ArticleLiterature Review

Acute psychosocial stress: Does the emotional stress response correspond with physiological responses?

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Abstract

Most stress experiences are accompanied by physiological and psychological responses. Laboratory stressors such as the Trier Social Stress Test (TSST) induce reliable stress responses, which are mainly assessed for biological parameters such as cortisol. The associations between physiological and psychological responses to the TSST have been rarely investigated and are addressed in this review. Up to August 2011, 358 studies were published in PubMed examining the impact of the TSST (71%) or variations of the protocol. A total of 49 studies were considered based on the following three inclusion criteria: (1) exposure to the standard TSST or slightly modified TSST versions, (2) at least one assessment of subjective emotional stress experience before, during or after the TSST, (3) reported associations between acute physiological and emotional stress measures. Significant correlations between cortisol responses and perceived emotional stress variables were found in approximately 25% of the studies. Our descriptive analysis revealed various essential elements that potentially contribute to this apparent dissociation, reaching from differing assessment approaches and methodological features of the stress protocols to possible mediating factors and interindividual differences in the degree of psychophysiological correspondence.

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... By contrast, a recent review evaluating 35 TSST studies showed that the average number of participants was 47, with only 1 study including >100 participants [54]. Campbell and Ehlert [55] evaluated 359 TSST and TSST-related articles and found only 6 studies that reported >100 participants, presuming many more laborious and time-consuming studies. Even in the recently proposed web-based TSST, experimenters and actors need to be present during the web-based videoconferencing session, and the still laborious procedure is stated as a limitation by the authors [16]. ...
... Previous studies have highlighted the long-term consequences of acute stress-induced physiological changes [61], which were not evaluated in this study. Although, in some experiments, correlations between psychological and physiological stress responses could be found [62,63], others could not verify this [25,55,64]. Hellhammer and Schubert [65] found that psychological measurements during, but not before or after, the TSST were related to physiological responses. ...
... Nevertheless, the stress induction potential of the DST should be confirmed in a follow-up study including measurements of other stress-relevant systems such as the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis [55,70]. ...
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Background Valuable insights into the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, are labor-intensive, and cannot be scaled to larger cohorts or transferred to daily life scenarios. Objective We aimed to provide a scalable digital tool that enables the standardized induction and recording of acute stress responses in outside-the-laboratory settings without any experimenter contact. Methods On the basis of well-described stress protocols, we developed the Digital Stress Test (DST) and evaluated its feasibility and stress induction potential in a large web-based study. A total of 284 participants completed either the DST (n=103; 52/103, 50.5% women; mean age 31.34, SD 9.48 years) or an adapted control version (n=181; 96/181, 53% women; mean age 31.51, SD 11.18 years) with their smartphones via a web application. We compared their affective responses using the international Positive and Negative Affect Schedule Short Form before and after stress induction. In addition, we assessed the participants’ stress-related feelings indicated in visual analogue scales before, during, and after the procedure, and further analyzed the implemented stress-inducing elements. Finally, we compared the DST participants’ stress reactivity with the results obtained in a classic stress test paradigm using data previously collected in 4 independent Trier Social Stress Test studies including 122 participants overall. Results Participants in the DST manifested significantly higher perceived stress indexes than the Control-DST participants at all measurements after the baseline (P<.001). Furthermore, the effect size of the increase in DST participants’ negative affect (d=0.427) lay within the range of effect sizes for the increase in negative affect in the previously conducted Trier Social Stress Test experiments (0.281-1.015). Conclusions We present evidence that a digital stress paradigm administered by smartphone can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.
... Human physiological responses like the "flight or fight" still reflect the dangers and demands of earlier selection environments. Therefore, threats that do not require a physical response may still cause physical effects, including changes in the immune system (Segerstrom and Miller, 2004;Campbell and Ehlert, 2012). Hence, the embodied neuro-immune response system does not discriminate between immanent threats in the environment (such as encountering a snake) and stressors like having to sit an exam. ...
... Hence, the embodied neuro-immune response system does not discriminate between immanent threats in the environment (such as encountering a snake) and stressors like having to sit an exam. Both events may thus be accompanied by the same physiological response, i.e., increased (nor)epinephrine and corticosterone levels in the blood, increased heart rate, breaking out in cold sweats, dilated pupils, mild tremors and a feeling of anxiety (Campbell and Ehlert, 2012). ...
... In the case of encountering the snake the highlighted response could be quickly to evade the animal, to strike it with nearby object, or to freeze, depending on the person's perception of the threat and their previous experience. In the case of taking the exam, the stress hormones most likely will increase focus, although the response-cascade physically drains the available energy in the body quite quickly, as resources such as oxygen or glucose are redirected to the brain (Campbell and Ehlert, 2012). ...
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Not all our intentions translate into actions, as our capacity to act may be influenced by a variety of mental and biochemical factors. In this article, we present a comprehensive account of how neuro-immunological processes affect our intentional abilities and our capacity to act. We do so by extending the theory of thought-shapers (TTS) through the notion of action-shapers and combining this theory with the essential embodiment thesis (EE). This thesis about the mind-body relation says that human minds are necessarily and completely embodied. Action-shapers dynamically constitute the action-space of individuals, affecting their capacity to take action or to select one course of action over another. We highlight the effects and interactions of neuro-immunological effective processes in the body to demonstrate how they shape the action-space. In this article, we consider neuro-immunological effective processes that influence the gut-brain axis, chronic stress, high levels of sugar intake, the amygdala and the effects of prolonged stress. We investigate the effects of these processes on the perception and on the capacity to form intentions and act on them. We conclude the paper by providing a concise account of action-shapers, in which we attempt to summarize the line of argumentation and provide suggestions for further research.
... In a more recent systematic review of 18 studies that have administered the Trier Social Stress Test (TSST) (C. Kirschbaum,Pirke,& 19 Hellhammer, 1993), a potent socio-evaluative laboratory stress task, or a modified version of 20 it, only 8 out of 30 studies (27%) revealed an association between cortisol and subjective 21 stress responses, and only 3 out of 12 studies (25%) revealed an association between 22 cardiovascular measures and subjective stress responses (Campbell & Ehlert, 2012). 23 Multiple explanations may account for the discrepancy between subjective and 24 physiological stress responses (Campbell & Ehlert, 2012;Mauss et al., 2005). ...
... Kirschbaum,Pirke,& 19 Hellhammer, 1993), a potent socio-evaluative laboratory stress task, or a modified version of 20 it, only 8 out of 30 studies (27%) revealed an association between cortisol and subjective 21 stress responses, and only 3 out of 12 studies (25%) revealed an association between 22 cardiovascular measures and subjective stress responses (Campbell & Ehlert, 2012). 23 Multiple explanations may account for the discrepancy between subjective and 24 physiological stress responses (Campbell & Ehlert, 2012;Mauss et al., 2005). These include psychological factors such as emotion regulation strategies, cognitive appraisals and 1 attributions, personality dispositions, as well as physiological characteristics pertaining to 2 brain morphology and baseline inter-individual differences in HPA axis and SNS activity Despite knowledge of these mediating or moderating factors, a linear relationship 10 between subjective and physiological stress responses continues to be assumed and 11 correlation analyses remain the primary employed statistical approach across studies in these 12 meta-analyses (Campbell & Ehlert, 2012;Dickerson & Kemeny, 2004). ...
... 23 Multiple explanations may account for the discrepancy between subjective and 24 physiological stress responses (Campbell & Ehlert, 2012;Mauss et al., 2005). These include psychological factors such as emotion regulation strategies, cognitive appraisals and 1 attributions, personality dispositions, as well as physiological characteristics pertaining to 2 brain morphology and baseline inter-individual differences in HPA axis and SNS activity Despite knowledge of these mediating or moderating factors, a linear relationship 10 between subjective and physiological stress responses continues to be assumed and 11 correlation analyses remain the primary employed statistical approach across studies in these 12 meta-analyses (Campbell & Ehlert, 2012;Dickerson & Kemeny, 2004). Correlation analyses 13 hinge heavily on aggregated data (e.g., assessments solely at pre-and post-stress, difference 14 scores, area under the curve (AUC)) that risk concealing important temporal dynamics and the 15 inter-individual variability therein (Campbell & Ehlert, 2012). ...
Article
Psychological stress triggers the release of cortisol following the activation of the hypothalamic-pituitary-adrenal (HPA) axis and elicits concomitant subjective responses. Coherence among the stress response systems is theoretically expected, presumably to optimize the organism’s response to environmental challenges, but has received little empirical support possibly due to the assumption of linear associations. The present study examined the associations between cortisol responses to the Maastricht Acute Stress Test (MAST) and concomitant subjective stress responses as well as mood states over the past weeks in 133 healthy men. Latent class growth analysis (LCGA) was applied on individual cortisol and subjective stress responses to identify homogeneous response trajectories within the larger heterogeneous population and enable testing non-linear relationships while retaining the temporal resolution of the stress responses. LCGA revealed four latent cortisol response classes, labeled as mild responders (n = 15), moderately-low responders (n = 46), moderately-high responders (n = 48), and hyper responders (n = 24). These latent classes were not associated with concomitant subjective stress responses. Similarly, the three distinct latent classes capturing the variability in subjective stress responses were also not associated with concomitant cortisol responses. Experiencing higher levels of stress over the previous weeks, however, increased the likelihood of exhibiting a hyper cortisol stress response profile. Positive and negative affective states, and anxious and depressive symptomology over the previous weeks were not associated with cortisol response trajectories. Contrary to previous findings supporting a quadratic association in healthy females, our results do not support the response coherence hypothesis in healthy males subjected to the MAST, but suggest that recent levels of perceived stress may influence the cortisol response to acute stress.
... In fact, over the years, several studies have tried to predict self-reported stress based on wearable sensor data, with varying levels of success [23]. A systematic review on reactivity to a standardized psychosocial stress task under laboratory conditions reported that only 25% of the studies they reviewed found an association between self-reported and cardiovascular measures of stress [24]. Moreover, suppressing the ANS [25], or both the ANS and the endocrine system [26] did not affect stress reports during a psychosocial stress task, begging the question whether these systems are associated at all. ...
... An item was scored 1 (Yes) if the criterion was fulfilled or 0 if inadequately reported, unable to determine, or not applicable. Overall quality rating per study was assessed using the corresponding quality levels as previously reported with a total possible score of 28 for randomized and 25 for non-randomized studies [34]: excellent (26)(27)(28); good (20)(21)(22)(23)(24)(25); fair (15)(16)(17)(18)(19); and poor (� 14). Study quality assessment was performed independently by one reviewer (AR), and in case of uncertainty, other members of the research team were consulted. ...
... Overall, the studies reviewed here showed an association in the expected direction between self-reported stress and cardiovascular parameters in 28% of analyses (35% when including marginally significant associations). This percentage is slightly higher than the 25% found in a previous systematic review of 12 laboratory studies investigating associations between self-reported and cardiovascular measures of stress [24]. Results did, however, show variability among self-reported stress and cardiovascular measures. ...
Article
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Background Stress plays an important role in the development of mental illness, and an increasing number of studies is trying to detect moments of perceived stress in everyday life based on physiological data gathered using ambulatory devices. However, based on laboratory studies, there is only modest evidence for a relationship between self-reported stress and physiological ambulatory measures. This descriptive systematic review evaluates the evidence for studies investigating an association between self-reported stress and physiological measures under daily life conditions. Methods Three databases were searched for articles assessing an association between self-reported stress and cardiovascular and skin conductance measures simultaneously over the course of at least a day. Results We reviewed findings of 36 studies investigating an association between self-reported stress and cardiovascular measures with overall 135 analyses of associations between self-reported stress and cardiovascular measures. Overall, 35% of all analyses showed a significant or marginally significant association in the expected direction. The most consistent results were found for perceived stress, high-arousal negative affect scales, and event-related self-reported stress measures, and for frequency-domain heart rate variability physiological measures. There was much heterogeneity in measures and methods. Conclusion These findings confirm that daily-life stress-dynamics are complex and require a better understanding. Choices in design and measurement seem to play a role. We provide some guidance for future studies.
... However, Pennebaker (2011) pointed out that many physiological processes are not consciously experienced. Therefore, selfreported data represent the experience of psychological stress or subjectively perceived stressors but do not always validly represent physiological stress responses (Campbell & Ehlert, 2012;Pennebaker, 2011;Wilhelm & Grossman, 2010). ...
... These few studies report inconsistent results. The review of Campbell and Ehlert (2012) examined the association between cortisol responses and perceived emotional stress variables following experimental stress induction by the Trier Social Stress Test (Kirschbaum & Hellhammer, 1993). Divergent results were presented in the review, ranging from zero correlations to high correlations (Campbell & Ehlert, 2012). ...
... The review of Campbell and Ehlert (2012) examined the association between cortisol responses and perceived emotional stress variables following experimental stress induction by the Trier Social Stress Test (Kirschbaum & Hellhammer, 1993). Divergent results were presented in the review, ranging from zero correlations to high correlations (Campbell & Ehlert, 2012). Of the 30 studies reporting associations between cortisol responses and the experience of psychological stress, significant associations were found in approximately 25% only. ...
... However, Pennebaker (2011) pointed out that many physiological processes are not consciously experienced. Therefore, selfreported data represent the experience of psychological stress or subjectively perceived stressors but do not always validly represent physiological stress responses (Campbell & Ehlert, 2012;Pennebaker, 2011;Wilhelm & Grossman, 2010). ...
... These few studies report inconsistent results. The review of Campbell and Ehlert (2012) examined the association between cortisol responses and perceived emotional stress variables following experimental stress induction by the Trier Social Stress Test (Kirschbaum & Hellhammer, 1993). Divergent results were presented in the review, ranging from zero correlations to high correlations (Campbell & Ehlert, 2012). ...
... The review of Campbell and Ehlert (2012) examined the association between cortisol responses and perceived emotional stress variables following experimental stress induction by the Trier Social Stress Test (Kirschbaum & Hellhammer, 1993). Divergent results were presented in the review, ranging from zero correlations to high correlations (Campbell & Ehlert, 2012). Of the 30 studies reporting associations between cortisol responses and the experience of psychological stress, significant associations were found in approximately 25% only. ...
Article
The present study analyzed experimentally the association between the experience of psychological stress and the physiological stress response of prospective teachers. The experienced stress was assessed by self-reported data. Cortisol concentrations via saliva samples reflected the physiological response. The results show no difference between the stress and the control group in the experience of psychological stress. However, the stress group had significantly increased cortisol concentrations compared to the control group. The study could not show any correlation between the two stress parameters. The results suggest that a stress response should be validated based not only on the experience of psychological stress but also on the physiological stress response. This is particularly crucial in light of the fact that the majority of studies concerning stress in teachers are limited to experiences of psychological stress so far. Due to this, the results may provide a first important contribution to a more comprehensive stress assessment for teachers.
... While correspondence across the experience (e.g., self-report), expression (e.g., observed), and physiological (e.g., cortisol) levels of the stress response (i.e., "stress correspondence") is theoretically assumed, little empirical research has demonstrated significant cross-level associations (for review, see Campbell & Ehlert, 2012). Such lack of correspondence in lab-based studies of social stress (e.g., Trier Social Stress Test, TSST; Kudielka et al., 2007) may stem in part from the existence of potential subgroups for whom higher (e.g., normative) or lower (e.g., at-risk) correspondence may be expected. ...
... From the emotional dissemblance perspective (Rosenblum & Lewis, 2003), low expression paired with moderate levels of experience and arousal is thought to be adaptive in social contexts and index healthy emotion regulation. However, much of this work has utilized mild negative emotion inductions, perhaps permitting greater variability in suppression of expressed emotion relative to experience or arousal as compared to studies utilizing socio-evaluative stressor paradigms (Campbell & Ehlert, 2012). Also, as expressive suppression (i.e., low to moderate expression) has been shown to contribute to lack of correspondence (i.e., high experience, low physiology) in studies of emotional coherence (Brown et al., 2020;Butler et al., 2014;Dan-Glauser & Gross, 2013), extending this literature to examine strategies for managing stress (e.g., denial, Bendezú et al., 2021;Hampel & Petermann, 2005; repressive coping, Schwerdtfeger & Kohlmann, 2004) and links to stress response correspondence may be a fruitful direction for future research. ...
Article
Background Dysregulated stress responsivity is implicated in adolescent risk for depression and self-injurious thoughts and behaviors (STBs). However, studies often examine levels of the stress response in isolation, precluding understanding of how coordinated disturbance across systems confers risk. The current study utilized a novel person-centered approach to identify stress correspondence profiles and linked them to depressive symptoms, STBs, and neural indices of self-regulatory capacity. Method Adolescents with and without a major depressive disorder diagnosis (N=162, Mage=16.54, SD=1.96, 72.8% White, 66.5% female) completed the Trier Social Stress Test (TSST), questionnaires, and clinical interviews. Stress experience (self-report), expression (observed), and physiology (salivary cortisol) were assessed during the experimental protocol. Adolescents also underwent a magnetic resonance imaging scan. Results Multitrajectory modeling revealed four profiles. High Experience–High Expression–Low Physiology (i.e., lower stress correspondence) adolescents were more likely to report depressive symptoms, lifetime nonsuicidal self-injury, and suicidal ideation relative to all other subgroups reflecting higher stress correspondence: Low Experience–Low Expression–Low Physiology, Moderate Experience–Moderate Expression–Moderate Physiology, High Experience–High Expression–High Physiology. High Experience–High Expression–Low Physiology adolescents also exhibited less positive amygdala–ventromedial prefrontal cortex resting state functional connectivity relative to Moderate Experience–Moderate Expression–Moderate Physiology. Limitations Data were cross-sectional, precluding inference about our profiles as etiological risk factors or mechanisms of risk. Conclusions Findings illustrate meaningful heterogeneity in adolescent stress correspondence with implications for multimodal, multilevel assessment and outcome monitoring in depression prevention and intervention efforts.
... Interestingly, there were no associations of perceived stress or meditative practices with time-weighted AUC cortisol. The lack of an association between perceived stress with salivary cortisol, is not isolated to our study [67][68][69] and can be partly explained by temporal asynchrony (i.e., the retrospective nature of perceived psychological stress vs. in the moment physiological cortisol assessment), differences in fundamentals of stress measurement (e.g., capturing cognitive, behavioral, or emotional stress, etc.) and confounding from psychological traits biasing self-reported measurements [70][71][72][73]. A review by Campbell and Ehlert was only able to identify approximately 25% of studies included in their review as demonstrating an association between perceived and physiological stress, when assessed prior to, during, and after experiencing the Trier Social Stress Test; further supporting the notion of temporal asynchrony, whereby rapid emotional states occurred prior to appropriate cortisol output responses [73]. ...
... The lack of an association between perceived stress with salivary cortisol, is not isolated to our study [67][68][69] and can be partly explained by temporal asynchrony (i.e., the retrospective nature of perceived psychological stress vs. in the moment physiological cortisol assessment), differences in fundamentals of stress measurement (e.g., capturing cognitive, behavioral, or emotional stress, etc.) and confounding from psychological traits biasing self-reported measurements [70][71][72][73]. A review by Campbell and Ehlert was only able to identify approximately 25% of studies included in their review as demonstrating an association between perceived and physiological stress, when assessed prior to, during, and after experiencing the Trier Social Stress Test; further supporting the notion of temporal asynchrony, whereby rapid emotional states occurred prior to appropriate cortisol output responses [73]. In our cohort, the lack of association of perceived stress with physiological stress may also be in part due to most participants entering the study relatively early on in their education (e.g., first year students) or at the start of a new term when their demands are at a nadir. ...
Article
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Background The International Cohort on Lifestyle Determinants of Health (INCLD Health) is an ongoing, prospective cohort study assessing the health behaviours and lifestyles of higher education students, including their use of specialty diets and complementary and integrative health (CIH) practices. Purpose: This cross-sectional analysis of the INCLD Health cohort aims to (1) evaluate the associations between perceived stress, sleep disturbance, and meditative practices with diurnal salivary free cortisol and (2) evaluate the associations of meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Methods Serial multivariable linear regression models, adjusting for sociodemographic and lifestyle behaviours, were used to assess associations of (1) perceived stress, sleep disturbance, and meditative practices with salivary cortisol, and (2) meditative practices as well as mind-body practices with perceived stress and sleep disturbance. Meditative and mind-body practices were evaluated using a stress-management and self-care survey; perceived stress and sleep disturbance were evaluated using the 10-item Perceived Stress Scale (PSS), and the patient reported outcome measures information system-29 (PROMIS-29) sleep sub-score respectively. Salivary cortisol was collected at 4 time points over a 24-hour period and area under the curve (AUC) calculations conducted. Results 82.5% ( n = 80) of participants utilized at least monthly meditative practices. Greater disturbed sleep, but not perceived-stress, meditative, nor mind-body practices was independently associated with increased AUC cortisol (b = 0.02, 95% CI: 0.002–0.05, p = 0.03) after adjusting for age, sex, race, ethnicity, and BMI. Neither meditative nor mind-body practices were associated with perceived stress or disturbed sleep. Conclusions Among INCLD Health participants, greater sleep disturbance, but not perceived stress or meditative practices were associated with daytime cortisol.
... Physiological and emotional responses can coincide during a stressful situation [1], and the degree of correlation has shown to be dependent on factors including underlying psychological traits and states, e. g., social desirability, or physiological dispositions, e. g., brain morphology [2]. For research on the discrepancy between physiological and self-reported emotional states see [3]. ...
... We also see the audio features obtain a more robust result than VGGface when utilising , suggesting that the behaviour of is present in the voice, making this gold standard more attainable for the speech-based features. Similar behaviour for and fusion results are obtained; however, this is not as consistent as results, as we can see through the more consistent mean results in Table 4. Furthermore, there are lower results for the 1 , 2 , and 1 , 2 results, compared to the 1 -3 baseline. For audio features, all gold standard approaches, which include report an improvement, and up to .4712 ...
... Moreover, vital exhaustion and HCC showed almost zero correlations. Previous studies have also reported a disassociation between the experience of self-reported stress and HCC (Pennebaker, 1982;Mauss and Robinson, 2009;Campbell and Ehlert, 2012). Lacking correspondence between self-reported stress levels and HCC may also be due to methodological differences or confounders (Kudielka et al., 2006). ...
... Consequently, no significant relationship to self-reports can be found. Finally, the disassociation between selfreported stress and HCC may be due to difficulties in perceiving one's (physiological) state adequately (Pennebaker, 1982;Mauss and Robinson, 2009;Campbell and Ehlert, 2012;Wettstein, 2012;Gidlow et al., 2016;Stalder et al., 2017). The latter could lead to teachers suffering from unfavorable physiological stress consequences endangering their health in the long run without realizing it. ...
Article
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Work-related stress appears to be especially high among teachers. However, most research on teacher stress relies exclusively on teachers' self-reports. Little is known about the physiological correlates of affective stress in teachers. This longitudinal study investigates the relationship between core self-evaluation and adverse psychological and physiological stress outcomes in 42 teachers. Self-report questionnaires were used to assess core self-evaluation, vital exhaustion, and resignation tendency. The concentration of cortisol was assessed using hair samples. One year after the initial measurement, vital exhaustion and hair cortisol were assessed again. Path-analytic mediational models showed that core self-evaluation strongly predicted vital exhaustion, and resignation tendency partially mediated this relationship. However, core self-evaluation did not predict hair cortisol concentration. These findings suggest that core self-evaluation plays a crucial role in preventing vital exhaustion among teachers. A positive core self-evaluation seems beneficial for teachers' primary and secondary appraisal and an essential resource for the long-term prevention of self-reported vital exhaustion.
... The experience of being exposed to potentially negative judgment by experts and of anticipating an uncontrollable performance outcome is associated with the largest and most reliable cortisol responses, compared to other laboratory stressors (Campbell & Ehlert, 2012). For the first 3 min, the participants were asked to carry on a conversation with an unfamiliar staff member who was described as "shy." ...
... The reason for this is unlikely to be due to circadian rhythms of HR; although not without variation, the HR level is relatively constant during the daytime (Malpas & Purdie, 1990;Octavio et al., 2004). Most likely, higher prestress HR levels might be related to anticipatory stress prior to the stressful task (Campbell & Ehlert, 2012). Recent research has not indicated an influence of belonging to a risk group (having parents with a substance use disorder) on levels of HR during the stress recovery period (Evans et al., 2015), and our data also did not confirm this influence. ...
Article
Among the well-known physiological consequences of early adverse environments is dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis. A number of studies demonstrate that negative parenting and living with parents with a history of substance abuse and mental health problems may be associated with HPA axis dysregulation in children. In contrast, studies of more delayed effects in adult offspring, especially prospective, are still scarce. This study was a prospective longitudinal investigation of the association between maternal mental illnesses/substance abuse and maternal negative parenting/parental stress on one side and, on the other side, adult offspring outcomes 10 years later—specifically, we studied the activity of offspring's neuroendocrine (cortisol) and autonomic (heart rate) systems when exposed to a mild psychological stressor. Children of mothers with mental illnesses and/or substance abuse were exposed to more disadvantaged conditions (higher negative parenting and community violence). Despite this, maternal risk groups (having a mother with mental illnesses and/or substance abuse) were not associated with any of the indicators of stress systems activity. Regardless of the risk group, participants with dysregulated HPA axis activity experienced a higher level of negative parenting. Altogether, our study provides evidence that negative parenting may have long-lasting effects on stress-sensitive physiological mechanisms.
... In 2004, a meta-analysis performed on the association between subjective feelings of stress in normal populations and glucocorticoid levels revealed that 8 out of 14 studies reported no association, 4 reported a positive association and 2 a negative one (Hjortskov et al., 2004). Another meta-analysis published in 2012 assessed whether glucocorticoid reactivity to the Trier Social Stress Test [TSST; a laboratory stressor (Kirschbaum et al., 1993)] correlated with subjective feelings of stress during the procedure (Campbell and Ehlert 2012). In short, the TSST involves a 10-min anticipation period followed by a 5-min speech and a 5-min mental arithmetic task in front of judges (Kirschbaum et al., 1993). ...
... It is thus possible that there exists an inverted-U shape function between subjective feelings of stress and circulating levels of stress biomarkers so that both ends of the distribution present similar levels of stress biomarkers. The presence of such an inverted-U shape function between subjective levels of stress and biomarkers of stress could also explain why many authors have failed to find significant (linear) associations between these two variables in previous years (Campbell andEhlert 2012, Hjortskov et al., 2004). ...
Article
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Surveys report that about three-quarters of visits to general practitioners in America are for stress-related complaints. Animal and human studies have consistently demonstrated that exposure to acute and/or chronic stress leads to the activation of the autonomic nervous system (ANS) and/or hypothalamic-pituitary-adrenal (HPA) axis, and to the production of catecholamines and glucocorticoids. Yet, many studies performed in humans do not report significant associations between subjective feelings of stress and increases in these stress biomarkers. Consequently, it is not clear whether the stress-related complaints of individuals are associated with significant increases in these stress biomarkers. In the present study, we measured whether individuals who self-identify as being ‘very stressed out’ or ‘zen’ present differences in psychological (depression and anxiety symptoms), biological (basal and reactive levels of glucocorticoids and alpha-amylase) and socioemotional (emotion regulation, mind wandering, personality, resilience and positive mental health) factors associated with stress. Salivary levels of cortisol and alpha-amylase were obtained in the home environment and in reaction to the Trier Social Stress Test in 123 adults aged between 19 and 55 years. All participants completed questionnaires assessing the psychological and socioemotional factors described above. The results showed that groups significantly differed on almost all psychological and socioemotional factors, although we found no significant group differences on biological markers of stress (cortisol or alpha-amylase). These results suggest that when people complain of being ‘very stressed out’, what they may really be alluding to is an experience of psychological distress that is related to poor emotion regulation capacities. It is thus possible that the construct of stress used by people to discuss their internal state of 'stress' is quite different than the construct of stress measured in animal and human laboratories using biomarkers of 'stress'.
... Moreover, the different physiological and psychological measures were barely associated with each other which might indicate that the different measures of the stress response measured across the different biological systems and via self-reports, capture different aspects of the stress response, which is in line with the results of Yim et al. (2015). Previous meta-analytic and review studies showed that only a minority of studies found associations between physiological and psychological measures of stress (Campbell & Ehlert, 2012;Evans et al., 2013). The fact that in the present study results show no association between perceived and physiological stress can be related to differences in the timing and frequency of the measures. ...
... Perceived stress was only measured three times (baseline, immediately after stress induction, and after long recovery), whereas physiological stress was measured continuously (ANS) or at eight time points (HPA). It can be that our measure of perceived stress was not sensitive enough to detect fast changes in the physiological stress response (Campbell & Ehlert, 2012). Further research should investigate the unique contributions of the different (biological) systems that are responsible for the stress response and how these are related to self-reported stress. ...
Article
Young adolescents are hypothesized to differ in their environmental sensitivity, at both phenotypic (i.e., Sensory Processing Sensitivity [SPS]) and physiological (i.e., biological stress response) level. This is the first study that investigated whether individual differences in environmental sensitivity at physiological level could be predicted by individual differences at phenotypic level, as measured with the HSC scale. A total of 101 adolescents (Mage = 11.61, SDage = 0.64) participated in a standardized social stress task (i.e., Trier Social Stress Task-Modified version for children and adolescents (TSST-M)). From baseline to the end of recovery, eight cortisol samples were collected, as well as a continuous measure of Autonomic Nervous System activity. Adolescents reported on SPS and on perceived stress before, during, and after TSST-M. As a follow-up analysis, the quality of the environment, the possible overlap with Neuroticism, and several covariates were considered. Multilevel models were used to investigate within- and between-person differences in stress reactivity across different systems. Results indicate significant individual differences in heart rate, heart rate variability, skin conductance, cortisol, and perceived stress in response to the TSST-M. Only for perceived stress significant differences in SPS were observed, with more sensitive individuals perceiving more negative and less positive affect. For environmental quality and the interaction between SPS and Neuroticism results showed higher recovery rates of heart rate in high quality environments and stronger cortisol responses for adolescents scoring high on both SPS and Neuroticism. Potential explanations for these findings and implications for current theorizing on environmental sensitivity are discussed.
... In this connection, some studies report changes in behavioral patterns under acute stress: an increase in response time (RT) and a fall in the rate of correct responses (CR) (Sänger, Bechtold, & Schoofs, 2014;Scholz et al., 2009). However, the laboratory studies mostly use reconstructed stressors of acute mental stress (Campbell & Ehlert, 2012;Pattyn et al., 2010;Shields, Rivers, Ramey, Trainor, & Yonelinas, 2019;Verschoor & Markus, 2011). ...
Article
Abstract An assessment-related stress is an object of interest of both educational and neurobiological research. In educational literature “feeling stressed” is measured by self-reports and mostly in the situation of high-stakes examinations before and after exam. In neurophysiological research “acute stress” is laboratory observed through controlled variables. However, the studies of functionally measured stress in real school context are missing in scientific literature. This article relates the results of a study carried out in a real school context during a class test. Stress data obtained through the functional measurement (HRV) in 16 students and behavioral data in 76 students were analyzed. The results show that class tests under assessment are more stressful compared to non-assessed tests. A decrease in number of correct responses and an increase in response time was observed. Girls show better performance and respond more slowly under assessment. The results are discussed in the scope of interdisciplinary research. Key words: stress response, class assessment test, HRV, performance, gender.
... Interestingly, the lack of stress-preventive effects of the test product on PSS in case of below average changes in cortisol suggests that this strain is less effective in the absence of HPA-axis activation. Although discrepancies between biological and behavioral stress-responses are common, 26 we speculate that lower HPA-axis activation may be indicative of a lack of anticipatory stress to public speech. ...
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Psychological stress negatively affects the intestinal barrier function in animals and humans. We aimed to study the effect of Lactobacillus rhamnosus CNCM I-3690 on intestinal permeability and stress-markers during public speech. Healthy students were randomized to L. rhamnosus-containing (test) or acidified (placebo) milk consumed twice daily for 4 weeks, with 46 subjects per treatment group. Small intestinal permeability was quantified by a 2 h urinary lactulose-mannitol ratio (LMR, primary outcome), fractional excretion of lactulose (FEL) and mannitol (FEM). Salivary cortisol, State-Trait Anxiety Inventory (STAI) and Perceived Stress scores (PSS) were collected. No between-treatment differences were found for LMR (p = .71), FEL or FEM. Within-treatment analyses showed similar LMR and FEL but a stress-induced increase of FEM with the placebo (p < .05) but not test product. Despite a similar increase in salivary cortisol, the stress-induced increase in STAI was significantly lower with the test product vs. placebo (p = .01). Moreover, a stress-preventative effect of the probiotic was found for PSS and more pronounced in subjects with high stress-induced cortisol (p = .01). While increased FEM was mediated by salivary cortisol levels, the effect of the test product on subjective stress was not mediated by changes in FEM. No serious adverse events occurred. In conclusion, we demonstrated that L. rhamnosus CNCM I-3690 prevented stress-induced hyperpermeability to mannitol. Subjective but not objective stress-markers were reduced with L. rhamnosus vs. placebo, suggesting anxiolytic effects, which were independent of barrier stabilization and attractive for the reduction of stress in both health and disease. Clinicaltrials.gov, number NCT03408691.
... Second, training using self-reports can have limited reliability as an assessment of the individual's subjective stress. Self-reported stress may not reflect the physiological stress response, may have low sensitivity to rapidly changing emotional states, and may be fabricated to avoid social judgement from colleagues or superiors (Campbell & Ehlert, 2012). Third, training pedagogies focus too much on task proficiency, which may be rigid and inflexible when faced with novel stressors, rather than how the individual manages stress during task execution (Delahaij et al., 2006). ...
Conference Paper
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Training systems are a potential stress countermeasure by simulating high stress conditions in a safe and controlled environment. Training often involves increasing the complexity of scenarios over time until trainees can reliably execute the task. However, several limitations reduce the long-term retention and robustness of training during intense acute stress felt in-situ. These limitations include generalized training practices that are not tailored to the individual, unreliability of self-reported subjective stress, over-trained skills that are inflexible and not robust to novel stressors, training pedagogies that focus too much on task proficiency rather how the individual manages stress during task execution, and ambiguity for when trainers should increase/decrease training difficulty. Adaptive systems are proposed as a supplement while training individuals to maintain task performance. An adaptive system is a joint human-computer system that is able to automate functions/tasks to varying degrees to help the user, often without explicit instruction. In the context of training for stressful tasks, an adaptive system could detect and monitor stress using physiological sensors and machine learning and use this information to modify scenarios to provide individualized training. This would allow coping skills to be practiced without overwhelming or under-stimulating the trainee’s stress tolerance, adapt training according to proficiency in both task execution and physiological stress, and offer clear benchmarks for when to increase/decrease training difficulty. Coupled with a simulated training environment, an adaptive system could adapt training by altering the task procedure and implicitly changing in the task environment to help the user build resilience to novel stressors. This paper presents conceptual approaches and applications for training stressful operations using adaptive systems. A generic adaptive stress training system framework is described along with recommendations based on an experimental example in the spaceflight domain for training emergency fire procedures in a virtual reality International Space Station.
... During the testing period, participants are video and audio recorded for later analyses of verbal and non-verbal behavior (Kirschbaum et al., 1993). In numerous studies, the robustness of the TSST was confirmed and the experiment showed strong and reliable cortisol stress responses (e.g., Allen et al., 2014;Campbell & Ehlert, 2012;Foley & Kirschbaum, 2010;Het et al., 2012). ...
Thesis
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Modern science understands stress as a complex process, and various aspects thereof have been associated with poor health. However, defining the term still is difficult and available stress assessment tools rely on different conceptualizations and target various aspects of stress. The aim of this dissertation is to clarify stress assessment components; thereby, the focus lies on three gaps in stress assessment. The empirical studies summarized in this thesis aim at closing these gaps by 1) Offering a new life stress assessment tool, 2) Discussing a new multi-modal approach to assess a laboratory stressful task, and 3) Presenting a new developed stimulus-response inventory to assess coping. Study one presents the German version of the ‘Stress and Adversity Inventory’ for adults to assess life stress exposure (Sturmbauer, Shields, et al., 2019). Study two presents an adapted real-life situation as an example for a new stress assessment protocol to experimentally induce arousal by investigating simulated medical consultations (Sturmbauer et al., 2022). Study three presents the ‘Coping Inventory for Medical Situations’ as a new tool to assess cognitive avoidant and vigilant coping addressed for researchers and clinicians working with patients in medical care (Sturmbauer, Hock, et al., 2019). Consequently, the three empirical studies are integrated into current research and matched with a published stress typology for precise stress assessment. Finally, future directions will emphasize the future applicability of the presented tools and conclude this thesis
... This system regulates the body's fight, flight, or freeze response, which is often associated with increased heart rate, shallow breathing and fatigue. This process can be activated in as little as a moment of real or imagined threatening stress (Campbell and Ehlert, 2012) and can leave the body susceptible to illness and disease, particularly when experienced frequently over time (Gouin et. al., 2008). ...
Preprint
Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxy-methamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a "breakthrough therapy," signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.
... First, while the lack of the stress condition's effect on mood and self-value may at first glance look like a failed manipulation, we maintain that this is not the case. A review of stress inductions and their relation to subjective measurements of their effects (such as on mood and self-value) has found that more often than not (i.e., in approximately 75% of the studies) a correspondence between objective (physiological) measures and subjective (psychological) measures of stress is lacking (Campbell and Ehlert, 2012). Although this discrepancy (i.e., finding an effect on objective measures but not on subjective measures) may seem problematic for one's ability to conclude that participants experienced stress, relatively 'harmless' reasons for this discrepancy seem most likely. ...
Article
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Literature concerning the relationship between social media use and wellbeing is inconsistent in its findings, and most research has focused on time spent on social media rather than on what emerging adults do there, with whom and why. Here, we investigated whether momentary social stress affects emerging adults’ social media use, and whether this social media use relates to subsequent changes in wellbeing. We implemented a multi-method paradigm utilising objective and self-report data to investigate how social stress relates to how (much) and why emerging adults use social media. We report on findings based on 114 17–25-year-old emerging adults recruited on university campus. Our findings suggest that social stress does not affect adolescents’ subsequent social media use and that there is no relationship between social media use after stress and changes in momentary wellbeing. Our work illustrates the need for detailed approaches in social media and psychological wellbeing research.
... symptoms at baseline. Moreover, a systematic review on the responsiveness to acute psychological stressors in healthy individuals indicated that only in approximately one quarter of the studies subjective emotional response corresponds with parameters of the physiological stress response [53]. At the same time, a considerable number of studies failed to detect any group differences in participants' emotional responses which queries the validity of self-reported data. ...
Article
Objective Irritable bowel syndrome (IBS) is a highly prevalent disorder of the gut-brain interaction characterized by abdominal discomfort and pain associated with altered bowel habits in the absence of structural abnormalities. Chronic psychological stress is considered a risk factor for the development of IBS. The multifactorial pathogenesis involves complex interactions between biological, psychological and social factors, yet the underlying mechanisms have not been fully understood. Methods We systematically reviewed the literature from the databases MEDLINE, Embase and PsycINFO to assess stress responsivity of patients with IBS in comparison to healthy individuals, specifically focusing acute psychological stressors. Results A total of 37 case–control studies were included in the narrative synthesis. Findings comprised subjective changes in emotion (k = 18) and of gastrointestinal symptoms (k = 8) as well as objective parameters of gastrointestinal motility (k = 10), autonomic nervous system (k = 23), hypothalamic–pituitary–adrenal axis (k = 11), functional brain activity (k = 7) and immune system (k = 3). Mental stress was found to increase IBS-specific symptomatology and alter gastrointestinal motility. Some patients with IBS showed stress-induced emotional hyperresponsivity and different patterns of neural activation. Autonomic and endocrine stress responses depend on the type of stressor and showed no clear evidence of differential reactivity, partly due to confounding factors. Data on acute immunological changes remains sparse and requires further investigation. Conclusions Current evidence suggests altered stress reactivity in patients with IBS however, it remains unclear whether it can be attributed to the syndrome itself or the high prevalence of psychiatric comorbidities.
... It should be noted that it is possible for self-reported stress levels to be discordant with the physiological stress levels of athletes, as they are a representation of their perception of the stress experienced. Moreover, such discordance was found in other studies utilizing laboratory-induced stress [70][71][72]. ...
Article
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Sport-related concussion is a serious public health issue affecting millions of individuals each year. Among the many negative side effects, emotional symptoms, such as stress, are some of the most common. Stress management is repeatedly cited by expert groups as an important intervention for this population. It was shown that music has relaxing effects, reducing stress through the activation of brain areas involved in emotions and pleasure. The objective of this study was to explore the effects of a music-listening intervention compared with silence on experimentally induced stress in concussed and non-concussed athletes. To this aim, four groups of athletes (non-concussed music, non-concussed silence, concussed music, and concussed silence) performed the Trier Social Stress Test, for which both physiological (skin conductance level) and self-reported stress measurements were taken. No significant difference was found in the pattern of stress recovery for self-reported measurements. However, the skin conductance results showed greater and faster post-stress recovery after listening to music compared with silence for concussed athletes only. Taken together, these results suggest that music could be an efficient stress management tool to implement in the everyday life of concussed athletes to help them prevent stress accumulation.
... Exclusion criteria were (a) current risk of suicide or self-harm (HRSD suicide item >2); (b) current substance abuse disorder; (c) current or past diagnosis of schizophrenia or psychosis, bipolar disorder, or severe eating disorder requiring medical monitoring; (d) history of organic mental or bodily disease; and (e) participating in psychotherapy in the last three months. Patients were enrolled in 16-session manualized psychotherapy for MDD, as part of a randomized control trial [33,34]. The study was approved by the relevant Institutional Review Board, and informed consent was obtained from all participants involved in the study. ...
Article
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The importance of the role of affect in psychotherapy for major depressive disorder (MDD) is well established, but the common use of self-reported measures may limit our understanding of its underlying mechanisms. A promising predictor of patient affect is the stress hormone cortisol. To date, no studies have studied in-session changes in cortisol in psychotherapy for MDD. We investigated whether an increase in patient cortisol over the course of a session correlated with higher negative and lower positive affect. Given previous findings on healthy individuals on the contagious nature of stress, an additional aim was to examine whether these relationships are moderated by therapist cortisol. To this end, 40 dyads (including 6 therapists) provided saliva samples before and after four pre-specified sessions (616 samples). After each session, the patients provided retrospective reports of in-session affect. We found no association between patient cortisol and affect. However, increases in patient cortisol predicted negative affect when the therapists exhibited decreases in cortisol, and increases in patient cortisol predicted positive affect when the therapists showed increases. Our study provides initial evidence for the importance of the social context in the cortisol–affect relationship in MDD.
... Moreover, significant correlations between cortisol responses and perceived stress scores were found using our digital version of the TSST. By comparison, approximately 25% of the studies using the standard TSST have found correspondence between physiological arousal and subjective emotional stress experience [26]. ...
Article
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(1) Background: In the present pilot study, we examined the response of cortisol to a digital version of the Trier Social Stress Test (TSST) and corresponding eating preferences in non-overweight and overweight adolescents. (2) Methods: The experimental study group included 35 adolescents aged 15.7 ± 0.5 years (16 boys and 19 girls). The participants were split into two groups: non-overweight (N = 24) and overweight (N = 11), according to the Body Mass Index (BMI). We induced acute stress in all participants, using a digital version of the Trier Social Stress Test (TSST), with three different digital tasks. We measured salivary cortisol before the test (T0), during the stress induction by digital tasks (T5, T10, T15), and 25 min after the stress test (T40). The Health Behavior in School-Aged Children Questionnaire (HBSC) was administered to assess the influence of stress on eating behavior: the consumption of fruit, vegetables, sweets, and soft drinks and the frequency of snacks. (3) Results: Among the entire group of adolescents, we observed a significant difference between the sexes in terms of cortisol response, girls being predominantly hyperreactive (13 girls compared to 5 boys, p = 0.03). In overweight adolescents, the cortisol reactivity was lower in boys and higher in girls (p = 0.05). The overweight hyperreactive adolescents, as compared to the hyporeactive ones, had a higher frequency of daily consumption of sweets (25% vs. 0%) and soft drink (25% vs. 0). (4) Conclusions: The individual patterns of cortisol reactivity to laboratory-induced stress could be associated with an increased risk of unhealthy eating behavior in adolescents.
... However, during the TSST a standardized stressor is used, whereas EMA studies measured subjective stress in daily life. One should therefore consider that even under laboratory conditions subjective stress and cortisol responses are not fully matched [176]. Especially among studies examining stressor severity within life domains among healthy individuals it is noteworthy that increased stressor severity was associated with higher levels of salivary cortisol when maximum time lags between those variables did not exceed 20 minutes [76,84,88,92] and that studies allowing for longer time lags found no such association [82,86,90,91]. ...
Article
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Objective This review aims to provide an overview of ecological momentary assessment (EMA) studies analyzing stress reactivity during daily life in terms of direct and moderated influence of acute stress on physiological responses. Materials and methods A systematic literature search was performed on November 29, 2021 using Web of Science, MEDLINE and PsycINFO to identify prospective EMA studies targeting acute stressors or stress under naturalistic conditions, without restrictions of publication date or population. Study quality was assessed for multiple EMA-specific sources of bias. Results Out of 4285 non-duplicate records, 107 publications involving 104 unique studies were included. The majority of studies assessed acute physiological stress responses primarily through salivary cortisol (n = 59) and cardiovascular outcomes (n = 32). Most studies performed at least three measurements per day (n = 59), and had a moderate risk of recall bias (n = 68) and confounding (n = 85). Fifty-four studies reported a compliance of ≥80%. Direct, non-moderated positive associations were observed between acute stress exposure and concurrent cortisol levels (44%, n = 11/25), systolic (44%, 8/18) and diastolic blood pressure (53%, 8/15) and heart rate (53%, 9/17). Several inter- and intra-individual moderators were identified, such as age, gender, health status, chronic stress, work-related resources, physical activity and stress coping indicators. Conclusions About half of the reviewed EMA studies demonstrated direct associations between everyday acute stress exposure and physiological responses, including increased cortisol levels, blood pressure and heart rate. Results further suggested various moderator variables that could help develop tailored prevention strategies and identify groups at higher risk for dysfunctional stress responses. Registration PROSPERO—Reg.-No.: PROSPERO 2020 CRD42020163178 .
... Stress reactivity is a multicomponent phenomenon, encompassing cognitive, emotional, physiological and behavioural responses (Campbell and Ehlert, 2012). Although the precise nature of emotion is not yet clear, theorists and researchers agree that emotion involves changes across multiple response systems (Gross et al., 2006). ...
Chapter
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Background. There is now a substantial body of evidence linking the baseline level of heart rate variability (HRV) with the magnitude of stress-induced changes in autonomic control of heart rate. However, the extent to which these interindividual differences in stress responses can be attributed to the statistical phenomenon of regression to the mean (RTM) remains unproven. We sought to test the hypothesis that the statistical artefact RTM explains part of the baseline effect. Methods. We illustrate the RTM effect using heart rate recording was carried out on 1233 volunteers, from which 137 were randomly
... Although people who reported higher levels of loneliness at baseline showed greater increases in inflammatory responsivity across both conditions, changes in loneliness did not explain changes in inflammatory response following either intervention. It is not uncommon in behavioral intervention research for psychosocial and biological outcomes to diverge (Campbell and Ehlert, 2012); improvements in psychosocial outcomes are commonly found following both mindfulness and active comparison interventions (influenced by many factors, including expectancies) (Goyal et al., 2014), whereas improvements in biological stress processes are often more specific to mindfulness intervention (Lindsay et al., 2018). Further research is needed to determine precise psychosocial mechanisms linking mindfulness training with changes in stress-related biological processes. ...
Article
Loneliness is a potent psychosocial stressor that predicts poor health and mortality among older adults, possibly in part by accelerating age-related declines in immunocompetence. Mindfulness interventions have shown promise for reducing loneliness and improving markers of physical health. In a sample of lonely older adults, this two-arm parallel trial tested whether mindfulness training enhances stimulated interleukin-6 (IL-6) production, a measure of innate immune responsivity. Lonely older adults (65-85 years; N=190) were randomized to an 8-week Mindfulness-Based Stress Reduction (MBSR) or control Health Enhancement Program (HEP) intervention. Lipopolysaccharide (LPS)-stimulated production of IL-6 was measured in vitro by blinded outcome assessors at pre-intervention, post-intervention, and 3-month follow-up. Mixed-effects linear models tested time (pre, post, follow-up) by condition (MBSR vs. HEP) effects. As predicted, a significant time × condition effect on stimulated IL-6 production was observed across pre, post, and follow-up timepoints. Significant MBSR vs. HEP differences emerged from pre- to post-intervention (p=.009, d=.38) and from pre-intervention to 3-month follow-up (p=.017, d=.35), with larger increases in IL-6 production following MBSR compared to HEP. No study-related adverse events were reported. Results show that mindfulness training may be effective for boosting innate immunocompetence among lonely older adults. Given that immunocompetence tends to decline with age, mindfulness training may help to counteract the effects of aging and psychosocial stress on infection risk and recovery from injury.
... We showed that the reduction of gesture, submissive and flight behaviors may represent the behavioral attempt to downregulate the heightened [21] anxiety experienced by participants with EDs in comparison to healthy peers. Furthermore, an association between the biological (cortisol) response and objectively assessed behaviors (submissiveness, gesture and gazing another's face) was observed both in women with EDs and in healthy women, while no significant association between physiological and psychological measurements was reported in previous studies in ED people [63] and in mixed psychiatric populations (for a review see Campbell & Ehlert, 2012). This supports the idea that objectively assessed non-verbal behaviors may be coupled with physiological measures more strongly than subjective psychological experiences. ...
Article
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Purpose Evidence that social difficulties promote the development and the maintenance of eating disorders (EDs) derive from self-reported data and only partially from experimental tasks. This study objectively assessed non-verbal behaviors of individuals with EDs in a psycho-social stress scenario. Methods Thirty-one women suffering from EDs (13 with anorexia nervosa and 18 with bulimia nervosa) and 15 healthy women underwent the Trier Social Stress Test (TSST), the paradigm of psycho-social stress, and were videotaped. Throughout the procedure, anxiety feelings were measured by the State-Trait Anxiety Inventory state subscale and saliva samples were collected to evaluate cortisol levels. Non-verbal behaviors were analyzed through the Ethological Coding System for Interviews and were compared between study samples through multivariate analysis of variance. Multivariate regression analyses were performed to assess the association between anxiety, cortisol and behavioral responses to TSST. Results Women with EDs showed reduced submissiveness, flight (cutoff from social stimuli) and gesture compared to healthy peers during TSST. Submissiveness and flight behaviors were negatively associated with stress-induced anxiety, while TSST-induced anxiety and cortisol increases were positively associated with looking at the other’s face behavior in participants with EDs. In this population, cortisol reactivity was also positively associated with submissiveness and negatively with gesture. Conclusion Women with EDs showed a hostile and freezing response to acute psycho-social stress: reduced submissiveness and flight may represent strategies to manage social anxiety. These findings confirm that the non-verbal behavior assessment provides complementary information to those derived from traditional measurements and suggests research and clinical implications. Level of evidence I Evidence obtained from experimental study .
... It should also be mentioned that subjective stress experience and physiological reactivity were not always congruent. This wellknown apparent incongruence (79) can arise from confounding factors such as age (80), sex (81) or the nature of the stressor. Other, external factors in larger samples may show different results. ...
Article
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Past research links depression and blunted cardiac vagal reactivity to chronic stress. Yet, to our knowledge no experiment investigates heart rate (variability) responses to a repeated laboratory stressor in patients with depression. Repeated exposure may provide valuable information on stress reactivity in depression. Fifty-nine women (30 inpatients diagnosed with depression and 29 matched controls) underwent two consecutive runs of a mental arithmetic stress paradigm consisting of one baseline and two exposures to control, stress, and recovery phases of 5 min each, in a case-control design. Subjective stress and electrocardiography were recorded. Variance of heart rate (HR) and root mean square of successive RR interval differences (RMSSD) were analyzed using linear mixed models. Overall, physiological parameters (HR and RMSSD) and subjective stress showed a strong group effect (all p < 0.001). In both groups, subjective stress and HR increased in response to stress, but the subjective stress levels of patients with depression did not return to baseline levels after the first stressor and for the remainder of the experiment (all p < 0.004 compared to baseline). Patients’ HR reactivity responded oppositely: while HR recovered after the first stress exposure, no reactivity was observed in response to the second exposure. These findings may suggest that the often-reported blunted HR/HRV response to stressors results from exhaustion rather than an incapacity to react to stress. The altered HR reactivity could indicate allostatic (over-) load in depression.
... For example, salivary cortisol levels collected throughout the day were shown to be associated with momentary negative affect in several AA studies (Jacobs et al., 2007;Schlotz, 2019). These and other encouraging findings support the view that reliable associations between indicators of different stress response levels (here: momentary stress ratings and cortisol) can be found when appropriate methods are applied, although a lack of significant covariation of stress indicators is a well-known phenomenon (Campbell and Ehlert, 2012;Fahrenberg, 1979). ...
Article
The LawSTRESS project is a controlled prospective-longitudinal study on psychological, endocrine, central nervous and genetic predictors of responses to long-lasting academic stress in a homogenous cohort. In this first project report, we focused on the association between daily life stress and the cortisol awakening response (CAR). The CAR, a distinct cortisol rise in the first 30 to 45 minutes after morning awakening, is a well-established marker of cortisol regulation in psychoneuroendocrinology. Law students from Bavarian universities (total n = 452) have been studied over a 13-months period at six sampling points starting 12 months prior exam. The stress group (SG) consisted of students experiencing a long-lasting and significant stress period, namely the preparation for the first state examination for law students. Law students assigned to the control group (CG) were studied over an equally long period without particular and sustained stress exposure. To investigate stress related alterations in the CAR, we examined a subsample of the LawSTRESS project consisting of 204 students with 97 participants from the SG (69.1% female, mean age = 22.84 ±1.82) and 107 from the CG (78.5% female, mean age = 20.95 ±1.93). At each sampling point, saliva samples for cortisol assessment were collected immediately upon awakening and 30 as well as 45 minutes later. Perceived stress in daily life was measured by repeated ambulatory assessments (about 100 queries over six sampling points). The time course of perceived stress levels in the two groups differed significantly, with the SG showing an increase in perceived stress until the exam and a decrease thereafter. Stress levels in the CG were relatively stable. The CAR was not significantly different between groups at baseline. However, a blunted CAR in the SG compared to the baseline measure and to the CG developed over the measurement timepoints and reached significance during the exam. Remarkably, this effect was neither associated with the increase in perceived stress nor with anxiety and depression symptoms, test anxiety and chronic stress at baseline. The present study successfully assessed multidimensional stress trajectories over 13 months and it documented the significant burden, law students preparing for the first state examination are exposed to. This period was related to a blunted CAR with presumed physiological consequences (e.g., on energy metabolism and immune function). Mean psychological stress levels as well as the CAR returned to baseline levels after the exam, suggesting a fast recovery in the majority of the participants.
... First, all three measures of anxiety did not always concur (see Supplementary Table 5). On the one hand, a dissociation between physiological and subjective measures of anxiety is very common (19,109) and seems to reflect a different response of the autonomic nervous system and of subjective (conscious) experience to perceived stress (19,110). A dissociation between heart rate and skin conductance reactions is also found in SAD (72). ...
Article
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Background Social anxiety disorder (SAD) is characterized by a significant amount of fear when confronted to social situations. Exposure therapy, which is based on fear extinction, does not often lead to full remission. Here, based on evidence showing that rapid eye movement (REM) sleep promotes the consolidation of extinction memory, we used targeted memory reactivation (TMR) during REM sleep to enhance extinction learning in SAD. Methods Forty-eight subjects with SAD were randomly assigned to two groups: control or TMR group. All patients had two successive exposure therapy sessions in a virtual reality (VR) environment, where they were asked to give a public talk in front of a virtual jury. At the end of each session, and only in the TMR group ( N = 24), a sound was paired to the positive feedback phase of therapy (i.e., approval of their performance), which represented the memory to be strengthened during REM sleep. All participants slept at home with a wearable headband device which automatically identified sleep stages and administered the sound during REM sleep. Participants' anxiety level was assessed using measures of parasympathetic (root mean square of successive differences between normal heartbeats, RMSSD) and sympathetic (non-specific skin conductance responses, ns-SCRs) activity, and subjective measures (Subjective Units of Distress Scale, SUDS), during the preparation phase of their talks before (T1) and after (T2) one full-night's sleep and after 1 week at home (T3). Participants also filled in a dream diary. Results We observed an effect of time on subjective measures of anxiety (SUDS). We did not find any difference in the anxiety levels of the two groups after 1 week of TMR at home. Importantly, the longer the total duration of REM sleep and the more stimulations the TMR group had at home, the less anxious (increased RMSSD) these participants were. Finally, fear in dreams correlated positively with ns-SCRs and SUDS at T3 in the TMR group. Conclusion TMR during REM sleep did not significantly modulate the beneficial effect of therapy on subjective anxiety. Yet, our results support that REM sleep can contribute to extinction processes and substantiate strong links between emotions in dreams and waking stress levels in these patients.
... A common assumption regarding alpha power, backed by a significant body of research, is that alpha power is inversely proportional to cortical activity as it likely reflects an inhibitory control system of the brain (Allen et al., 2004;Jensen and Mazaheri, 2010;Mathewson et al., 2011). The reduction of alpha power can therefore be explained by the fact that the psychosocial stress response leads to a state of higher arousal and vigilance as well as the activation of the HPA axis (Campbell and Ehlert, 2012;Kudielka et al., 2004), which leads to higher cortical activity so the individual can correctly cope and adapt to the applied stressor. The results and the accompanying meta-analysis provide convincing evidence to conclude that frontal alpha power is significantly impacted (i.e., reduced) by psychosocial stress, although some caution is warranted. ...
Article
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Whereas the link between psychosocial stress and health complications has long been established, the influence of psychosocial stress on brain activity is not yet completely understood. Electroencephalography (EEG) has been regularly employed to investigate the neural aspects of the psychosocial stress response, but these results have not yet been unified. Therefore, in this article, we systematically review the current EEG literature in which spectral analyses were employed to investigate the neural psychosocial stress response and interpret the results with regard to the three stress phases (anticipatory, reactive, and recovery) in which the response can be divided. Our results show that three EEG measures, alpha power, beta power and frontal alpha asymmetry (FAA), are commonly utilized and that alpha power consistently decreases, beta power shows a tendency to increase, and FAA varies inconsistently. We furthermore found that whereas changes in alpha power are independent of the stress phase, and changes in beta power show a relative stress phase independent trend, other EEG measures such as delta power, theta power, relative gamma and theta-alpha power ratio show less stress phase independent changes. Meta-analyses conducted on alpha power, beta power and FAA further revealed a significant effect size (hedge's g = 0.6; p = 0.001) for alpha power, but an insignificant effect size for beta power (hedge's g = −0.31; p = 0.29) and FAA (hedge's g = 0.01, p = 0.93). From our results, it can be concluded that psychosocial stress results in significant changes in some spectral EEG indices, but that more research is needed to further uncover the precise (temporal) mechanisms underlying these neural responses.
... Although we tried to limit the effect of social desirability during the VSRI, it is still possible that members overreported stress events to preserve a positive image of themselves as the game motivation was high. In contrast, some members may have underreported "stressful" moments within the VSRI (Campbell and Ehlert 2012). Namely, participants could have felt physiologically stressed, without them describing it necessarily in such a way. ...
Article
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Team stress is an emergent cognition in which members jointly appraise their current task situations. The sharedness of stress appraisals has been elaborately studied in social groups such as couples, families, friends, and small communities. However, insights into teams have been rather limited. Keeping in mind the effects of stress on teams, it is essential to understand how team stress will form in teams over time. Seven dyad teams were observed during a 13-min flight simulation task. Researchers used the course of action analysis to reconstruct and distinguish one top-down (i.e., the shared stress configuration) and three bottom-up configuration types (i.e., the mimic, interactive, and independent stress configurations). Our findings suggest that especially the bottom-up influence of social stressors plays an important role in the team stress, especially when members verbally interact with one another. This proposes that, in comparison to the influence of contextual factors, diverse empathic processes play a more distinct role in the formation of team stress than initially thought in teams. This article also intends to illustrate how team stress can be studied over time, and how this type of output can contribute to a more fine-grained theoretical understanding of how team stress forms over time in teams. Last, it also provides some basic practical insights into the design of stress feedback systems.
... While research on the psycho-social causes of health inequalities is arguably too diverse as to be described as a unified theory, Elstad [12] has identified three core assumptions: 1) that the unequal distribution of stress is an important determinant of health inequalities in affluent societies, 2) that stress is significantly influenced by the individual's social relations, and 3) that the quality of the latter is influenced by overall levels of social inequity. Emotional distress may affect biological processes in the body directly (e.g. the association between stress and heart disease), or indirectly (e.g. the association between stress and risk behaviours) [13][14][15][16][17]. Typical psycho-social determinants include experiences of relative deprivation, work-related stress, lack of job autonomy, lack of social capital, and experiences of discrimination and stigma, as well as the negative life events and stressors that having a low SES may entail. ...
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Aims: While Marxist class analysis has strongly influenced the development of health inequality research, other aspects of Marx's theory have received less attention. Among the most relevant of Marx's theoretical contributions for social inequalities in health is the theory of alienation. As empirical applications of the theory of alienation are currently scarce, the purpose of this commentary is to invigorate interest in alienation theory within the field of health inequality research by demonstrating its potential to illuminate the relationship between social inequality, psycho-social affects and health outcomes. Results: Alienation theory describes how the class structure of capitalist societies creates experiences of powerlessness, estrangement and isolation. These experiences are further posited as emerging from the exploitation of labour, thus connecting social inequality to psychological wellbeing. Alienation theory is particularly compatible with psycho-social explanations of health inequalities, which similarly posits that social inequality affects health through psychological mechanisms. We argue that alienation theory contributes in three ways to health inequality research: a) by suggesting potential mechanisms and offering predictions that may be put to use in empirical research, b) by providing a potential explanation of the welfare state paradox, and c) by situating the psycho-social determinants of health within a critical analysis of the sources of social inequality in capitalist society. Conclusions: Alienation theory may provide a more textured understanding of the relationship between inequality and psycho-social health, while also foregrounding issues of class, power and exploitation that are often absent from psycho-social explanations.
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Previous research has shown that relaxation interventions can reduce distress, anxiety, and depression. The exact mechanisms that underlie the efficacy of relaxation interventions remain unresolved. This study aimed to investigate whether applied relaxation (AR) leads to changes in cortisol secretion and whether these effects mediate fewer symptoms due to AR. Data come from a randomized controlled preventive interventional trial (N = 277) with elevated tension/distress, anxiety, or depressive symptomatology. Participants were randomized to an intervention group (IG; n = 139, received AR training), or a non-interventional control group (CG, n = 138). Psychopathological symptoms were assessed with DASS-21 and diagnoses of mental disorders via DIA-X-5. Cortisol was measured as short-term index in saliva (six times/d for 2 d at pre-, post-, and follow-up [FU] assessment) and long-term index in hair samples (once at pre-assessment and FU, respectively). Data were analyzed as pre-specified secondary analyses of the randomized controlled trial (RCT) on completer basis (n = 134 CG, n = 102 IG), using multivariable-adjusted linear regression models and mediation analyses (the DASS-21 change in the IG vs. CG with cortisol (area under the curve [AUC]) as mediator). From pre- to post-assessment, total daily salivary cortisol (AUC) decreased more strongly in the IG vs. CG (β-coefficient: -13.83, 95% confidence interval [CI]: -26.85 to -0.81), but was rendered non-significant when adjusting for pre-assessment AUC. This effect was not found for the cortisol awakening response (CAR) or hair cortisol. There was no evidence for a mediation of cortisol (AUC). These findings provide little support for the idea that cortisol reductions explain the beneficial effects of AR on mental health.
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Driven by the need to inform evidence-based intervention strategies for performance and health promotion in esports, this thesis aimed to provide a starting point for future research on esports and, in particular, psychophysiological stress in esports. To this end, this work began by addressing why and how sport and exercise psychology could research esports. Following this, a systematic review of the literature on stress in non-competitive and competitive esports was performed. The results indicated that playing esports in competitive settings–in contrast to non-competitive settings–seems to be related to psychophysiological stress responses, and also highlighted a number of theoretical and methodological limitations with research in this area. To build on this initial understanding of stress in esports, a qualitative study was conducted that explored the subjective experiences of professional players. Here, a variety of stressors, perceived stress responses, and coping strategies were identified. To complete the work, a different perspective and approach was taken, using an online questionnaire to investigate perceived performance factors and stress management strategies utilized by sport psychologists and performance coaches in esports. Overall, this work provided a number of implications for future research and applied practice that are addressed in this thesis.
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This study investigated psychological stress-induced blood pressure (BP) elevation according to self-measured data obtained by a wearable watch-type oscillometric device for multiple days in 50 working hypertension patients (mean ± SD age: 60.5 ± 8.9 years; 92.0% men; 96% treated for hypertension). Participants were asked to self-measure their BPs at five predetermined times as well as at any additional time points at their own discretion under ambulatory conditions for a maximum of 7 days. At the time of each BP measurement, participants self-reported their location, emotion, and degree of stress. A total of 1220 BP readings with self-reported situational information were obtained from 50 participants over 5.5 ± 1.2 days. Systolic BP (SBP) and diastolic BP (DBP) measured during moments of self-reported negative emotions (i.e., anger, tension, anxiety, or sadness) were significantly higher (5.0 ± 1.3 and 2.0 ± 0.8 mmHg, both p < 0.05) than those during moments of self-reported positive emotions (i.e., happiness or calm). SBP/DBP were significantly increased under a moderate or high degree of stress by [4.5 ± 1.1]/[2.5 ± 0.7] and [10.2 ± 3.0]/[4.7 ± 1.8] mmHg, respectively. As a result, it was estimated that SBP/DBP increased 15.2/8.5 mmHg in the presence of highly stressful negative emotions. In conclusion, self-measurement of BP monitoring with a wearable device for multiple days is a feasible method to detect daily stress-induced BP elevation in working adults.
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Research indicates that animal-assisted therapy programs can reduce stress responses. However, animals are not always permitted in public settings. Thus, alternative forms to the physical presence of an animal could be beneficial. The objective of this study was to determine (1) whether exposure to an active-dog video can help improve subjective and physiological responses to stress more than a tranquil-dog video, (2) whether exposure to dog videos can improve subjective and physiological stress responses more than nature videos, and (3) whether exposure to dog (and nature) videos can improve subjective and physiological stress responses more than a control video. Participants (n = 103; female = 78, male = 25) completed a stressful task and were randomly assigned to watch one of five videos: active dog (dog playing with a toy), tranquil dog (dog lying down quietly), active nature (fast-paced waterfall in a forest), tranquil nature (slow-moving stream in a forest), or blank screen (control video; a video of a black screen). Improvements in subjective (i.e., decrease in stress, anxiety, negative affect, and/or increase in happiness, relaxation, positive affect) and physiological (decrease in heart rate and blood pressure) responses to the stressor were examined. This study found no evidence that the active-dog video improved subjective or physiological responses more than the tranquil-dog video. However, this study found evidence that dog videos can decrease subjective anxiety and increase positive affect more than nature videos. Similarly, this study also found that dog videos can decrease subjective anxiety and increase happiness and positive affect more than can the control video. The effects of the dog videos and nature videos (and control video) on the remaining subjective measures and all physiological responses did not differ. Together, the results show some evidence that dog videos may be better at improving subjective anxiety, happiness, and positive affect responses than nature and/or control videos. However, the results did not show evidence that dog videos could alleviate any physiological responses more than the other videos. Practical applications of these findings include how to improve subjective anxiety and affect responses in public settings (e.g., universities) when animals are not allowed.
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For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Objective Conduct disorder (CD) involves aggressive and antisocial behavior and is associated with blunted cortisol stress response in male youths. Far less is known about cortisol stress responsivity in female youths with CD or other neuroendocrine responses in both sexes. Although CD is linked to early adversity, the possibility that neuroendocrine alterations may mediate the relationship between early adversity and CD has not been systematically investigated. Method Within the European FemNAT-CD multi-site study, salivary cortisol, testosterone, the testosterone/cortisol ratio, oxytocin, and psychological stress response to a standardized psychosocial stress test (the Trier Social Stress Test) together with common pre- and postnatal environmental risk factors were investigated in 130 pubertal youths with CD (63% female, 9-18 years) and 160 sex-, age-, and puberty-matched healthy controls (HCs). Results The TSST induced psychological stress in both CD and HCs. In contrast, female and male youths with CD showed blunted cortisol, testosterone, oxytocin, and testosterone/cortisol stress responses compared to HCs. These blunted stress responses partly mediated the relationship between environmental risk factors and CD. Conclusion Findings from this unique sample, including many female youths with CD, provide evidence for a widespread attenuated stress responsivity of not only stress hormones, but also sex hormones and neuropeptides in CD and its subgroups (e.g., with limited prosocial emotions). Results are the first to demonstrate blunted neuroendocrine stress responses in both female and male youths with CD. Early adversity may alter neuroendocrine stress responsivity. Biological mechanisms should be investigated further to pave the way for personalized intervention, thereby improving treatments for CD.
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Autonomic nervous system function and thereby bodily stress and recovery reactions may be assessed by wearable devices measuring heart rate (HR) and its variability (HRV). So far, the validity of HRV-based stress assessments has been mainly studied in healthy populations. In this study, we determined how psychosocial stress affects physiological and psychological stress responses in both young (18-30 yrs) and middle-aged (45-64 yrs) healthy individuals as well as in patients with arterial hypertension and/or either prior evidence of prediabetes or type 2 diabetes. We also studied how an HRV-based stress index (Relax-Stress Intensity, RSI) relates to perceived stress (PS) and cortisol (CRT) responses during psychosocial stress. Approach: A total of 197 participants were divided into three groups: 1) healthy young (HY, N=63), 2) healthy middle-aged (HM, N=61) and 3) patients with cardiometabolic risk factors (Pts, N=73, 32-65 yrs). The participants underwent a group version of Trier Social Stress Test (TSST-G). HR, HRV (quantified as root mean square of successive differences of R-R intervals, RMSSD), RSI, PS, and salivary CRT were measured regularly during TSST-G and a subsequent recovery period. Main results: All groups showed significant stress reactions during TSST-G as indicated by significant responses of HR, RMSSD, RSI, PS, and salivary CRT. Between-group differences were also observed in all measures. Correlation and regression analyses implied RSI being the strongest predictor of CRT response, while HR was more closely associated with PS. Significance: The HRV-based stress index mirrors responses of CRT, which is an independent marker for physiological stress, around TSST-G. Thus, the HRV-based stress index may be used to quantify physiological responses to psychosocial stress across various health and age groups.
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Peripersonal space (PPS) is the region of space surrounding the body. It has a dedicated multisensory-motor representation, whose purpose is to predict and plan interactions with the environment, and which can vary depending on environmental circumstances. Here, we investigated the effect on the PPS representation of an experimentally induced stress response and compared it to a control, non-stressful, manipulation. We assessed PPS representation in healthy humans, before and after a stressful manipulation, by quantifying visuotactile interactions as a function of the distance from the body, while monitoring salivary cortisol concentration. While PPS representation was not significantly different between the control and experimental group, a relation between cortisol response and changes in PPS emerged within the experimental group. Participants who showed a cortisol stress response presented enhanced visuotactile integration for stimuli close to the body and reduced for far stimuli. Conversely, individuals with a less pronounced cortisol response showed a reduced difference in visuotactile integration between the near and the far space. In our interpretation, physiological stress resulted in a freezing-like response, where multisensory-motor resources are allocated only to the area immediately surrounding the body.
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It is increasingly recognized that psychological stress is linked with type 2 diabetes mellitus and its late complications. Thus, the aim of the current study was to investigate the psychophysiological response to acute psychosocial stress in patients with type 2 diabetes. In total, 53 type 2 diabetes patients with complications, 16 type 2 diabetes patients without complications, and 47 age and gender matched non-diabetic participants underwent the Trier Social Stress Test. Subjective as well as biological parameters (i.e., blood levels of cortisol, adrenocorticotropic hormone (ACTH), norepinephrine, methylglyoxal) were assessed repeatedly before and after stress induction. Data were analyzed by means of multilevel regression. Patients with type 2 diabetes showed an exaggerated cortisol response to acute stress as compared to age matched control participants (diabetes*T2 est. = 1.23, p < .001), while stress-induced alterations of ACTH and subjective parameters did not differ. Norepinephrine levels were lower among patients (diabetes est. = −4.36, p = .044) and tended to decrease earlier than in controls. The subjective reaction of type 2 diabetes patients with complications was stronger than that of patients without complications (complication*T2 est. = −1.83, p = .032), while their endocrine response to stress was similar. Stress had no effect on methylglyoxal level, and there were no group differences regarding methylglyoxal response. These results show that the cortisol reactivity of patients with type 2 diabetes to acute psychosocial stress is increased compared to a control group. Thus, alterations of the hypothalamus-pituitary-adrenal axis – especially regarding its dynamic regulation – are a plausible link between psychological stress and type 2 diabetes and its complications.
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Birth by Caesarean-section (C-section), which increases the risk for metabolic and immune disorders, disrupts the normal initial microbial colonisation of the gut, in addition to preventing early priming of the stress and immune-system priming. Animal studies have shown there are enduring psychological processes in C-section born mice. However, the long-term impact of microbiota-gut-brain axis disruptions due to birth by C-section on psychological processes in humans is unknown. Forty age matched healthy young male university students born by C-section and 36 vaginally delivered male students were recruited. Participants underwent an acute stressor, the Trier social stress test (TSST), during a term-time study visit. A subset of participants also completed a study visit during the university exam period, representing a naturalistic stressor. Participants completed a battery of cognitive tests and self-report measures assessing mood, anxiety, and perceived stress. Saliva, blood, and stool samples were collected for analysis of cortisol, peripheral immune profile, and the gut microbiota. Young adults born by C-section exhibit increased psychological vulnerability to acute stress and a prolonged period of exam-related stress. They did not exhibit an altered salivary cortisol awakening response to the TSST, but their measures of positive affect were significantly lower than controls throughout the procedure. Both C-section and vaginally-delivered participants performed equally well on cognitive assessments. Most of the initial effects of delivery mode on the gut microbiome did not persist into adulthood as the gut microbiota profile showed modest changes in composition in adult vaginally-delivered and C-sectioned delivered subjects. From an immune perspective, concentrations of IL-1β and 1L-10 were higher in C-section participants. These data confirm that there is a potential enduring effect of delivery mode on the psychological responses to acute stress during early adulthood. The mental health implications of these observations require further study regarding policies on C-section use.
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Psychedelic medicine is an emerging field that examines entheogens, psychoactive substances that produce non-ordinary states of consciousness (NOSC). 3,4-methylenedioxymethamphetamine (MDMA) is currently in phase-3 FDA clinical trials in the United States (US) and Canada to treat the symptoms of posttraumatic stress disorder (PTSD). MDMA is used in conjunction with manualized therapy, because of its effectiveness in reducing fear-driven stimuli that contribute to trauma and anxiety symptoms. In 2017, the FDA designated MDMA as a “breakthrough therapy,” signaling that it has advantages in safety, efficacy, and compliance over available medication for the treatment of trauma-, stress-, and anxiety-related disorders such as PTSD. In the US and Canada, historical and contemporary racial mistreatment is frequently experienced by Black people via a variety of macro and micro insults. Such experiences trigger physiological responses of anxiety and fear, which are associated with chronically elevated stress hormone levels (e.g., cortisol and epinephrine), similar to levels documented among those diagnosed with an anxiety disorder. This paper will explore the benefits of entheogens within psychedelic assisted-therapy and their potential benefits in addressing the sequelae of pervasive and frequent negative race-based experiences and promoting healing and thriving among Black, Indigenous and other People of Color (BIPOC). The author(s) discuss the ethical responsibility for providing psychedelic-assisted therapy within a culturally competent provider framework and the importance of psychedelic researchers to recruit and retain BIPOC populations in research and clinical training.
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Fast and accurate decision-making are central in police officers’ duties. The processing of information relevant to inform decisions can be biased by the state of mind of officers, notably in the presence of stressful conditions. We sought to examine the link between different sources of stress and the presence of an interpretation bias in a task presenting ambiguous faces. A sample of 234 Canadian police officers took part in an online study measuring the number of stressful life events and the level of occupational stress. Participants were assigned to a stress-induced group or a control group. The stress induction was a challenging arithmetic task and the control task was a non-challenging arithmetic task. Participants indicated if the facial expression of 60 ambiguous faces was ‘negative’ or ‘positive’. The dependent measure was the mean number of positive interpretations. Perceived stress level, measured on a visual analogue scale, collected throughout the task indicated that the induction was successful. We found no difference in interpretations resulting from the stress induction. We did however find a significant negative correlation between the perceived stress measures and the interpretation of the faces; higher levels of perceived stress were associated with less positive interpretations. The number of stressful life events and occupational stress level were not associated with face interpretation. Paperwork and fatigue were reported as the most stressful aspects of the job by the officers, consistent with what has been found in studies conducted with police services worldwide. This study also highlights the relevance of perceived stress in police officers. Keywords: interpretation, occupational stress, perceived stress, stressful life events, ambiguous faces
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Mild traumatic brain injury (mTBI) is one of the most common injuries experienced by Veterans and can frequently result in a variety of post-concussive symptoms. Post-concussive headaches (PCH), one of the most common symptoms, can persist for years after the injury occurred. The long-lasting impacts of PCH can be extremely distressing for Veterans, thus necessitating the need to find reliable biomarkers that directly relate to subjective feelings of distress. Yoga-based interventions have been shown to improve both subjective and objective markers of stress. Techniques used in yoga, such as the focus on releasing muscular tension, are also recommended as strategies for treating PCH. Thus, yoga-based interventions provide a unique context for the comparison of subjective and objective measures of distress in Veterans with PCH. In this secondary, exploratory analysis, we examined the relationship between perceived distress and cortisol in sixteen Veterans with mTBI and long-term PCH within the context of a yoga intervention feasibility study. The Visual Analogue Scale (VAS), a validated tool for measuring subjective distress, was administered to participants immediately before and after 75-min yoga classes, which occurred twice weekly over eight weeks. Participants also provided salivary cortisol (pre- and post-yoga) at in-person sessions (eight) to compare to changes in VAS scores. We found that VAS scores were significantly reduced within five of the eight assessed yoga classes, but there were no significant changes in cortisol levels. No significant correlations were found between VAS scores and salivary cortisol levels. When looking at how cortisol levels changed over time (i.e., over the series of eight yoga sessions), there was a significant downward trajectory in post-yoga cortisol, but not after taking pre-class cortisol into account (i.e., within yoga session cortisol change over time). Taken together, we found that subjective distress, but not cortisol was reduced by yoga classes. These data suggest that salivary cortisol did not match changes in perceived distress, thus emphasizing the ongoing challenges of relating subjective and objective measures.
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Objectives: To determine the covariance of heart rate variability (HRV) and self-reported neurobehavioral symptoms after traumatic brain injury (TBI) collected using mobile health (mHealth) technology. Setting: Community. Participants: Adults with lifetime history of TBI (n = 52) and adults with no history of brain injury (n = 12). Design: Two-week prospective ecological momentary assessment study. Main measures: Behavioral Assessment Screening Tool (BASTmHealth) subscales (Negative Affect, Fatigue, Executive Dysfunction, Substance Abuse, and Impulsivity) measured frequency of neurobehavioral symptoms via a RedCap link sent by text message. Resting HRV (root mean square of successive R-R interval differences) was measured for 5 minutes every morning upon waking using a commercially available heart rate monitor (Polar H10, paired with Elite HRV app). Results: Data for n = 48 (n = 38 with TBI; n = 10 without TBI) participants were included in covariance analyses, with average cross-correlation coefficients (0-day lag) varying greatly across participants. We found that the presence and direction of the relationship between HRV and neurobehavioral symptoms varied from person to person. Cross-correlation coefficients r ≤ -0.30, observed in 27.1% to 29.2% of participants for Negative Affect, Executive Dysfunction, and Fatigue, 22.9% of participants for Impulsivity, and only 10.4% of participants for Substance Abuse, supported our hypothesis that lower HRV would covary with more frequent symptoms. However, we also found 2.0% to 20.8% of participants had positive cross-correlations (r ≥ 0.30) across all subscales, indicating that higher HRV may sometimes correlate with more neurobehavioral symptoms, and 54.2% to 87.5% had no significant cross-correlations. Conclusions: It is generally feasible for community-dwelling adults with and without TBI to use a commercially available wearable device to capture daily HRV measures and to complete a short, electronic self-reported neurobehavioral symptom measure for a 2-week period. The covariance of HRV and neurobehavioral symptoms over time suggests that HRV could be used as a relevant physiological biomarker of neurobehavioral symptoms, though how it would be interpreted and used in practice would vary on a person-by-person and symptom domain basis and requires further study.
Chapter
Um polizeiliche Einsatzkräfte angemessen auf kritische Einsätze im Dienst vorzubereiten, sollten sie im möglichst realitätsnahen Einsatztraining erleben, wie Stress ihre Kognition und ihr Verhalten beeinflusst. Vor dem Hintergrund des Rahmenmodells der ökologischen Dynamiken stellt dieser Beitrag vor, wie Einsatztrainer*innen die Aufgabe, die Umgebung und die individuellen Voraussetzungen des/der Trainierenden so gestalten können, dass der/die Trainierende individualisierte Bewältigungsstrategien und funktionale Problemlösungen zum Umgang mit Stressreaktionen entwickeln kann. Allerdings erschweren der Mangel an repräsentativen Einsatzdaten, die Individualität in der Stressreaktion und die Unkenntnis über das optimale Stressniveau im Training die Gestaltung von Stress auslösenden Szenarien in der Praxis. Die Echtzeiterfassung von physiologischen Stressreaktionen hat das Potenzial für ein individualisiertes Einsatztraining unter Stress.
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Stress influences episodic memory formation via noradrenaline and glucocorticoid effects on amygdala and hippocampus. A common finding is the improvement of memory for central aspects of a stressful episode. This is putatively related to changes in the neural representations of specific experiences, i.e., their memory traces. Here we show that the memory improvement for objects that were encountered in a stressful episode relates to differences in the neural representations of these objects in the amygdala. Using functional magnetic resonance imaging, we found that stress specifically altered the representations of central objects: compared to control objects, they became more similar to one another and more distinct from objects that were not part of this episode. Furthermore, higher similarity of central objects to the main stressor—the faces of the stress-inducing committee members—predicted better memory. This suggests that the central objects were closely integrated into a stressor-centered memory representation. Our findings provide mechanistic insights into how stress shapes the memory trace and have profound implications for neurocognitive models of stressful and emotional memory.
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One pathway through which stressors are thought to influence physiology is through their effects on emotion. We used meta-analytic statistical techniques with data from nine studies to test the effects of acute laboratory stressors (speech, star mirror-image tracing, handgrip) on emotional (undifferentiated negative emotion, anger, anxiety) and cardiovascular (CV) response. In all of the studies, participants responded to stressors with both increased CV response and increased negative emotion. Increases in negative emotion were associated with increases in CV response across tasks, however, these associations were small. The range of variance accounted for was between 2% and 12%. Thus, the contribution of negative emotion, as assessed in these studies, to physiological responses to acute laboratory stressors was limited. Although these results raise questions about the role of emotion in mediating stress-elicited physiological responses, the nature of the acute laboratory stress paradigm may contribute to the lack of a strong association.
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One hundred fifteen college students were exposed to an evaluative speech task twice, separated by 2 weeks. At both sessions, we assessed cardiovascular, endocrine, immune, and psychological response at baseline and during the task. We found stability across sessions for stress-induced increases in anxiety and task engagement, heart rate, blood pressure, norpinephrine (but not epinephrine), cortisol, natural killer cell cytotoxicity, and numbers of circulating CD3+, CD8+, and CD56+ (but not CD4+ or CD19+) lymphocytes. The stable cardiovascular, immune, and endocrine reactivities were intercorrelated, providing evidence of a unified physiological stress response across these outcomes. Although stable stress-induced increases in task engagement were associated with the physiological stress responses, stress-induced anxiety was not.
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Researchers have theorized that changing the way we think about our bodily responses can improve our physiological and cognitive reactions to stressful events. However, the underlying processes through which mental states improve downstream outcomes are not well understood. To this end, we examined whether reappraising stress-induced arousal could improve cardiovascular outcomes and decrease attentional bias for emotionally negative information. Participants were randomly assigned to either a reappraisal condition in which they were instructed to think about their physiological arousal during a stressful task as functional and adaptive, or to 1 of 2 control conditions: attention reorientation and no instructions. Relative to controls, participants instructed to reappraise their arousal exhibited more adaptive cardiovascular stress responses-increased cardiac efficiency and lower vascular resistance-and decreased attentional bias. Thus, reappraising arousal shows physiological and cognitive benefits. Implications for health and potential clinical applications are discussed.
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It is well established that a lack of social support constitutes a major risk factor for morbidity and mortality, comparable to risk factors such as smoking, obesity, and high blood pressure. Although it has been hypothesized that social support may benefit health by reducing physiological reactivity to stressors, the mechanisms underlying this process remain unclear. Moreover, to date, no studies have investigated the neurocognitive mechanisms that translate experiences of social support into the health outcomes that follow. To investigate these processes, thirty participants completed three tasks in which daily social support, neurocognitive reactivity to a social stressor, and neuroendocrine responses to a social stressor were assessed. Individuals who interacted regularly with supportive individuals across a 10-day period showed diminished cortisol reactivity to a social stressor. Moreover, greater social support and diminished cortisol responses were associated with diminished activity in the dorsal anterior cingulate cortex (dACC) and Brodmann's area (BA) 8, regions previously associated with the distress of social separation. Lastly, individual differences in dACC and BA 8 reactivity mediated the relationship between high daily social support and low cortisol reactivity, such that supported individuals showed reduced neurocognitive reactivity to social stressors, which in turn was associated with reduced neuroendocrine stress responses. This study is the first to investigate the neural underpinnings of the social support-health relationship and provides evidence that social support may ultimately benefit health by diminishing neural and physiological reactivity to social stressors.
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Although previous studies of emotional responding have found that women are more emotionally expressive than men, it remains unclear whether men and women differ in other domains of emotional response. We assessed the expressive, experiential, and physiological emotional responses of men and women in 2 studies. In Study 1, undergraduates viewed emotional films. Compared with men, women were more expressive, did not differ in reports of experienced emotion, and demonstrated different patterns of skin conductance responding. In Study 2, undergraduate men and women viewed emotional films and completed self-report scales of expressivity, gender role characteristics, and family expressiveness. Results replicated those from Study 1, and gender role characteristics and family expressiveness moderated the relationship between sex and expressivity.
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Abuse and neglect are highly prevalent in children and have enduring neurobiological effects. Stressful early life environments perturb the hypothalamic-pituitary-adrenal (HPA) axis, which in turn may predispose to psychiatric disorders in adulthood. However, studies of childhood maltreatment and adult HPA function have not yet rigorously investigated the differential effects of maltreatment subtypes, including physical abuse. In this study, we sought to replicate our previous finding that childhood maltreatment was associated with attenuated cortisol responses to stress and determine whether the type of maltreatment was a determinant of the stress response. Salivary cortisol response to the Trier Social Stress Test (TSST) was examined in a non-clinical sample of women (n = 110). Subjects had no acute medical problems and were not seeking psychiatric treatment. Effects of five maltreatment types, as measured by the Childhood Trauma Questionnaire, on cortisol response to the TSST were investigated. To further examine the significant (p < 0.005) effect of one maltreatment type, women with childhood physical abuse (PA) (n = 20) were compared to those without past PA (n = 90). Women reporting childhood PA displayed a significantly blunted cortisol response to the TSST compared with subjects without PA, after controlling for estrogen use, age, other forms of maltreatment, and other potential confounds. There were no differences between PA and control groups with regard to physiological arousal during the stress challenge. In a non-clinical sample of women with minimal or no current psychopathology, physical abuse is associated with a blunted cortisol response to a psychosocial stress task.
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Anxiety vulnerability is associated with biases in attention: a tendency to selectively process negative relative to neutral or positive information. It is not clear whether this bias is: 1) related to the physiological response to stressful events, and 2) causally related to the development of anxiety disorders. We tested the predictive value of both preconscious and conscious attention biases in a prospective study of stress reactivity in a nonclinical sample. One hundred four male participants were assessed at baseline and then again 4 months (n = 82) and 8 months later (n = 70). Salivary cortisol and self-report measures were obtained at the baseline testing session in addition to measures of biased attention. Subsequent emotional reactivity was assessed by means of salivary cortisol and self-reported state-anxiety responses during a laboratory-based stressor (4 months later) as well as during a real-life stressor 8 months later (i.e., examination period). Regression analyses indicated that a preconscious negative processing bias was the best predictor of the cortisol response to stressful events. Importantly, a measure of selective processing provided a better indicator of subsequent emotional reactivity than self-report measures of neuroticism, trait-anxiety, and extraversion. These results suggest that preconscious biases toward negative material play a causal role in heightened anxiety vulnerability. Our results illustrate the potential utility of preconscious biases in attention in providing an early marker of anxiety vulnerability and a potential target for treatment intervention.
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Sex differences in emotional responding have been repeatedly postulated but less consistently shown in empirical studies. Because emotional reactions are modulated by cognitive appraisal, sex differences in emotional responding might depend on differences in emotion regulation. In this study, we investigated sex differences in emotional reactivity and emotion regulation using a delayed cognitive reappraisal paradigm and measured whole-brain BOLD signal in 17 men and 16 women. During fMRI, participants were instructed to increase, decrease, or maintain their emotional reactions evoked by negative pictures in terms of cognitive reappraisal. We analyzed BOLD responses to aversive compared to neutral pictures in the initial viewing phase and the effect of cognitive reappraisal in the subsequent regulation phase. Women showed enhanced amygdala responding to aversive stimuli in the initial viewing phase, together with increased activity in small clusters within the prefrontal cortex and the temporal cortex. During cognitively decreasing emotional reactions, women recruited parts of the orbitofrontal cortex, the anterior cingulate, and the dorsolateral prefrontal cortex to a lesser extent than men, while there was no sex effect on amygdala activity. In contrast, compared to women, men showed an increased recruitment of regulatory cortical areas during cognitively increasing initial emotional reactions, which was associated with an increase in amygdala activity. Clinical implications of these findings are discussed.
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Home baseline and laboratory stressor (Trier Social Stress Test for Children) measures of salivary cortisol were obtained from 82 participants (40 girls) aged 9, 11, 13, and 15 years. Measures of pubertal development, self-reported stress, parent reports of child depressive symptoms and fearful temperament, and cardiac measures of sympathetic and parasympathetic activity were also obtained. Significant increases in the home cortisol baselines were found with age and pubertal development. Cortisol stress reactivity differed by age group with 11-year-olds and 13-year-old boys showing blunted reactivity and 9-year-olds, 13-year-old girls, and 15-year-olds showing significant cortisol reactions. Cortisol reactivity correlated marginally with sexual maturation. Measures of sympathetic activity revealed increased sympathetic modulation with age. Higher sympathetic tone was associated with more fearful temperament, whereas greater cortisol reactivity was associated with more anxious and depressed symptoms for girls. The importance of these findings for the hypothesis that puberty-associated increases in hypothalamic-pituitary-adrenal axis activity heightens the risk of psychopathology is discussed.
Conference Paper
The brain circuitry underlying emotion includes several territories of the prefrontal cortex (PFC), the amygdala, hippocampus, anterior cingulate, and related structures. In general, the PFC represents emotion in the absence of immediately present incentives and thus plays a crucial role in the anticipation of the future affective consequences of action, as well as in the persistence of emotion following the offset of an elicitor. The functions of the other structures in this circuit are also considered. Individual differences in this circuitry are reviewed with an emphasis on asymmetry within the PFC and activation of the amygdala as 2 key components of affective style. These individual differences are related to both behavioral and biological variables associated with affective style and emotion regulation. Plasticity in this circuitry and its implications for transforming emotion and cultivating positive affect and resilience are considered.
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A review of 41 clinical and 54 analogue studies was undertaken to evaluate the relationship between anxiety response channels—physiological, behavioral and cognitive. The results indicated that congruence among response channels tended to be higher for the clinical populations than for the analogue populations. The data tend best to support Hodgson and Rachman's (1974) theory that anxiety channel congruence increases as a function of intensity of the anxiety. Tentative support was found for Bernstein and Paul's (1971) assertion that analogue and clinical subjects are sufficiently dissimilar as to obstruct the generalization of findings from one population to the other. Lastly, the congruence patterns suggest that behavioral and cognitive measures are less reliable indices of anxiety than physiological measures, especially in analogue samples.
Article
Despite strong popular conceptions of gender differences in emotionality and striking gender differences in the prevalence of disorders thought to involve emotion dysregulation, the literature on the neural bases of emotion regulation is nearly silent regarding gender differences (Gross, 2007; Ochsner & Gross, in press). The purpose of the present study was to address this gap in the literature. Using functional magnetic resonance imaging, we asked male and female participants to use a cognitive emotion regulation strategy (reappraisal) to down-regulate their emotional responses to negatively valenced pictures. Behaviorally, men and women evidenced comparable decreases in negative emotion experience. Neurally, however, gender differences emerged. Compared with women, men showed (a) lesser increases in prefrontal regions that are associated with reappraisal, (b) greater decreases in the amygdala, which is associated with emotional responding, and (c) lesser engagement of ventral striatal regions, which are associated with reward processing. We consider two non-competing explanations for these differences. First, men may expend less effort when using cognitive regulation, perhaps due to greater use of automatic emotion regulation. Second, women may use positive emotions in the service of reappraising negative emotions to a greater degree. We then consider the implications of gender differences in emotion regulation for understanding gender differences in emotional processing in general, and gender differences in affective disorders.
Article
Emotions seem to come and go as they please. However, we actually hold considerable sway over our emotions: We influence which emotions we have and how we experience and express these emotions. The process model of emotion regulation described here suggests that how we regulate our emotions matters. Regulatory strategies that act early in the emotion-generative process should have quite different outcomes than strategies that act later. This review focuses on two widely used strategies for down-regulating emotion. The first, reappraisal, comes early in the emotion-generative process. It consists of changing how we think about a situation in order to decrease its emotional impact. The second, suppression, comes later in the emotion-generative process. It involves inhibiting the outward signs of emotion. Theory and research suggest that reappraisal is more effective than suppression. Reappraisal decreases the experience and behavioral expression of emotion, and has no impact on memory. By contrast, suppression decreases behavioral expression, but fails to decrease the experience of emotion, and actually impairs memory. Suppression also increases physiological responding in both the suppressors and their social partners.
Article
Under social-evaluative stress, self-reported anxiety (cognitive and somatic),behavioural anxiety (motor, facial, verbal and social), physiological arousal (heart rate and skinresistance level), and task performance (cognitive and motor) were recorded. There was low, buttheoretically meaningful, concordance across response systems: significant relationshipsappeared among measures of cognitive aspects, and among those concerned with somaticaspects, but not between these two areas. Furthermore, concordance was higher in females thanin males specifically between the two response systems that can be voluntarily controlled (i.e.,self-report and behaviour) and the noncontrollable system (i.e., physiological arousal). Thesedifferences in concordance as a function of gender are explained in terms of emotional responsesuppression or masking in males.
Article
Researchers interested in emotion have long struggled with the problem of how to elicit emotional responses in the laboratory. In this article, we summarise five years of work to develop a set of films that reliably elicit each of eight emotional states (amusement, anger, contentment, disgust, fear, neutral, sadness, and surprise). After evaluating over 250 films, we showed selected film clips to an ethnically diverse sample of 494 English-speaking subjects. We then chose the two best films for each of the eight target emotions based on the intensity and discreteness of subjects' responses to each film. We found that our set of 16 films successfully elicited amusement, anger, contentment. disgust, sadness, surprise, a relatively neutral state, and, to a lesser extent, fear. We compare this set of films with another set recently described by Philippot (1993), and indicate that detailed instructions for creating our set of film stimuli will be provided on request.
Article
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
Article
Objective: In the vulnerability-stress concept of schizophrenia, schizophrenic patients are thought to display increased sensitivity to stress. Little is known about the biological mechanisms that are involved in stress processing in schizophrenic patients. In this study, hypothalamic-pituitary-adrenal (HPA) function in schizophrenic patients was studied for its essential role in stress processing and adaptation to the environment. Methods: Eighteen schizophrenic patients were compared to 21 healthy controls in their salivary cortisol response to a physical (bicycle ergometry) and a psychosocial (public speaking) stressor. Coping questionnaires were included as a measure of stress processing at the psychological level. Basal HPA function was assessed by measuring cortisol day profiles and feedback activity by using dexamethasone and hydrocortisone. Results: Schizophrenic patients showed blunted cortisol responses to the psychosocial stressor, but not to the physical stressor, in spite of similar increases in heart rate. The cortisol response to the psychosocial stressor tended to be negatively correlated to the use of passive and avoidant coping strategies. Basal HPA function appeared intact in the schizophrenic patients. Conclusions: The findings show a selective impairment in the response to psychosocial stress in schizophrenic patients. This suggests the involvement of brain systems that play a role in the activation of the HPA system to psychosocial stress, like arginin-vasopressin (AVP), and cognitive processes, like coping.
Conference Paper
Recent behavioral medicine studies have revealed that some hormones secreted in human body sensitively changes according to his/her mental stress. Thus it is expected as an objective measurement of mental stress. However this newly developed interdisciplinary studies frequently showed inconsistent results. Some technical reasons were indicated for this discrepancy. Above all, we focused on the fact that in all these studies the only method introduced to estimate the relationship between the level of hormones and the subjective stress scale was the correlation analysis. In this study we employed Rough set analysis in place of conventional linear correlation analysis for mining the relationship between a subjective stress scale, “Profile of Mood Scale” (POMS), and a well known stress biomarker, salivary cortisol. As a developing result, numbers of items (inquiries in POMS) which relatively associated with cortisol level were found, whereas no significant linear correlation was obtained between them.
Article
Recent findings suggest that elevated stress levels during the pre- and postpartum period are related to poor maternal and infant health outcomes; yet, few studies have prospectively examined the efficacy of stress management interventions on regulating stress levels among mothers and their infants. The current study examined whether a prenatal cognitive behavioral stress management (CBSM) intervention would be effective in regulating salivary cortisol (a biological marker of stress) and self-reported stress levels among mothers and their infants at six and 18 months postpartum, relative to two control groups. Our sample was comprised of predominantly Spanish-speaking, low-income women (80%; mean age=25±5 years) who were screened for depression during their second trimester of pregnancy (M=16±5 weeks of gestation). Women at high risk for depression [i.e., having either a past history of major depression or current elevated symptoms of depression (≥16 on CES-D)] were randomized to either a CBSM group (n=24) or a usual care (UC) group (n=33), while a low risk comparison (LRC) group (n=29) was comprised of women not meeting either depression criteria. ANCOVA analyses demonstrated that: (1) infants of women in the CBSM and LRC groups had significantly lower cortisol levels than infants of women in the UC group at six months postpartum (p<.001); and (2) women in the CBSM group had lower cortisol levels than women in the UC group at 18 months postpartum (p<.01). These results suggest that prenatal CBSM interventions may be efficacious in regulating biological markers of stress among mothers and their infants, thereby decreasing their risk for developing health complications over time.
Article
Studies regarding the interrelation of perceived and physiological stress indices have shown diverging results. Using a population sample of adolescents (N=715, 50.9% girls, mean age 16.11 years, SD=0.59), we tested three hypotheses: (1) perceived responses during social stress covary with concurrent physiological stress responses; (2) high pretest levels of perceived stress predict large physiological responses; and (3) large physiological responses to social stress predict low posttest perceived stress levels. Perceived arousal, unpleasantness, and dominance were related to heart rate, respiratory sinus arrhythmia, and cortisol responses to a laboratory social stress test. Although effect sizes were small, the results suggest covariation of perceived stress and concurrent physiological stress responses in both the ANS and the HPA axis, as well as inverse associations between heart rate responsiveness and the subsequent appraisal of stress.
Article
Food consumption in stressful situations vary as a function of individual difference factors (e.g., emotional vs. non-emotional eating), and may be related to hormonal responses elicited by the stressful event. These hormonal responses may be tied to specific emotions elicited by the stressful event. The present investigation examined the emotional and hormonal (cortisol, ghrelin) responses of high and low emotional eaters following a laboratory stressor (Trier Social Stress Test; TSST). Women (n=48) either high or low in emotional eating status were tested in a TSST or served as controls during which blood samples were taken for analysis of cortisol and ghrelin, both of which have been implicated in eating and in response to stressors. The TSST promoted elevated cortisol levels, being somewhat more pronounced in emotional than in non-emotional eaters. Both shame and anger were provoked by the TSST, and although both these emotions were correlated with cortisol levels, only anger significantly mediated the relationship between the stressor and cortisol levels. As well, baseline ghrelin levels in low emotional eaters exceeded that of high emotional eaters, and increased moderately in response to the stressor situation, irrespective of emotional eating status. Interestingly, when provided with food, ghrelin levels declined in the non-emotional eaters, but not in emotional eaters. The possibility is offered that the lack of a decline of ghrelin in emotional eaters may sustain eating in these individuals.