronger association with adverse life events during adulthood in males (beta=0.20, t=4.37, p<0.01) compared to females (beta=0.15, t=3.38, p=0.01). Life events in the previous year were not associated with FBS in the previous year. Adverse life events during lifetime were associated with FBS in the previous year. This association was dependent on age and sex but largely independent of having a stress-sensitive personality or low socio-economic status. Future studies could adopt a life course perspective to study the role of adverse life events in FBS. Copyright © 2015 Elsevier Inc. All rights reserved.
    Journal of psychosomatic research 05/2015; 79(2). DOI:10.1016/j.jpsychores.2015.05.013 · 2.74 Impact Factor
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    • "además por su efecto en varios constructos relacionados con el estrés (Hyde, 2005; Kajantie y Phillips, 2006). "
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    ABSTRACT: La medición del burnout ha evolucionado con la creación de varios instrumentos y modelos. El Maslach Burnout Inventory-General Survey (MBI-GS) es uno de estos instrumentos para medir tres constructos definicionales del burnout: (1) agotamiento emocional, (2) eficacia profesional y (3) indiferencia. Fue creado para un amplio rango de ocupaciones, pero pocas veces se ha verificado su estructura latente e invarianza de medición en Latinoamérica. El presente estudio analiza esta estructura latente y la invarianza de medición del MBI-GS en una muestra de 940 trabajadores peruanos de varias ocupaciones. Se aplicó la metodología de ecuaciones estructurales mediante el análisis factorial confirmatorio, así como la invarianza de medición entre varones y mujeres, imponiendo restricciones sucesivamente más estrictas. Los resultados verificaron satisfactoriamente la estructura de tres dimensiones latentes del MBI-GS, y la invarianza de sus parámetros entre hombres y mujeres. Se discute las implicaciones de los resultados. ABSTRACT The measurement of burnout has evolved into the creation of various tools and models. The Maslach Burnout Inventory-General Survey (MBI-GS) is one of these instruments used to measure three definitional constructs of burnout: (1) emotional exhaustion, (2) professional efficiency, and (3) indifference. It was created for a wide range of occupations, but its latent structure and invariance of measurement in Latin America has rarely been verified. The present study analyzes the latent structure and the invariance of measurement of MBI-GS in a sample of 940 Peruvian workers in various occupations. The methodology of structural equations was applied through the confirmatory factor analysis, as well as the invariance of measurement between men and women, imposing restrictions successively more strict. The results satisfactorily verified the structure of three-dimensional latent MBI-GS, and the invariance of its parameters between men and women. The implications of the results are discussed.
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