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... In this model, greater RSA reflects greater activity and integration of a neural network involved in cognitive, affective, and autonomic regulation in response to changing environmental demands. More recently, emphasizing the psychobiology of stress, the Generalized Unsafety Theory of Stress has proposed that higher resting RSA reflects general perceptions of safety versus threat (Brosschot et al., 2017). As Smith et al. (2020) point out, these perspectives are complementary, a common key insight being that the "vagus nerve is intimately involved in regulating humans' emotional responses to their social environment" (Muhtadie et al., 2015, p. 110). ...
... Although informed by social functioning conceptualizations of RSA, such a moderation effect would also be consistent with the Generalized Unsafety Theory of Stress (Brosschot et al., 2017). Physiologically perceiving discriminatory episodes as less threatening (i.e., lower RSA reactivity) might also help maintain social engagement in the mainstream culture. ...
... For example, it is possible that people who have acculturated to the mainstream culture to a greater extent because of various other individual differences (e.g., openness to experience of self-efficacy) are under less chronic stress as a result. This may in turn have led to increases in RSA (Brosschot et al., 2017;Thayer et al., 2009). Longitudinal research will be necessary to conclusively establish temporal precedence. ...
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Objective: This cross-sectional study examines associations between cardiac vagal control and mainstream acculturation by systematically investigating the independent contributions of resting, reactivity, and recovery Respiratory Sinus Arrhythmia (RSA)-physiological factors contributing to adaptive functioning, including social engagement capacity. This study also examines the moderating role of RSA reactivity in associations between perceived ethnic discrimination and mainstream acculturation. Method: The sample comprised 111 migrants from Maghreb (Morocco, Algeria, and Tunisia) to Montreal, QC, Canada. On average, participants (60 women) were 31 years old and had immigrated 7 years prior to the study. The study design was cross-sectional. We collected both psychophysiological (electrocardiogram) and self-report questionnaire data. Results: All three facets of cardiac vagal control are independently associated with mainstream acculturation: Higher mainstream acculturation was associated with higher resting RSA (β = .24), lower RSA reactivity (β = -.27), and higher recovery RSA (β = .26), controlling for several theoretically relevant covariates. Furthermore, lower RSA reactivity to a discrimination-recall task dampened the relation between perceived discrimination and mainstream acculturation (interaction β = -.20). Conclusions: This study replicates and extends prior work linking RSA and mainstream acculturation using a sample of racialized and marginalized migrants. It provides evidence that RSA is related to migrants' adoption of the mainstream culture and may modulate how they handle perceived ethnic discrimination. Thus, this study also provides evidence that RSA is tied to how individuals successfully navigate novel social environments, including novel cultural contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... Context-inappropriate affective responding and vmHRV can be understood within the Generalized Unsafety Theory of Stress (GUTS; Brosschot et al., 2017). In contrast to the classical conditioning view that negative emotional responses are learned (Watson & Rayner, 1920), GUTS posits that the default response of an organism is the defense/stress response. ...
... GUTS underscores resting vmHRV as an important marker of such top-down inhibitory processes. Specifically, higher levels of vmHRV reflect greater top-down PFC resources that are needed to inhibit subcortical threat circuits and hence suppress the default stress response (Brosschot et al., 2017;Thayer et al., 2012;Thayer & Lane, 2009). ...
... The SR (i.e., eye blink) is often elicited by auditory stimulation and assessed by electromyographic (EMG) activity of the orbicularis oculi muscle. Given that the SR is closely related to the prototypical fightor-flight stress response (Cannon, 1932), the SR can be used to index the default stress response (Brosschot et al., 2017;Yang & Friedman, 2017). Consistent with GUTS, low resting vmHRV (less top-down resources to inhibit the default stress response) has been associated with increased SR magnitude (Melzig et al., 2009), less SR habituation (Gorka et al., 2013), and greater SR potentiation in fear extinction (Pappens et al., 2014;Wendt et al., 2015Wendt et al., , 2019. ...
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Vagally mediated heart rate variability (vmHRV) is thought to index top–down control processes in emotion regulation. According to the Generalized Unsafety Theory of Stress (GUTS), resting vmHRV indexes top–down resources that are needed to inhibit subcortical threat circuits, which is important for context‐appropriate affective responding. Although this notion has been supported by studies of affective startle (SR) modification, direct evidence that top–down resources are the linking mechanism between vmHRV and context‐appropriate affective responding has been lacking. To investigate this possible mechanism, college‐aged participants (n = 92) were recruited to complete a picture viewing task and a concurrent working memory (WM) task. Concurrent WM load was manipulated, and the auditory SR stimulus was delivered while viewing affective pictures. Electrocardiography and electromyography were recorded to assess vmHRV and SR eyeblink, respectively. Results showed that WM load attenuated affective SR modification. As expected, the attenuating effects of load on affective SR modification were stronger among low vmHRV relative to high vmHRV individuals, indicating that vmHRV is linked to context‐appropriate affective responding through the mechanism of top–down resources. These results support the GUTS and suggest that atypical affective responding among low vmHRV individuals is attributed to the lack of WM resources. Our findings highlight the relation between vmHRV and top–down resources that have been implicated in emotion regulation and contribute to a better understanding of emotion dysregulation in psychopathology.
... This study was based on stress theory and expanded on previous studies to build a model of factors affecting fatigue in breast cancer patients receiving radiotherapy. In particular, the Generalized Unsafety Theory of Stress (GUTS) stipulates that social and environmental factors, as well as uncertainties and stressors can cause health risks and illness [24]. This theory considers psychological factors and explains the causal relationship between stress and illness more comprehensively than the conventional stress theory [24]. ...
... In particular, the Generalized Unsafety Theory of Stress (GUTS) stipulates that social and environmental factors, as well as uncertainties and stressors can cause health risks and illness [24]. This theory considers psychological factors and explains the causal relationship between stress and illness more comprehensively than the conventional stress theory [24]. Path setting of the main concept was based on a literature review, and the included factors affecting the fatigue of breast cancer patients undergoing radiotherapy were symptom assessment, anxiety and depression, social support, uncertainty, and stress [20,[25][26][27]. ...
... Uncertainty was a variable directly affecting fatigue. These results are consistent with the conceptual framework suggesting that uncertainty is a key concept in GUTS theory and leads to a stress response causing health problems [24]. Uncertainty was highly correlated with higher levels of fatigue in studies of young breast cancer survivors two to four years after treatment [44]. ...
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Fatigue in breast cancer patients undergoing radiotherapy has been studied less comprehensively than fatigue from chemotherapy. The aim of this study was to test the impact of psycho-social factors on the fatigue among breast cancer patients undergoing radiotherapy. This was a cross-sectional correlational study and participants were 210 breast cancer patients currently undergoing radiotherapy in an outpatient setting in Korea. Data collection was carried out from 22 July to 30 September 2019. The results of this study showed that symptom assessment, anxiety and depression, uncertainty, and perceived stress had a direct effect on the fatigue of breast cancer patients receiving radiotherapy, while social support had an indirect effect. These factors explained 67.2% of the fatigue among the participants. This study confirmed that various interventions for symptom assessment, anxiety and depression, uncertainty, and stress reduction need to be developed to reduce fatigue of breast cancer patients receiving radiotherapy. The present results form the basis for developing such interventions.
... Feeling safe in a place of residence is important for quality of life in advanced age (Bowling et al., 2003). Perceived unsafety underlies stress and anxiety responses (Brosschot et al., 2017) and may alter older people's mobility and participation in their community lives (Bowling et al., 2003;Farrall et al., 2009). Most research on feelings of unsafety experienced by older adults has focused on fear of crime (Ceccato & Bamzar, 2016;Hale, 1996;Tulloch, 2000), while research on various perceived reasons of unsafety in late life is very limited (Won et al., 2016). ...
... Hence, there is a need for a theoretically based analytic approach that takes into consideration multiple reasons of unsafety and allows to determine whether these perceived reasons have a unique contribution to the overall feelings of unsafety. The current study addresses this research gap by applying the Generalized Unsafety Theory of Stress (GUTS) (Brosschot et al., 2017(Brosschot et al., , 2018 and explores fear of crime, health limitations, infrastructure problems, and social climate as independent perceived reasons of unsafety experienced by older adults, while controlling for a range of socio-demographic factors. Gaining such understanding of different reasons for perceived unsafety in advanced age is important because it can guide preventive efforts and initiatives aimed at promoting safety. ...
... According to GUTS, perceived generalized unsafety may result from one or several compromised life domains and does not require a specific stressor or a threat (Brosschot et al., 2017(Brosschot et al., , 2018. Examples of such compromised domains include the body (e.g., physical illnesses or functional limitations), social networks (feeling lonely or disconnected from others), and the environmental context (e.g., unfavourable perception of one's housing or neighbourhood). ...
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Feeling safe is important for quality of life in advanced age. The current study aimed to investigate whether different perceived reasons for unsafety uniquely contribute to the feelings of unsafety in the neighbourhood and at home while ageing. Data from a cross-sectional survey study on older adults living independently in Sweden were analysed (N = 622, age range 64–106 years, 60.6% female). Binary logistic regressions revealed unique associations between fear of crime, unattractive social climate in the neighbourhood, and inconvenient infrastructure at home with experienced feelings of unsafety, while controlling for socio-demographic factors. When distinguishing between reasons for feeling unsafe in the neighbourhood and at home, different associations with socio-demographic factors emerged. Higher age was positively associated with health-related unsafety both in the neighbourhood and at home and was not related to fear of crime neither in the neighbourhood nor at home. Female gender was associated with both health-related unsafety and fear of crime in the neighbourhood and with health-related unsafety at home. Overall, the findings highlight the presence of a range of perceived reasons of unsafety relevant for older adults and the importance to consider these subjective unsafety reasons in further research and practice.
... As such, stress regulation and coping is essentially emotion regulation (Lazarus, 1993). We have argued that despite decades of stress research, most stress theories still cannot account for the large amount of prolonged stress-related physiological responses that are responsible for the deleterious effects of stress on health (Brosschot et al., , 2017(Brosschot et al., , 2018. We have argued that this is due to a wrong focus of stress theories on stressors and not what is the "active ingredient," which we propose, is perceived safety. ...
... We have argued that this is due to a wrong focus of stress theories on stressors and not what is the "active ingredient," which we propose, is perceived safety. A detailed discussion of stress theories is beyond the scope of the present article but several reviews exist in the literature (Brosschot et al., , 2017(Brosschot et al., , 2018Kivimäki & Steptoe, 2018;O'Connor et al., 2020). What is common to all stress theories is the notion that prolonged physiological dysregulation, such as exaggerated stress responses, blunted stress responses, or lack of perceived safety, is necessary for stress to have harmful effects on health. ...
... The autonomic imbalance idea of Julius (1995) and the generalized unsafety theory of stress (GUTS) model both take a neurobiological, evolutionary approach to understanding the effects of stress on health (Brosschot et al., , 2017(Brosschot et al., , 2018. As Julius noted "The sympathetic overactivity in hypertension reflects a chronic activation of the defense/ vigilance reaction." ...
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Darwin emphasized the intimate relationship between the brain and the heart over 150 years ago. Healthy aging is associated with significant changes in both the brain and the heart. The changes between these, the two most important organs of the body, are linked via the vagus nerve. In this review we examine the normative changes with aging and the effect that stress may have on how the brain-heart connection changes with age. We provide a framework based on the concept of neurovisceral integration and propose that stress regulation is emotion regulation. As such, studies that have investigated emotion regulation may yield insights into successful stress regulation that helps protect people from age-related decline. In addition, interventions that improve brain health also improve heart health and vice versa. We conclude by noting that significant sex and ethnic differences exist but that future studies are needed to more fully explicate how they may moderate the associations between stress and aging.
... However, the duration of the responseincluding anticipation and recovery -, and the response's alignment with stressor type and intensity matter as well. Two recent contributions to stress theorythe Perseverative Cognition Hypothesis and the Generalized Unsafety Theory (Brosschot et al, 2005(Brosschot et al, , 2017)shift focus from response magnitude to duration, and therefore provide an important framework for future psychoneuroimmunology (PNI) research. ...
... Two relatively recent contributions to stress theory, the Perseverative Cognition Hypothesis and the Generalized Unsafety Theory, draw attention to stress response duration and explain prolonged responses (Brosschot et al, 2005(Brosschot et al, , 2017. Perseveration, or recurrent, intrusive thoughts that precede or follow a stressor, extend the psychological and physiological consequences of a stressor. ...
... Twelve years later, Brosschot et al. crafted the Generalized Unsafety Theory to explain physiological stress responses that occur even outside of the context of an objective threat (Brosschot et al., 2017). This theory posits that the stress response is default, and people can vary in the extent to which it is inhibited even when they are in the same situation, depending on whether they recognize safety cues. ...
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Stress exposure is inevitable, and major life events often precede depression onset. However, a majority do not develop depression after a major life event. Inflexible physiological responses to stress, in which the magnitude or duration is disproportionate to the stressor, may increase risk for depression – especially in the context of frequent or repetitive stress. Although past psychoneuroimmunology (PNI) research focused primarily on stress response magnitude, two relatively recent stress theories – the Perseverative Cognition Hypothesis and Generalized Unsafety Theory – shift the focus to response duration, including anticipatory reactivity and poor recovery. Using these theories as framework, this article reviews evidence suggesting that psychological inflexibility, such as perseverative cognition, and the inability to recognize safety promote heightened and prolonged (i.e., inflexible) physiological stress responses. Moreover, interventions that increase psychological flexibility or safety recognition may foster more flexible physiological responses to psychological stress. By adopting the lens of flexibility to examine physiological responses to stress, PNI will speak the same language as clinical psychology, which has identified inflexibility as an etiological and maintenance factor of depression.
... Anxiety is sometimes described as a psychological response that is exacerbated in response to the unpredictable nature of seizures, and to restriction of life activities resulting in low self-esteem, stigmatization and social rejection [27]. Anxiety can also be conceptualized in neurophysiological and neurobiological terms; for example, psychosocial stress in the form of chronic anxiety has been described as a dysregulated physiological response of the organism to perceived unsafe conditions [31]. The main factors associated with anxiety are not necessarily epilepsy-related, since they concern history of depression, educational level, unemployment or female gender, chronic ill health, perceived side effects of antiepileptic medication but not the duration of epilepsy [32]. ...
... However, prolonged or intense exposure to stressful events leading to prolonged stress responses can potentially lead to tissue damage and disease. In addition, depending on characteristics of the individual in terms of their resilience and vulnerability to stressful events, the stress response may be more or less exaggerated and/or prolonged [31]. From the physiological point of view stress is a variable arising from the physical or social environment. ...
... The exhaustion stage appears when the stressful event occurs in long duration or strong intensity, so resources cannot be restored. Building on Selye's work, a recent model [31] has conceptualized chronic stress (and chronic anxiety) in terms of the innate default state of readiness of all organisms to produce a stress response, which when not required must be appropriately inhibited by prefrontal-limbic circuitry. Dysfunction of perception of and/or reaction to signals relating to safety of the individual in his or her current environment may therefore lead to a chronic state of perceived unsafety, accompanied by physiological and psychobehavioral responses to this. ...
Article
The prevalence of psychological distress, especially depressive and anxiety disorders, is higher in epilepsy than in other chronic health conditions. These comorbid conditions contribute even more than epileptic seizures themselves to impaired quality of life in patients with epilepsy (PWE). The link between these comorbidities and epilepsy appears to have a neurobiological basis, which is at least partly mediated by stress through psychological and pathophysiological pathways. The impact of stress in PWE is also particularly important because it is the most frequently reported seizure trigger. It is therefore crucial for clinicians to take stress-related conditions and psychiatric comorbidities into account when managing PWE and to propose clinical support to enhance self-control of stress. Screening tools have been specially designed and validated in PWE for depressive disorders and anxiety disorders (e.g. NDDI-E, GAD-7). Other instruments are useful for measuring stress-related variables (e.g. SRRS, PSS, SCS, MHLCS, DSR-15, ERP-R, QOLIE-31) in order to help characterize the individual "stress profile" and thus orientate patients towards the most appropriate treatment. Management includes both pharmacological treatment and nonpharmacological methods for enhancing self-management of stress (e.g. mindfulness-based therapies, yoga, cognitive-behavioral therapies, biofeedback), which may not only protect against psychiatric comorbidities but also reduce seizure frequency.
... Equally importantly, a growing body of evidence suggests that vagal tone is likely to be influenced by the quality of an individual's social relationships and social experiences. The generalized unsafety theory of stress posits that vagal tone will be reduced under conditions of threat (Brosschot et al., 2017). In the context of actual danger, this reduction in vagal tone is useful in facilitating adaptive stress responses (e.g., fight or flight) (Maier & Watkins, 1998). ...
... In the context of actual danger, this reduction in vagal tone is useful in facilitating adaptive stress responses (e.g., fight or flight) (Maier & Watkins, 1998). Several studies, for example, have found short-term links between situational changes in perceptions of threat vs. safety and corresponding short-term changes in vagal tone (Brosschot et al., 2016(Brosschot et al., , 2017Smith et al., 2020). Social baseline theory suggests that the absence of supportive others violates the default expectations of the brain, and is thus likely to create at least a mild degree of heightened experience of threat (Coan & Sbarra, 2015). ...
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Understanding whether and how the absence of positive relationships may predict longer-term physical health outcomes is central to building a working conceptual model of the interplay of social and physical development across the lifespan. This study sought to examine the extent to which difficulties establishing positive social relationships from adolescence onward serve as long-term predictors of low adult vagal tone, which in turn has been linked to numerous long-term health problems. A diverse community sample of 141 individuals was followed via multiple methods and reporters from age 13 to 29. Across this span, social relationship quality was assessed via close friend and peer reports, observations of romantic interactions, and self-reported romantic relationship satisfaction. A range of potential personality and functional covariates was also considered. Vagal tone while at rest was assessed at age 29. Adult vagal tone was predicted across periods as long as 16 years by: adolescents’ difficulty establishing themselves as desirable companions among peers; early adults’ inability to establish strong close friendships; and lack of warmth in romantic relationships as an adult. Poor early adult friendship quality statistically mediated the link from adolescent peer difficulties to adult vagal tone. A range of potential confounding factors was examined but was not linked to vagal tone. Within the limits of the correlational design of the study, robust connections between adult vagal tone and social relationship quality from adolescence onward suggest at least a possible mechanism by which relationship difficulties may get ‘under the skin’ to influence future physiological functioning.
... It has been suggested that IU is a biological phenomenon and that all people are born with an innate tendency to be intolerant of uncertainty, as it is evolutionarily adaptive to be afraid of the unknown (Brosschot et al., 2016(Brosschot et al., , 2017. According to this model, this genetic stress response is said to be the "default" and it is inhibited by feelings of safety. ...
... Previous studies using both child and adult samples have suggested a directional causality from autism traits to intolerance of uncertainty to anxiety. Such models do not easily account for the evolutionary model of learned tolerance for uncertainty suggested by Brosschot et al. (2016Brosschot et al. ( , 2017. Based on previous work we anticipate a strong positive association between selfreported autism traits and self-reported anxiety. ...
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Several models of anxiety in autistic adults have focused on the role of intolerance of uncertainty which has biological and evolutionary bases, as a cognitive explanation for the high prevalence of anxiety in autism. This framework suggests that all people are born with a healthy level of intolerance of uncertainty, and as we develop, this intolerance is lessened as we learn when situations are safe and begin to understand and manage the uncertainty. This process of learning about managing uncertainty does not happen in the same way in those who are high in autistic traits, which could be the reason for the high levels of anxiety symptoms commonly seen in this population. We examined archival data of 199 non-autistic and 55 autistic adults from prior studies in which we collected self-report measures of autistic traits, intolerance of uncertainty, sensory processing, and anxiety. We conducted two path analyses to examine the role of intolerance of uncertainty in anxiety in autistic adults. The first model tested the idea that intolerance of uncertainty, an evolutionary phenomenon common for all people, could explain some of the cognitive aspects of anxiety in autism. The second model suggests that primary neurodevelopmental differences associated with autistic traits underlie the sensory sensitivity and sensory seeking behaviors, which in turn increase intolerance of uncertainty and subsequent anxiety. We found that the “neurodevelopmental” model had better model fit than the “evolutionary stress” model, suggesting that the neurodevelopmental impact of higher levels of autistic traits could moderate a non-autistic trajectory of learning to manage uncertainty as children develop and understand that uncertainty is common and acceptable.
... Others have proposed relationships between safety and stress (Bond et al., 2010;Dollard and McTernan, 2011;Brosschot et al., 2017;Slavich, 2020) that focus on constructs previously explored by the Polyvagal Theory (Porges, 2007). For example, the relationship between safety and stress forms the basis for the Generalized Unsafety Theory of Stress (GUTS) proposed by Brosschot et al. (2017). ...
... Others have proposed relationships between safety and stress (Bond et al., 2010;Dollard and McTernan, 2011;Brosschot et al., 2017;Slavich, 2020) that focus on constructs previously explored by the Polyvagal Theory (Porges, 2007). For example, the relationship between safety and stress forms the basis for the Generalized Unsafety Theory of Stress (GUTS) proposed by Brosschot et al. (2017). Although the two theories use different terms and constructs, the two theories can be contrasted if we assume that stress and threat responses are equivalent. ...
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Contemporary strategies for health and wellbeing fail our biological needs by not acknowledging that feelings of safety emerge from internal physiological states regulated by the autonomic nervous system. The study of feelings of safety has been an elusive construct that has historically been dependent upon subjectivity. Acknowledging that feelings of safety have a measurable underlying neurophysiological substrate would shift investigations of feelings of safety from a subjective to an objective science. Polyvagal Theory provides an innovative scientific perspective to study feelings of safety that incorporates an understanding of neuroanatomy and neurophysiology. This perspective identifies neural circuits that downregulate neural regulation of threat reactions and functionally neutralize defensive strategies via neural circuits communicating cues of safety that enable feelings of safety to support interpersonal accessibility and homeostatic functions. Basically, when humans feel safe, their nervous systems support the homeostatic functions of health, growth, and restoration, while they simultaneously become accessible to others without feeling or expressing threat and vulnerability. Feelings of safety reflect a core fundamental process that has enabled humans to survive through the opportunistic features of trusting social engagements that have co-regulatory capacities to mitigate metabolically costly defense reactions. Through the study of neural development and phylogeny, we can extract foundational principles and their underlying mechanisms through which the autonomic nervous system leads to feelings of safety and opportunities to co-regulate. Several principles highlight the validity of a science of safety that when implemented in societal institutions, ranging from healthcare to education, would enhance health, sociality, and lead to greater productivity, creativity, and a sense of wellbeing. By respecting our need to feel safe as a biological imperative linked to survival, we respect our phylogenetic heritage and elevate sociality as a neuromodulator that functionally provides the scientific validation for a societal focus on promoting opportunities to experience feelings of safety and co-regulation.
... If it is not the kind of adverse experiences that organisms encounter that triggers different neurobiological responses, what does? One possibility is that the individual's perception of the event is more influential on neurobiology than the features of the event itself (Brosschot, Verkuil, & Thayer, 2017;Goldstein & McEwen, 2002;Lazarus, 1990;B. S. McEwen, 2019;Peters, McEwen, & Friston, 2017;Sapolsky, 2015). ...
... Recent proposals have suggested that flipping the way scientists have historically construed stress from "presence of perceived threat" to "lack of perceived safety" may provide greater insight into individual differences in responses to stress and experiences of adversity (Brosschot et al., 2017;Porges, 2015). This idea is based on findings that psychological factors (such as novelty, withholding reward, and anticipation of punishment) rather than direct physical threat, injury, or actual punishment most potently activates stress-response systems (Mason, 1959(Mason, , 1975. ...
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Discovering the processes through which early adverse experiences affect children’s nervous-system development, health, and behavior is critically important for developing effective interventions. However, advances in our understanding of these processes have been constrained by conceptualizations that rely on categories of adversity that are overlapping, have vague boundaries, and lack consistent biological evidence. Here, we discuss central problems in understanding the link between early-life adversity and children’s brain development. We conclude by suggesting alternative formulations that hold promise for advancing knowledge about the neurobiological mechanisms through which adversity affects human development.
... This range of variability in neurobiological responses to similar types of stressors has led to the proposition that it is not the type or features of an adverse event, but rather the organisms' perception and interpretation of that event, that that has different effects on neurobiological systems [166,177,178]. There is now a wealth of research in adults demonstrating that individual variability in neurobiological responses to stress is informed through the assessment of factors that shape perceptions and interpretations of stress [10, 179,180]. ...
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Background Chronic and/or extreme stress in early life, often referred to as early adversity, childhood trauma, or early life stress, has been associated with a wide range of adverse effects on development. However, while early life stress has been linked to negative effects on a number of neural systems, the specific mechanisms through which early life stress influences development and individual differences in children’s outcomes are still not well understood. Main text The current paper reviews the existing literature on the neurobiological effects of early life stress and their ties to children’s psychological and behavioral development. Conclusions Early life stress has persistent and pervasive effects on prefrontal–hypothalamic–amygdala and dopaminergic circuits that are at least partially mediated by alterations in hypothalamic–pituitary–adrenal axis function. However, to date, this research has primarily utilized methods of assessment that focus solely on children’s event exposures. Incorporating assessment of factors that influence children’s interpretation of stressors, along with stressful events, has the potential to provide further insight into the mechanisms contributing to individual differences in neurodevelopmental effects of early life stress. This can aid in further elucidating specific mechanisms through which these neurobiological changes influence development and contribute to risk for psychopathology and health disorders.
... Children's perceptions of scarcity or insecurity associated with family poverty might influence their neurobiology (Brosschot, Verkuil, & Thayer, 2017;Lazarus & Folkman, 1984;McEwen, 2019;Peters, McEwen, & Friston, 2017;Sapolsky, 2015). This type of effect depends upon how organisms perceive the controllability and predictability of stressors (Bollini, Walker, Hamann, & Kestler, 2004;Muller, 2012). ...
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Nearly 1 in 5 children in the United States lives in a household whose income is below the official federal poverty line, and more than 40% of children live in poor or near-poor households. Research on the effects of poverty on children's development has been a focus of study for many decades and is now increasing as we accumulate more evidence about the implications of poverty. The American Academy of Pediatrics recently added “Poverty and Child Health” to its Agenda for Children to recognize what has now been established as broad and enduring effects of poverty on child development. A recent addition to the field has been the application of neuroscience-based methods. Various techniques including neuroimaging, neuroendocrinology, cognitive psychophysiology, and epigenetics are beginning to document ways in which early experiences of living in poverty affect infant brain development. We discuss whether there are truly worthwhile reasons for adding neuroscience and related biological methods to study child poverty, and how might these perspectives help guide developmentally based and targeted interventions and policies for these children and their families.
... Safety is associated with high level of vagal function, which facilitates positive emotion, social connection and even, physical health (Kok and Fredrickson, 2010;Kok et al., 2013). The link between safety and vagal function has been highlighted in several influential theories including the generalised unsafety theory of stress (GUTS) (Brosschot et al., 2017) and polyvagal theory (Porges, 2011;Dana, 2018). The GUTS theory presents the stress response as a default response and that chronic stress can lead to the experience of 'generalised unsafety, ' which ultimately compromises bodily capacity (e.g., obesity, low aerobic fitness and aging), social networks (e.g., loneliness) and daily contexts through context conditioning (e.g., workrelated stress). ...
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Individuals with Acquired Brain Injury (ABI) suffer chronic impairment across cognitive, physical and psycho-social domains, and the experience of anxiety, isolation and apathy has been amplified by the COVID-19 pandemic. A qualitative evaluation was conducted of 14 individuals with ABI who had participated in series of COVID adapted group-based intervention(s) that had been designed to improve wellbeing. Eight themes were identified: Facilitating Safety, Fostering Positive Emotion, Managing and Accepting Difficult Emotions, Promoting Meaning, Finding Purpose and Accomplishment, Facilitating Social Ties, (Re)Connecting to Nature, and Barriers to Efficacy. Findings are discussed with respects to recent theoretical developments in positive psychology and wellbeing science and support the use of online and outdoor interventions to enhance wellbeing in individuals living with ABI during the COVID-19 pandemic. This paper makes a unique contribution to second wave positive psychology (PP2.0) through the application of recent advances in wellbeing science to an ABI population during the COVID-19 pandemic. In doing so, this paper lays the foundation for new interventions that not only reduce impairment and distress, but also create opportunities for meaning and enhanced wellbeing in people living with chronic conditions and those individuals living with ABI in particular.
... (GUTS; Brosschot et al., 2017) which posits that the physiological defensive response is the default response of our organism, which is constantly inhibited by prefrontal regions and is released when such inhibitory control is lacking. Importantly, according to GUTS, prefrontal dis-inhibition and the consequent physiological stress-response can occur even without the conscious perception of being stressed. ...
Article
The left dorsolateral prefrontal cortex (dlPFC) has been implicated in the regulation of stress-related cognitive processes and physiological responses and is the principal target of noninvasive brain stimulation techniques applied to psychiatric conditions. However, existing studies are mostly correlational and causal evidence on the role of this region in mediating specific psychophysiological mechanisms underpinning stress-related responses are needed to make the application of such techniques more efficient. To fill this gap, this study used inhibitory continuous theta burst stimulation (cTBS) in healthy individuals to examine the extent to which activity of the left dlPFC is associated with cognitive (subjective focus on a tracking task), behavioral (reaction times and variability), and physiological responses (heart rate and its variability and cortisol level) following induction of perseverative cognition. Compared to sham and left ventral PreMotor area stimulation (as active control area), inhibition of left dlPFC determined sustained autonomic and neuroendocrine activation and increased the subjective perception of being task-focused, while not changing the behavioral and self-reported stress-related responses. Adopting a causative approach, we describe a role of left dlPFC in inhibitory control of the physiological stress-response associated to perseverative thinking.
... This central role for social isolation and rejection in affecting health is consistent with Social Safety Theory (Slavich, 2020a), which posits that social isolation and rejection strongly upregulate inflammatory activity, and with Social Baseline Theory, which argues that the social network is the primary source of safety (Coan, 2010). Indeed, loneliness is one factor that has been associated with generalized unsafety and prolonged physiological activation (Brosschot et al., 2017). All in all, experiencing psychosocial stressors such as social isolation and rejection has been shown to negatively impact mental health (Benros et al., 2013; ...
Article
The COVID-19 pandemic has led to widespread increases in mental health problems, including anxiety and depression. The development of these and other psychiatric disorders may be related to changes in immune, endocrine, autonomic, cognitive, and affective processes induced by a SARS-CoV-2 infection. Interestingly, many of these same changes can be triggered by psychosocial stressors such as social isolation and rejection, which have become increasingly common due to public policies aimed at reducing the spread of SARS-CoV-2. The present review aims to shed light on these issues by describing how viral infections and stress affect mental health. First, we describe the multi-level mechanisms linking viral infection and life stress exposure with risk for psychopathology. Then, we summarize how resilience can be enhanced by targeting vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation and targeting lifestyle factors, such as exercise. With these biopsychosocial insights in mind, researchers and healthcare professionals will be better equipped to reduce risk for psychopathology and increase resilience during this challenging pandemic period and beyond.
... The reasons for this gap are many. Stress management is often habitual (i.e., experientially suppressed) (Chen et al., 2016;Brosschot et al., 2017), making accurate elicitation of self-reported data notoriously difficult (Petitmengin, 2006). The wide range in how people describe both discrimination and coping as well as how we categorize that data underlies why studies identify 400+ coping strategies with no agreedupon reduction (Skinner et al., 2003). ...
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Digital gaming's many benefits starkly contradict its well-cited toxicity. To accurately understand and compare how players cope with discriminatory stress in the context of play, 241 US players were surveyed on recurring sources of discrimination during gameplay and strategies for coping across ranging experiential prompts. Qualitative analysis created a taxonomy of discriminatory targets, discriminatory acts, and coping strategies specific to online digital play. We compare experiences, perceptions, and beliefs around coping across intersections of race, gender, and class (with notes on ability and age) and describe how player identities inform in-game behavior and exposure to types of discrimination and how coping strategies are navigated. We discuss the accumulative, anticipatory, and intergenerational nature of discriminatory stress in gaming, its stratified effects on well-being, and the role of discrimination in belief formation as well as ability to advocate for oneself and others.
... The results of the literature review highlight that individual differences in IU, and by proxy fear of the unknown (Carleton, 2016a(Carleton, , 2016b, is in part responsible for the maintenance of learned fear and anxiety (Brosschot et al., 2016;Brosschot, Verkuil, & Thayer, 2017;Grupe & Nitschke, 2013;Tanovic et al., 2018). The literature review revealed that individual differences in IU are most critical for classical threat conditioning mechanisms when the probabilistic structure of the environment includes a greater quantity of unknowns (i.e., the absence of information about threat and safety contingencies and the omission of the US). ...
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Intolerance of uncertainty (IU), the tendency to find uncertainty aversive, is an important transdiagnostic dimension in mental health disorders. Over the last decade, there has been a surge of research on the role of IU in classical threat conditioning procedures, which serve as analogues to the development, treatment, and relapse of anxiety, obsessive-compulsive, and trauma-and stressor-related disorders. This review provides an overview of the existing literature on IU in classical threat conditioning procedures. The review integrates findings based on the shared or discrete parameters of uncertainty embedded within classical threat conditioning procedures. Under periods of unexpected uncertainty, where threat and safety contingencies change, high IU, over other self-reported measures of anxiety, is specifically associated with poorer threat extinction learning and retention, as well as overgeneralisation. Under periods of estimation and expected uncertainty, where the parameters of uncertainty are being learned or have been learned, such as threat acquisition training and avoidance learning, the findings are mixed for IU. These findings provide evidence that individual differences in IU play a significant role in maintaining learned fear and anxiety, particularly under volatile environments. Recommendations for future research are outlined, with discussion focusing on how parameters of uncertainty can be better defined to capture how IU is involved in the maintenance of learned fear and anxiety. Such work will be crucial for understanding the role of IU in neurobiological models of uncertainty-based maintenance of fear and anxiety and inform translational work aiming to improve the diagnosis and treatment of relevant psychopathology.
... This central role for social isolation and rejection in affecting health is consistent with Social Safety Theory (Slavich, 2020a), which posits that social isolation and rejection strongly upregulate inflammatory activity, and with Social Baseline Theory, which argues that the social network is the primary source of safety (Coan, 2010). Indeed, loneliness is one factor that has been associated with generalized unsafety and prolonged physiological activation (Brosschot et al., 2017). All in all, experiencing psychosocial stressors such as social isolation and rejection has been shown to negatively impact mental health (Benros et al., 2013; ...
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Recent studies have linked compassion with higher vagally-mediated heart rate variability (vmHRV), a measure of parasympathetic activity, and metanalytic evidence confirmed significant and positive associations. Compassion, however, is not to be confused with soothing positive emotions: in order to engage in actions aimed to alleviate (self or others) suffering, the pain should resonate, and empathic sensitivity should be experienced first. The present study examined the association between vmHRV and the empathic sensitivity and action components of trait and state compassion. To do so, several dispositional questionnaires were administered and two videos inducing empathic sensitivity (video 1) and compassionate actions (video 2) were shown, while the ECG was continuously recorded, and momentary affect was assessed. Results showed i) scores on subscales assessing the empathic component of trait compassion were inversely related to resting vmHRV; ii) vmHRV decreased after video 1 but significantly increased after video 2. As to momentary affect, video 1 was accompanied with an increase in sadness and a decrease of positive affect, whereas video 2 was characterized by an increase in anger, a parallel decrease of sadness, and an increase (although non-significant) in positive affect. Overall, present findings support the notion that it is simplistic to link compassion with higher vmHRV. Compassion encompasses increased sensitivity to emotional pain, which is naturally associated with lower vmHRV, and action to alleviate others’ suffering, which is ultimately associated with increased vmHRV. The importance of adopting a nuanced perspective on the complex physiological regulation that underlies compassionate responding to suffering is discussed.
... Our mind is constantly seeking cues for safety or danger, even when we are not aware of this, and these social signals are transduced to biological signals, including patterns of autonomic activity and gene expression that are linked to inflammation. It is thought that exposure to or perception of frequent social threats (such as social rejection, discrimination, violence, and lack of safety) creates higher chronic systemic inflammation and sympathetic arousal, even while sleeping, and greater risk of affective disorders (Brosschot et al., 2017;O'Donovan et al., 2013;Slavich, 2020;Slavich et al., 2010). Conversely, social support, and social capital including perceived safety in neighborhoods, may be stress buffering, and are often associated with less inflammation and longer telomeres (Brown et al., 2020;Rentscher et al., 2020;Thames et al., 2019;Geronimus et al., 2015;Park et al., 2015). ...
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Geroscience offers a counterpoint to the challenged pursuit of curing diseases of aging by focusing on slowing the biological aging process for extended healthspan earlier in life. Remarkable progress has led this field toward animal trials and the next challenge lies with translation to humans. There is an emerging number of small human trials that can take advantage of new models integrating behavioral and social factors. Understanding dynamic aging mechanisms, given the powerful social determinants of aging (Crimmins, 2019) and human variability and environmental contexts (Moffitt, 2019), will be critical. Behavioral and social factors are intrinsic to aging. Toxic stressors broadly defined can lead to stress-acceleration of aging, either directly impacting aging processes or by shaping poor behavioral health, and underlie the socioeconomic disparities of aging. In contrast, hormetic stressors, acute intermittent stressors of moderate intensity, can produce stress resilience, the ability for quick recovery and possibly rejuvenation of cells and tissues. Although health research usually examines static biomarkers, aging is reflected in ability to recover from challenges pointing to new interventions and targets for examining mechanisms. A fuller model incorporating stress resilience provides innovative biobehavioral interventions, both for bolstering response to challenges, such as COVID-19, and for improving healthspan.
... Theories such as attachment theory and social baseline theory have emphasized how significant others are important for alleviating distress, increasing felt safety and security, and providing social support (Beckes & Coan, 2011). Additionally, the Generalized Unsafety Theory of Stress (GUTS; Brosschot, Verkuil, & Thayer, 2017), has postulated that the lack of social support results in chronically disinhibited stress responses as evidenced by low resting RSA. As such, research generally shows that higher RSA is associated with better social functioning (Balzarotti et al., 2017). ...
Article
Respiratory sinus arrhythmia (RSA), an index of the parasympathetic nervous system, has recently gained attention as a physiological component of regulatory processes, social connectedness, and health. Within the context of romantic relationships, studies have operationalized and conceptualized RSA in disparate ways, obscuring a clear pattern of findings. This systematic review synthesizes the rapidly developing literature and clarifies the role of RSA in romantic relationships. We evaluate support for three conceptual hypotheses: (1) resting baseline RSA is associated with better quality relationships; (2) phasic RSA is reflective of changes in threat and connection during couple interactions; and (3) physiological linkage in RSA between romantic partners relates to positive or negative relationship functioning depending on the nature of the linkage (e.g., in-phase vs. antiphase). We identified 26 empirical studies that tested associations between RSA and an index of romantic relationships (i.e., relationship satisfaction). Our findings show that higher RSA is not uniformly "good" for relationships. Higher resting baseline RSA was contemporaneously associated with better quality relationships, yet higher baseline RSA was also unexpectedly associated with relationship violence. Short-term decreases in RSA were found during relationship conflict, though the opposite-phasic increases in RSA during positive romantic partner interactions-was not found due to mixed empirical support. As expected, evidence for RSA linkage was found, though the connection between linkage and relationship functioning depends on the context in which it was measured. We discuss methodological limitations and directions for future research.
... These group differences declined throughout the duration of exposure, suggesting that the effort to down-regulate cardiac acceleration by prefrontal control is reduced during the course of exposure, probably because patients felt safer in this context with no interoceptive threat occurring during the course of time. These findings support the idea put forward by Thayer and others 24,35 suggesting that the default response to uncertainty, novelty and potential threat is sympathoexcitatory preparation that is inhibited through vagal control via prefrontal activation. According to the threat imminence or defense cascade model 5-7 entering such a context in which a potential threat might be encountered this chronotropic control of the heart is also accompanied by general hypervigilance to all potentially dangerous cues that-in the case of PD/AG-arise from inside the body. ...
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Theoretically, panic disorder and agoraphobia pathology can be conceptualized as a cascade of dynamically changing defensive responses to threat cues from inside the body. Guided by this trans-diagnostic model we tested the interaction between defensive activation and vagal control as a marker of prefrontal inhibition of subcortical defensive activation. We investigated ultra-short-term changes of vagally controlled high frequency heart rate variability (HRV) during a standardized threat challenge (entrapment) in n = 232 patients with panic disorder and agoraphobia, and its interaction with various indices of defensive activation. We found a strong inverse relationship between HRV and heart rate during threat, which was stronger at the beginning of exposure. Patients with a strong increase in heart rate showed a deactivation of prefrontal vagal control while patients showing less heart rate acceleration showed an increase in vagal control. Moreover, vagal control collapsed in case of imminent threat, i.e., when body symptoms increase and seem to get out of control. In these cases of defensive action patients either fled from the situation or experienced a panic attack. Active avoidance, panic attacks, and increased sympathetic arousal are associated with an inability to maintain vagal control over the heart suggesting that teaching such regulation strategies during exposure treatment might be helpful to keep prefrontal control, particularly during the transition zone from post-encounter to circa strike defense. Trial Registration Number : ISRCTN80046034.
... The generalized unsafety theory of stress (GUTS) provides a possible explanation of how decreased HRV and anxiety disorders might be linked [7]. It proposes that the stress response is per default active but chronically inhibited as long as safety is perceived. ...
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Background Individuals suffering from an anxiety disorder are characterized by chronically low heart rate variability (HRV) compared to healthy individuals during resting state conditions. However, when examining HRV and HR in response to a stressor, mixed results have been obtained when comparing anxious and non-anxious groups. Methods The primary aim of the present study was to investigate HRV and HR responding in 26 clinically anxious and 14 control individuals before, during and after a stressful working memory task. Results Results indicate no between-group differences in HRV and HR at baseline. When starting the working memory task, the control group decreased significantly in HRV and the anxious group did not differ substantially in their change pattern from baseline to the start of the stressor. Finally, during the recovery phase of the working memory task, the clinically anxious and control individuals did not differ in their HFV or HR response compared to baseline. Conclusions From a clinical perspective, the results suggest that screening for the presence of anxiety disorders may help to identify patients with impaired HRV and HR functioning and to intervene on these important patient characteristics early in the treatment process.
... 45 An autonomic dysfunction characterised by tonic sympathetic hyperactivity and parasympathetic hypoactivity (particularly during night time) along with an overall blunted sympathetic response to stress has been indicated in FM. 46,47 This has been further supported by observations of abnormalities in heart rate variability (HRV) of patients with FM, 47,48 including low vagal tone, which is considered to be a putative biomarker of chronic stress. 49 Although some studies have pointed out that aberrations in the hypothalamus-pituitaryadrenal (HPA) axis and in the autonomic nervous system (ANS) are associated with an increased susceptibility to develop chronic widespread pain (CWP), 50,51 it remains unclear whether these dysregulations are a precursor of FM, a byproduct of the functional decline associated with this condition, or a surrogate marker of a co-factor, namely stress. 12,52 In fact, these abnormalities may stem from many other confounding factors, including medication use, 53 presence of comorbidities 54 or trauma history, 55 that are not always accounted for in studies investigating the association between HPA/ANS abnormalities and FM. ...
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Research into the neurobiological and psychosocial mechanisms involved in fibromyalgia (FM) has progressed remarkably in recent years. Despite this, current accounts of FM fail to capture the complex, dynamic and mutual crosstalk between neurophysiological and psychosocial domains. We conducted a comprehensive review of the existing literature in order to synthesise current knowledge on FM, explore and highlight multi-level links and pathways among different systems and build bridges between existing approaches. An extensive panel of international experts in neurophysiology and psychosocial aspects of FM discussed the collected evidence and progressively refined and conceptualized its interpretation. Fibromyalgia is a complex condition resulting from the dynamic interplay between multiple systems and processes. We provided an updated overview of the most relevant observations in FM to date as well as the potential pathways by which they are related and exert their mutual influence, to produce the manifestations commonly associated with FM. This review constituted the first step towards and supported the development of a much needed model capable of integrating the main factors implicated in FM into a single, unified model that may prove valuable in understanding and managing FM.
... Given the role of anxiety and stress in shaping our behavior, it is critical for healthcare professionals to comprehend this situation. However, it has been reported worldwide that COVID-19 anxiety and stress assessment scales are mostly one-dimensional and have limited psychometric properties [11][12][13]. In our country, only a short form of the Coronavirus Anxiety Scale Turkish version is available to evaluate this anxiety level. ...
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Purpose: The aim of this study was to assess the Turkish adaptation of the COVID Stress Scale (CSS) on the basis of determining the stress caused by the coronavirus disease (COVID-19) pandemic, and to test its validity and reliability. Methods: The English CSS was translated into Turkish using forward and backward translation. Data were collected online from 360 participants. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach's alpha reliability coefficient, and test-retest methods were used to evaluate reliability. Results: The Turkish version of the CSS has 36 items consistent with the original scale and has five factors: COVID danger and contamination, socioeconomic consequences of COVID, COVID xenophobia, traumatic stress due to COVID, and compulsive checking for COVID. The construct validity of the Turkish version of the CSS was verified by the adjusted goodness of fit index > .85, and comparative fit index > .95. The content validity index of each item was 91%. The corrected item-total correlations of the scale ranged from .51 to .89. Internal consistency was reliable, with a Cronbach's α of .93. Conclusion: The Turkish version of the CSS is valid and reliable. It can be used as a measurement tool for the assessment of COVID-related stress.
... Future studies could consider using more extensive or objective measures of stress (e.g., multiple reports, biological assessment). Nevertheless, capturing one's subjective experience of stress is critical as research and theory suggests that individuals' perceptions of stressful events play a prominent role in driving their biobehavioral responses (Brosschot, Verkuil, & Thayer, 2017;Smith & Pollak, 2021). Despite these limitations, this study was based on a large sample of young adults who underwent a comprehensive neurocognitive functioning assessment in addition to surveys about perceived stress and psychiatric symptoms. ...
Article
Extensive research documents the impact of psychosocial stress on risk for the development of psychiatric symptoms across one's lifespan. Further, evidence exists that cognitive functioning mediates this link. However, a growing body of research suggests that limited stress can result in cognitive benefits that may contribute to resilience. The hypothesis that low-to-moderate levels of stress are linked to more adaptive outcomes has been referred to as hormesis. Using a sample of young adults from the Human Connectome Project (N = 1,206, 54.4% female, Mage = 28.84), the present study aims to test the hormetic effect between low-to-moderate perceived stress and psychopathological symptoms (internalizing and externalizing symptoms), as well as to cross-sectionally explore the intermediate role of cognitive functioning in this effect. Results showed cognitive functioning as a potential intermediating mechanism underlying the curvilinear associations between perceived stress and externalizing, but not internalizing, behaviors. This study provides preliminary support for the benefits of limited stress to the process of human resilience.
... Thus, high vmHRV is associated with higher self-and emotion regulation capacity (Laborde et al., 2018; et al., 2012). Conversely, individuals with low vmHRV, for instance, exhibit deficient emotional processing (e.g., Steinfurth et al., 2018) as well as altered physiological responses to environmental demands (Brosschot et al., 2017), and have a higher risk of depression (Kemp & Quintana, 2013), which is characterized by disturbed prefrontal activity (Koenigs & Grafman, 2009). ...
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Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation and transcranial direct current stimulation are widely used to test the involvement of specific cortical regions in various domains such as cognition and emotion. Despite the capability of stimulation techniques to test causal directions, this approach has been only sparsely used to examine the cortical regulation of autonomic nervous system (ANS) functions such as heart rate (HR) and heart rate variability (HRV) and to test current models in this regard. In this preregistered (PROSPERO) systematic review and meta‐analysis, we aimed to investigate, based on meta‐regression, whether NIBS represents an effective method for modulating HR and HRV measures, and to evaluate whether the ANS is modulated by cortical mechanisms affected by NIBS. Here we have adhered to the PRISMA guidelines. In a series of four meta‐analyses, a total of 131 effect sizes from 35 sham‐controlled trials were analyzed using robust variance estimation random‐effects meta‐regression technique. NIBS was found to effectively modulate HR and HRV with small to medium effect sizes. Moderator analyses yielded significant differences in effects between stimulation of distinct cortical areas. Our results show that NIBS is a promising tool to investigate the cortical regulation of ANS, which may add to the existing brain imaging and animal study literature. Future research is needed to identify further factors modulating the size of effects. As many of the studies reviewed were found to be at high risk of bias, we recommend that methods to reduce potential risk of bias be used in the design and conduct of future studies.
... Youth's perceptions of their environmental contexts, such as their neighborhoods, schools, and families, can play a critical role in academic, interpersonal, and occupational success (Brosschot et al., 2017;Burton et al., 1997;Caspi et al., 2012;Chen et al., 2004;Orstad et al., 2017;Repetti et al., 2002;Roosa et al., 2003Roosa et al., , 2009Thapa et al., 2013). Specifically, youth's perceptions of threat in their neighborhoods, schools, and families are associated with poorer mental health (e.g., Aneshensel & Sucoff, 1996;Kasen et al., 1990), social functioning (e.g., Fite et al., 2010), and neurocognitive performance (e.g., Fay-Stammbach et al., 2014). ...
Article
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Perceived threat in youth's environments can elevate risk for mental health, social, and neurocognitive difficulties throughout the lifespan. However, few studies examine variability in youth's perceptions of threat across multiple contexts or evaluate outcomes across multiple domains, ultimately limiting our understanding of specific risks associated with perceived threats in different contexts. This study examined associations between perceived threat in youth's neighborhood, school, and family contexts at ages 9-10 and mental health, social, and neurocognitive outcomes at ages 11-12 within a large US cohort (N = 5525) enrolled in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Latent profile analysis revealed four distinct profiles: Low Threat in all contexts, Elevated Family Threat, Elevated Neighborhood Threat, and Elevated Threat in all contexts. Mixed-effect models and post hoc pairwise comparisons showed that youth in Elevated Threat profile had poorer mental health and social outcomes 2 years later. Youth in the Elevated Family Threat profile uniquely showed increased disruptive behavior symptoms, whereas youth in the Elevated Neighborhood Threat profile predominantly displayed increased sleep problems and worse neurocognitive outcomes 2 years later. Together, findings highlight the importance of considering perceptions of threat across multiple contexts to achieve a more nuanced developmental picture.
... In adults, having high-quality and supportive social relationships is associated with reduced perceptions of stress as well as dampened psychological and physiological responses to laboratory stress (for review see Eisenberger, 2013;Hawkley & Capitanio, 2015). These effects are thought to in part result from high-quality and supportive social relationships acting as a signal of safety (Beckes & Coan, 2011;Brosschot et al., 2017). Together this suggests social distancing measures implemented in response to the COVID-19 pandemic may alter children's experiences of stress associated with the pandemic by shifting perceptions of safety. ...
Article
Chronic and/or extreme stress in childhood, often referred to as early life stress, is associated with a wide range of long-term effects on development. Given this, the COVID-19 pandemic has led to concern about how stress due to the pandemic will affect children's development and mental health. Although early life stress has been linked to altered functioning of a number of neural and biological systems, there is a wide range of variability in children's outcomes. The mechanisms that influence these individual differences are still not well understood. In the past, studies of stress in childhood focused on the type of events that children encountered in their lives. We conducted a review of the literature to formulate a new perspective on the effects of early life stress on development. This new, topological model, may increase understanding of the potential effects of the COVID-19 pandemic on children's development. This model is oriented on children's perceptions of their environment and their social relationships, rather than specific events. These factors influence central and peripheral nervous system development, changing how children interpret, adapt, and respond to potentially stressful events, with implications for children's mental and physical health outcomes.
... Indeed, in current theorising, stress itself is regarded as a form of uncertainty (35). If, following a recently proposed model, chronic stress is conceptualised as arising from a generalised perception of unsafety (36), the effect of the media can be seen as constructing the world as unsafe by default. Chronic stressors, characterised by uncontrollability and inescapability, have long been recognised as a major aetiological factor in depressed affect (37)(38)(39). ...
Article
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Global communities are currently confronted with a number of complex problems and threats, the reality of which is amplified by the media. These environmental and socio-political stressors have been accompanied by the spread of problematic psychological and behavioural tendencies, such as the growing polarisation of opinions and values, online radicalisation and extremism, deepening xenophobia and nationalism, the proliferation of irrational beliefs and conspiracy theories, and resistance to rational public policy measures. Here we argue that although they fall outside the scope of psychopathology, they nevertheless currently constitute a major challenge for psychiatry as a research domain and a clinical practise. To substantiate this claim, we outline the mechanisms by which media-transmitted stressors impact mental well-being and possibly psychopathology. The common denominator of these global problems and the media's construction of reality is the increase in uncertainty, unpredictability, and uncontrollability, which prompts defensive responding and, in predisposed individuals, functions as a potent source of chronic stress. These contribute to cognitive inflexibility, a strong predisposing factor for the development of rigid beliefs and attitudes, which to varying degrees underlie the adverse psychological and behavioural tendencies mentioned above. We suggest that the tightening of beliefs and ideas that is the result of cognitive rigidity may correspond to the clinical characteristics of induced delusional disorder. This can be seen as a (ultimately maladaptive) defensive strategy for coping with a high degree of uncertainty and unpredictability. We conclude by briefly outlining the possible ways in which psychiatry can face this challenge.
... The results of the literature review provide direct evidence for modern IU theory outlined by Carleton (2016aCarleton ( , 2016b and through methods recommend by Shihata et al. (2016) that individual differences in IU, and by proxy fear of the unknown activates the behavioural inhibition system (i.e. increased vigilance and arousal) (Gray and McNaughton, 2003), and is in part responsible for the maintenance of learned fear and anxiety (Brosschot et al., 2016;Brosschot et al., 2017;Grupe and Nitschke, 2013;Tanovic et al., 2018). ...
Article
Full-text available
Intolerance of uncertainty (IU), the tendency to find uncertainty aversive, is an important transdiagnostic dimension in mental health disorders. Over the last decade, there has been a surge of research on the role of IU in classical threat conditioning procedures, which serve as analogues to the development, treatment, and relapse of anxiety, obsessive-compulsive, and trauma- and stressor-related disorders. This review provides an overview of the existing literature on IU in classical threat conditioning procedures. The review integrates findings based on the shared or discrete parameters of uncertainty embedded within classical threat conditioning procedures. Under periods of unexpected uncertainty, where threat and safety contingencies change, high IU, over other self-reported measures of anxiety, is specifically associated with poorer threat extinction learning and retention, as well as overgeneralisation. Under periods of estimation and expected uncertainty, where the parameters of uncertainty are being learned or have been learned, such as threat acquisition training and avoidance learning, the findings are mixed for IU. These findings provide evidence that individual differences in IU play a significant role in maintaining learned fear and anxiety, particularly under volatile environments. Recommendations for future research are outlined, with discussion focusing on how parameters of uncertainty can be better defined to capture how IU is involved in the maintenance of learned fear and anxiety. Such work will be crucial for understanding the role of IU in neurobiological models of uncertainty-based maintenance of fear and anxiety and inform translational work aiming to improve the diagnosis and treatment of relevant psychopathology.
... Given the potential promise of IU as a transdiagnostic target for mental health interventions (22)(23)(24)(25), understanding the neurobiological basis of IU has become paramount (26,27). From animal and human evidence, it is well established that uncertainty plays a fundamental role in the neurobiology of anxiety and stress (28)(29)(30)(31)(32)(33). However, only recently has research began to emerge on the importance of individual differences in IU in associative threat and safety learning mechanisms (27,34). ...
Article
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Background Intolerance of uncertainty (IU), the tendency to find uncertainty distressing, is an important transdiagnostic dimension in mental health disorders. Higher self-reported IU has been linked to poorer threat extinction training (i.e. the updating of threat to safe associations), a key process that is targeted in exposure-based therapies. However, it remains to be seen whether IU-related effects during threat extinction training are reliably and specifically driven by the IU construct or a particular subcomponent of the IU construct over other self-reported measures of anxiety. Methods A meta-analysis of studies from different laboratories (experiment n = 18; sample n = 1006) was conducted on associations between different variants of self-reported IU (i.e. 27-item, 12-item, inhibitory and prospective subscales), trait anxiety and threat extinction training via skin conductance response. The specificity of IU and threat extinction training was assessed against measures of trait anxiety. Results All of the self-reported variants of IU, but not trait anxiety, were associated with threat extinction training via skin conductance response (i.e. continued responding to the old threat cue). Specificity was observed for the majority of self-reported variants of IU over of trait anxiety. Conclusions The findings suggest that the IU construct broadly accounts for difficulties in threat extinction training and is specific over other measures of self-reported anxiety. These findings demonstrate the robustness and specificity of IU-related effects during threat extinction training and highlight potential opportunities for translational work to target uncertainty in therapies that rely on threat extinction principles such as exposure therapy.
Article
Having sensitive, contingent, and supportive social relationships has been linked to more positive outcomes after experiences of early childhood adversity. Traditionally, social relationships are construed as moderators that buffer children from the effects of exposure to adverse events. However, recent data support an alternative view: that supportive social relationships influence children’s later outcomes by shaping their perceptions of safety and stress, regardless of the particular events to which children are exposed. This perspective has implications for understanding vulnerability and resilience in children.
Article
Several labels, such as neuroticism, negative emotionality, and dispositional negativity, indicate a broad dimension of psychopathology. However, largely separate, often disorder-specific research lines have developed that focus on different cognitive and affective characteristics that are associated with this dimension, such as perseverative cognition (worry, rumination), reduced autobiographical memory specificity, compromised fear learning, and enhanced somatic-symptom reporting. In this article, we present a theoretical perspective within a predictive-processing framework in which we trace these phenotypically different characteristics back to a common underlying "better-safe-than-sorry" processing strategy. This implies information processing that tends to be low in sensory-perceptual detail, which allows threat-related categorical priors to dominate conscious experience and for chronic uncertainty/surprise because of a stagnated error-reduction process. This common information-processing strategy has beneficial effects in the short term but important costs in the long term. From this perspective, we suggest that the phenomenally distinct cognitive and affective psychopathological characteristics mentioned above represent the same basic processing heuristic of the brain and are only different in relation to the particular type of information involved (e.g., in working memory, in autobiographical memory, in the external and internal world). Clinical implications of this view are discussed.
Article
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.
Chapter
Safety is normally understood as an ‘avoidance’ goal, the objective being to reduce risks and harms. Can it also be understood more positively, as an ‘approach’ goal? If so, what would that positive motivation entail, and what benefits might it bring? The world has never been safer, yet levels of stress and worry are increasing. Governments are spending heavily fighting crimes and hazards but in addition to that, we should focus on promoting aspects that make people feel safe. If the focus is on threats and crime, then the focus is on the absence of safety, not on the presence of feeling safe. And feeling unsafe is intrinsically bad even if that fear sometimes leads to sensible preventive action. Feeling safe, on the other hand, is intrinsically good. Sometimes it is instrumentally harmful to feel unrealistically safe. But, there is also some plausible evidence in support of the idea that we can make places safer by making people feel safer in them. We propose here a ‘Positive Safety Lens’ (PSL) as a complement to traditional ‘avoidance’ approaches to safety. We identify seven attributes of the PSL and discuss their potential benefits for safety research and safety promotion.
Article
This study examined struggles to establish autonomy and relatedness with peers in adolescence and early adulthood as predictors of advanced epigenetic aging assessed at age 30. Participants ( N = 154; 67 male and 87 female) were observed repeatedly, along with close friends and romantic partners, from ages 13 through 29. Observed difficulty establishing close friendships characterized by mutual autonomy and relatedness from ages 13 to 18, an interview-assessed attachment state of mind lacking autonomy and valuing of attachment at 24, and self-reported difficulties in social integration across adolescence and adulthood were all linked to greater epigenetic age at 30, after accounting for chronological age, gender, race, and income. Analyses assessing the unique and combined effects of these factors, along with lifetime history of cigarette smoking, indicated that each of these factors, except for adult social integration, contributed uniquely to explaining epigenetic age acceleration. Results are interpreted as evidence that the adolescent preoccupation with peer relationships may be highly functional given the relevance of such relationships to long-term physical outcomes.
Article
The Generalized Unsafety Theory of Stress posits that low heart rate variability contributes to a perception of “generalized unsafety” (i.e., constantly perceiving oneself to be unsafe), independent of stressful events or stress‐related symptomatology. We tested this claim by examining if resting heart rate variability, trait worry, posttraumatic stress symptoms, trauma history, and age of onset predicted fear inhibition, a measure of generalized unsafety. A Pavlovian discriminant conditioning paradigm was used to assess fear inhibition level by comparing eyeblink startle potentiation to a threat cue (presented with air blast) with startle potentiation to a safety signal (never presented with air blast). Survey and laboratory responses were collected from 42 adults who were 20 years old on average, 86% Women, and 76% White. Heart rate variability did not independently predict variation in fear inhibition, as hypothesized. Rather, higher levels of posttraumatic stress symptoms and greater cumulative interpersonal trauma predicted lower fear inhibition. Individuals reporting childhood trauma had higher trait worry, which predicted more severe posttraumatic stress symptoms. These findings highlight the role of attenuated inhibitory learning in stress‐related symptomatology and developmentally disruptive trauma. Ability to distinguish threat from safety is a plausible biobehavioral mechanism by which adversity impacts development.
Article
Smiling has been a topic of interest to psychologists for decades, with a myriad of studies tying this behavior to well-being. Despite this, we know surprisingly little about the nature of the connections between smiling and physical health. We review the literature connecting both naturally occurring smiles and experimentally manipulated smiles to physical health and health-relevant outcomes. This work is discussed in the context of existing affect and health-relevant theoretical models that help explain the connection between smiling and physical health including the facial feedback hypothesis, the undoing hypothesis, the generalized unsafety theory of stress, and polyvagal theory. We also describe a number of plausible pathways, some new and relatively untested, through which smiling may influence physical health such as trait or state positive affect, social relationships, stress buffering, and the oculocardiac reflex. Finally, we provide a discussion of possible future directions, including the importance of cultural variation and replication. Although this field is still in its infancy, the findings from both naturally occurring smile studies and experimentally manipulated smile studies consistently suggest that smiling may have a number of health-relevant benefits including beneficially impacting our physiology during acute stress, improved stress recovery, and reduced illness over time.
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The polyvagal theory (Porges, 2007) proposes that physiological flexibility dependent on heart- brain interactions is associated with prosociality. So far, whether prosociality has a causal effect on physiological flexibility is unknown. Previous studies present mitigated results on this matter. In a randomized double-blind protocol, we used a generation of social closeness procedure against a standardized control condition in order to manipulate social affiliation as a prosocial interaction factor. High frequency heart rate variability (HF-HRV, indexing physiological flexibility), electromyographical activity of the corrugator supercilii (sensitive to the valence of the interaction) and self-reported measure of social closeness were monitored before, during, and after experimental manipulation. Cooperation was measured after the experimental manipulation as an index of behavioral prosociality. Data reveal no evidence toward and effect of the experimental manipulation on these measures. We discuss methodological aspects related to the experimental constraints observed in social psychophysiology. Implications for the experimental test of the polyvagal theory are approached within alternative theoretical frameworks.
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Psychophysiological research on music performance has focused on musicians' short-term affective, cognitive, and physiological responses. Much less attention has been devoted to the investigation of musicians' psychophysiological activity beyond the performance situation. Musicians report having both positive and negative performance-related thoughts (e.g., "My concert was good" and "I made a lot of mistakes") for days following performances. The potential physiological implications of this post-performance cognitive processing are largely unknown. Salivary cortisol (sC) and salivary alpha-amylase (sAA) are markers of the activity of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathoadrenal medullary (SAM) system, respectively. The goal of the present study was to investigate whether self-reported positive and negative post performance-related thoughts predict the daily sC output and the daily sAA activity at the between-and within-person levels during a 2-day period following a solo music performance. Seventy-two university music students collected saliva samples six times per day and reported their positive and negative performance-related thoughts for 2 days after a solo performance. We tested between-person and within-person components of positive and negative post performance-related thoughts as predictors of the diurnal area under the curve with respect to ground (AUCg) for sC and sAA while adjusting for relevant person-level and day-level variables. Negative post performance-related thoughts were positively associated with sC AUCg both at the between-and within-person levels, whereas positive post performance-related thoughts were negatively associated with sC AUCg at the between-person level. Post performance-related thoughts did not significantly predict sAA AUCg. These findings provide evidence for a relationship between affectively valenced cognitive processing of a recent music performance and the activity of the HPA axis. Although the directionality of this relationship remains to be established more conclusively, the study makes a significant contribution to the literature on the prolonged psychophysiological effects of music performance situations and more broadly of social-evaluative stressors. Integrating the topic of post-performance cognitive processing and its optimal management into performance training programs would likely have positive effects on music students.
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Objective: To determine the prevalent stress factors among new students to the Faculties of Nursing at the Faculties of Nursing at the Universities of Cadiz, Cordoba, Huelva and Seville, and the influence of socio-demographic, academic, socio-economic, orientation and health factors. Design: A descriptive, observational and cross-sectional study. Methodology: 617 first year nursing students were surveyed (with a 95.66 % response rate) by means of two questionnaires, one for socio-demographics and health, the other for the stress perceived by new students. A descriptive analysis of the stress factors was then carried out for the frequency, mean and standard deviation. The relation between factors was examined through differential analysis by means of the Mann-Whitney U and Kruskal-Wallis non-parametric tests. Results: The situations of greatest anxiety among new undergraduates are “taking examinations” and “the amount of work I have to do”. Consequently, the most stressful factor is “academic stress” whilst the least stressful is “feelings of loneliness”. The students who feel most stress across various factors can be identified as: over 25, women, studying outside their home province, and living in rented accommodation during the academic year. Conclusions: Starting a degree in nursing is a stressful time, and students can find their health, quality of life and academic performance negatively affected. The main determinants of stress among new undergraduates are the joint demands of examinations and workload. It would undoubtedly be enlightening to examine this issue further in order to find the possible causes of the problem and to develop strategies that can help in its prevention and so improve the students’ experience of university.
Chapter
Based on the notion that the body is perceived as a unitary object, this chapter summarizes the bottom-up aspects of interoception in the broader sense (aka somatovisceral afference). It describes the homeostatic (visceral) and somatosensory pathways from the receptors to the major cortical centers, as well as the major levels of integration. The evolutionary theory by Craig on the development of body feelings in primates is also presented. Further, the neural correlates of affective feelings, i.e., core subjectivity, as well as recent neurocognitive approaches to the development of the doer/knower aspect of the self are described. The processes presented in this chapter are dominantly non-conscious, i.e., not directly related to body sensations. From the viewpoint of adaptation, the position of body-related information is complex. On the one hand, internal cues catching attention can distract us from more important external information and overload our limited attentional capacity. On the other hand, certain signals indicate the necessity of behavioral steps for the maintenance of homeostasis, thus their appearance in conscious awareness cannot be avoided. These signals have become marked with positive or negative affect (pleasure or displeasure) in the course of natural selection.
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A child's social relationships serve critical functions during development. The interface between a child's social world and their immune system, particularly innate immunity, which helped children survive in the face of infections, nutritional scarcity, and violence throughout human history, is the focus of this Annual Research Review. This article reviews the state of research on social relationships and innate immune inflammation during childhood. Warmth and rejection in childhood social relationships, as well as physical trauma and unpredictable social environments, were not consistently related to circulating inflammatory markers such as interleukin-6 and C-reactive protein during childhood. Instead, links between social environments and inflammation were observed in studies that focus on children with greater background risk factors, such as low family socioeconomic status, family history of mood disorders, or presence of chronic interpersonal stressors combined with acute episodic stressors. In addition, studies on worse childhood social environments and greater inflammation in adulthood were more consistent. Warmth and rejection in the social environment may be related to sensitivity of immune cells to the anti-inflammatory actions of glucocorticoids, though this is primarily observed in adolescent women at risk for depression. Additional mechanistic evidence suggests that greater warmth and less rejection are related to processes that regulate inflammation, including greater expression of the glucocorticoid receptor gene and lower expression of genes that are responsive to the pro-inflammatory transcription factor NF-kappa B. The article concludes by discussing implications of the interface between a child's social relationships and inflammation for mental health and other recent (on evolutionary timescales) health threats, as well as recommendations for future research, and recommendations for researchers interested in integrating inflammatory measures in developmental research.
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Background: Understanding diurnal secretion of cortisol in association with behavioral attitudes as a result of perception of unsafety environment is a main interest in prospective studies establishing the impact of chronic stress in cognitive processes. Adaptive secretion of cortisol, a biomarker of the hypothalamic-hypophysis-adrenal (HPA) axis, has been correlated with perception of uncertainty in surroundings as a consequence of perseverative cognition and unconscious thoughts. Objective: To determine whether diurnal secretion pattern of cortisol was associated with behavioral attitudes indexes generated from answers to standardized questionnaires from Panamerican Health Organization/World Health Organization (PAHO/WHO) agencies. Methods: Saliva cortisol dynamic range was evaluated by immuno-essay. Cortisol awakening response (CAR) and total secreted cortisol was established in a cross-sectional study of four saliva samples per day from volunteers (n = 135) between 19 and 65 years old. Results: Saliva cortisol dynamic range followed a significant decay along the day. Reduction of social interaction and increase of defensive behavioral attitude was associated with older groups of age. In this study, two subgroups of subjects with a steeper cortisol secretion (slope significant non-zero), and flatter cortisol secretion (slope no significant non-zero) were detected. Noticeable, we detected and association between measurements of cortisol secretion from subjects with a flatter cortisol dynamic range and behavioral defensive and inhibition of social interaction indexes. Conclusion: These findings suggested chronical dysregulation of HPA axis as a result of perseverative cognitive perception of unsafety environment which may be precedent to cognitive impairment in the population.
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Background: Dyads receiving palliative care for advanced heart failure are at risk for the loss of feeling safe, experienced as a fractured sense of coherence, discontinuity in sense of self and relationships, and strained social connections and altered roles. However, few theory-based interventions have addressed feeling safe in this vulnerable population. Purpose: The purpose of this article is to describe the development of the Nostalgic Remembering Intervention to strengthen feeling safe and promote adaptive physiological and psychological regulation in dyads receiving palliative care for heart failure. Conclusions: Systematic intervention development is essential to understand what, for whom, why, and how an intervention works in producing outcomes. Program theory provided a systematic approach to the development of the Nostalgic Remembering Intervention, including conceptualization of the problem targeted by the intervention, specification of critical inputs and conditions that operationalize the intervention, and understanding the mediating processes leading to expected outcomes. Clinical implications: Creating a foundation for cardiovascular nursing research and practice requires continued, systematic development of theory-based interventions to best meet the needs of dyads receiving palliative care for heart failure. The development of the Nostalgic Remembering Intervention to strengthen feeling safe in dyads provides a novel and relevant approach.
Article
Objective: Medically unexplained physical symptoms (MUPS) and related syndromes are common and place a substantial burden on both patients and society. Chronic psychological distress and dysregulation of the autonomic nervous system may be common factors associated with MUPS, although previous studies have reported mixed results. The aims of this meta-analysis are to provide an updated synthesis of studies investigating heart rate variability (HRV) indices associated with autonomic nervous system functioning in three common MUPS syndromes and to explain inconsistencies in previous study findings. Methods: Literature search yielded 58 studies comparing HRV indices of reduced parasympathetic activity of healthy individuals with those of patients with chronic fatigue syndrome (npatients = 271), irritable bowel syndrome (npatients = 1005), and fibromyalgia (npatients = 534). Separate random-effects meta-analyses were conducted on studies measuring root mean square of successive differences (RMSSD) and high-frequency HRV (HF-HRV). Results: Regardless of syndrome type, patients had significantly lower RMSSD (k = 22, Hedges g = -0.37 [-0.53 to -0.21], p < .001) and HF-HRV (k = 52, Hedges g = -0.69 [-1.03 to -0.36], p < .001) than did healthy individuals. Sample age and publication year explained a substantial variation in RMSSD, whereas controlling for confounders in statistical analyses explained variation in HF-HRV. Conclusions: Lower RMSSD and HF-HRV in patients with MUPS versus healthy controls indicates that autonomic nervous system dysregulation, particularly lower parasympathetic activity, may play a role in patients with these conditions. This conclusion may have important implications for the underlying mechanisms and treatment of MUPS and related syndromes.
Article
Objective: Greater negative affect has been associated with an increased risk of the metabolic syndrome (METs). However, all studies to date have examined this association using explicit affect measures based on subjective ratings of emotional experiences. Prior studies suggest that implicit affect, representing the automatic, prereflective appraisal process involved in conscious emotional experiences, is associated with physiological stress responses independent of explicit affect. Furthermore, low resting heart rate variability (HRV) may increase the risk of stress-related diseases. The goals of this study were to evaluate the associations between implicit and explicit affect and METs and to assess whether these associations were amplified by lower HRV. Methods: This secondary analysis of a larger study included 217 middle-aged women who completed measures of implicit affect, explicit affect, high-frequency HRV, and the different components of METs. Results: There was a significant interaction between implicit negative affect and HRV predicting METs (odds ratio = 0.57, 95% confidence interval = 0.35-0.92), such that the combination of higher implicit affect and lower HRV was associated with a greater likelihood of METs. Similarly, there was a main effect of implicit negative affect as well as an interaction between implicit negative affect and HRV on the lipid accumulation product (b (standard error) = -0.06 (0.02), 95% confidence interval = -0.11 to -0.02), a combination of waist circumference and triglycerides. Conclusions: Higher implicit negative affect in the context of lower HRV may be related to a greater risk of METs. The present findings highlight the relevance of including implicit affect measures in psychosomatic medicine research.
Article
Developmental theories often assume that specific environmental risks affect specific outcomes. Canonical Correlation Analysis was used to test whether 28 developmental outcomes (measured at 11-15 years) share the same early environmental risk factors (measured at 0-3 years), or whether specific outcomes are associated with specific risks. We used data from the UK Millennium Cohort Study (N = 10,376, 51% Female, 84% White) collected between 2001 and 2016. A single environment component was mostly sufficient for explaining cognition and parent-rated behavior outcomes. In contrast, adolescents' alcohol and tobacco use were specifically associated with their parents', and child-rated mental health was weakly associated with all risks. These findings suggest that with some exceptions, many different developmental outcomes share the same early environmental risk factors.
Article
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex and/or gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body’s primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing “minority stress” in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
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Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose-response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age.
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A growing body of research has confirmed that workplace bullying is a source of distress and poor mental health. Here we summarize the cross-sectional and longitudinal literature on these associations. Systematic review and meta-analyses on the relation between workplace bullying and mental health. The cross-sectional data (65 effect sizes, N = 115.783) showed positive associations between workplace bullying and symptoms of depression (r = .28, 95% CI = .23-.34), anxiety (r = .34, 95% CI = .29-.40) and stress-related psychological complaints (r = .37, 95% CI = .30-.44). Pooling the literature that investigated longitudinal relationships (26 effect sizes, N = 54.450) showed that workplace bullying was related to mental health complaints over time (r = 0.21, 95% CI = 0.13-0.21). Interestingly, baseline mental health problems were associated with subsequent exposure to workplace bullying (r = 0.18, 95% CI = 0.10-0.27; 11 effect sizes, N = 27.028). All data were self-reported, raising the possibility of reporting- and response set bias. Workplace bullying is consistently, and in a bi-directional manner, associated with reduced mental health. This may call for intervention strategies against bullying at work.
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Many of the body’s adaptive responses, such as pain, fever, and fear, are defenses that remain latent until they are aroused by cues that indicate the presence of a threat. Natural selection should shape regulation mechanisms that express defenses only in situations where their benefits exceed their costs, but defenses are often expressed in situations where they seem unnecessary, with much resulting useless suffering. An explanation emerges from a signal detection analysis of the costs and benefits that shaped defense regulation mechanisms. Quantitative modeling of optimal regulation for all-ornone defenses and for continuously variable defenses leads to several conclusions. First, an optimal system for regulating inexpensive all-or-none defenses against the uncertain presence of large threats will express many false alarms. Second, the optimum level of expression for graded defenses is not at the point where the costs of the defense and the danger are equal, but is instead where the marginal cost of additional defense exceeds the marginal benefit. Third, in the face of uncertainty and skewed payoff functions, the optimal response threshold may not be the point with the lowest cost. Finally, repeated exposures to certain kinds of danger may adaptively lower response thresholds, making systems vulnerable to runaway positive feedback. While we await quantitative data that can refine such models, a general theoretical perspective on the evolution of defense regulation can help to guide research and assist clinical decision making.
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We tested the hypothesis that reduced rostral anterior cingulate cortex (rACC)-subcortical functional connectivity in depressed subjects might account for depression-related autonomic dysregulation. Ten healthy and ten depressed subjects categorized their immediate subjective emotional responses to picture sets while undergoing functional magnetic resonance imaging and electrocardiography. Using an rACC cluster commonly activated in both groups by emotion categorization as a seed region, we then performed voxel-wise functional connectivity analyses to examine rACC connectivity across the brain in depressed and control subjects. rACC had significantly stronger connectivity with a region of the inferior pons in controls than in depressed subjects. Within-subjects differences in rACC-pons connectivity also significantly correlated with measures of both heart rate variability and depression severity. These findings support the hypothesis that autonomic dysregulation in depression may be associated with a functional disconnection between rACC and autonomic brainstem nuclei. Copyright © 2015. Published by Elsevier B.V.
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Perseverative cognition, such as worry and rumination, is a common reaction to stressful events. In this review, we present a self-regulation perspective on perseverative cognition and propose that it forms part of the default response to threat, novelty and ambiguity. This default response is enhanced in chronic worriers who show difficulties in recognizing signals of safety, due to excessive goal commitment and the use of perseverative cognition as a strategy to cope with perceived threats to goal attainment. It is proposed that worrying about stressful events increases the total amount of time that stress has a 'wear and tear' effect on the human body. Studies supporting this perseverative cognition hypothesis are reviewed. Moreover, we provide preliminary evidence that unconscious forms of perseverative cognition have substantial somatic health effects as well. In conclusion, a focus on perseverative cognition is warranted when investigating links between stressful events and somatic health.
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The present study aimed to investigate the possible mechanisms linking a single-item measure of global self-rated health (SRH) with morbidity by comparing the association strengths between SRH with markers of autonomic nervous system (ANS) function, inflammation, blood glucose and blood lipids. Cross-sectional comprehensive healthcheck data of 3947 working adults (age 42±11) was used to calculate logistic regressions, partial correlations and compare correlation strength using Olkins Z. Adjusted logistic regression models showed a negative association between SRH (higher values indicating worse health) and measures of heart rate variability (HRV). Glycemic markers were positively associated with poor SRH. No adjusted association was found with inflammatory markers, BP or lipids. In both unadjusted and adjusted linear models Pearson's correlation strength was significantly higher between SRH with HRV measures compared to SRH with other biomarkers. This is the first study investigating the association of ANS function and SRH. We showed that a global measure of SRH is associated with HRV, and that all measures of ANS function were significantly more strongly associated with SRH than any other biomarker. The current study supports the hypothesis that the extent of brain-body communication, as indexed by HRV, is associated with self-rated health.
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It has been known for many years that the ability to exert behavioral control over an adverse event blunts the behavioral and neurochemical impact of the event. More recently, it has become clear that the experience of behavioral control over adverse events also produces enduring changes that reduce the effects of subsequent negative events, even if they are uncontrollable and quite different from the original event controlled. This review focuses on the mechanism by which control both limits the impact of the stressor being experienced and produces enduring, trans-situational "immunization". The evidence will suggest that control is detected by a corticostriatal circuit involving the ventral medial prefrontal cortex (mPFC) and the posterior dorsomedial striatum (DMS). Once control is detected, other mPFC neurons that project to stress-responsive brainstem (dorsal raphe nucleus, DRN) and limbic (amygdala) structures exert top-down inhibitory control over the activation of these structures that is produced by the adverse event. These structures, such as the DRN and amygdala, in turn regulate the proximate mediators of the behavioral and physiological responses produced by adverse events, and so control blunts these responses. Importantly, the joint occurrence of control and adverse events seems to produce enduring plastic changes in the top-down inhibitory mPFC system such that this system is now activated by later adverse events even if they are uncontrollable, thereby reducing the impact of these events. Other issues are discussed that include a) whether other processes such as safety signals and exercise, that lead to resistance/resilience, also use the mPFC circuitry or do so in other ways; b) whether control has similar effects and neural mediation in humans, and c) the relationship of this work to clinical phenomena.
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Moods can be regarded as fluctuating dispositions to make positive and negative evaluations. Developing an evolutionary approach to mood as an adaptive process, we consider the structure and function of such states in guiding behavioural decisions regarding the acquisition of resources and the avoidance of harm in different circumstances. We use a drift diffusion model of decision making to consider the information required by individuals to optimise decisions between two alternatives, such as whether to approach or withdraw from a stimulus that may be life enhancing or life threatening. We show that two dimensions of variation (expectation and preparedness) are sufficient for such optimal decisions to be made. These two dispositional dimensions enable individuals to maximize the overall benefits of behavioural decisions by modulating both the choice made (e.g., approach/withdraw) and decision speed. Such a structure is compatible with circumplex models of subjectively experienced mood and core affect, and provides testable hypotheses concerning the relationships that occur between valence and arousal components of mood in differing ecological niches. The paper is therefore a useful step toward being able to predict moods (and the effect of moods) using an optimality approach.
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This study aimed to investigate whether interindividual differences in autonomic inhibitory control predict safety learning and fear extinction in an interoceptive fear conditioning paradigm. Data from a previously reported study (N = 40) were extended (N = 17) and re-analyzed to test whether healthy participants' resting heart rate variability (HRV) - a proxy of cardiac vagal tone - predicts learning performance. The conditioned stimulus (CS) was a slight sensation of breathlessness induced by a flow resistor, the unconditioned stimulus (US) was an aversive short-lasting suffocation experience induced by a complete occlusion of the breathing circuitry. During acquisition, the paired group received 6 paired CS-US presentations; the control group received 6 explicitly unpaired CS-US presentations. In the extinction phase, both groups were exposed to 6 CS-only presentations. Measures included startle blink EMG, skin conductance responses (SCR) and US-expectancy ratings. Resting HRV significantly predicted the startle blink EMG learning curves both during acquisition and extinction. In the unpaired group, higher levels of HRV at rest predicted safety learning to the CS during acquisition. In the paired group, higher levels of HRV were associated with better extinction. Our findings suggest that the strength or integrity of prefrontal inhibitory mechanisms involved in safety- and extinction learning can be indexed by HRV at rest.
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Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter of a century. Although the focus of research has been on objective social roles and health behavior, the brain is the key organ for forming, monitoring, maintaining, repairing, and replacing salutary connections with others. Accordingly, population-based longitudinal research indicates that perceived social isolation (loneliness) is a risk factor for morbidity and mortality independent of objective social isolation and health behavior. Human and animal investigations of neuroendocrine stress mechanisms that may be involved suggest that (a) chronic social isolation increases the activation of the hypothalamic pituitary adrenocortical axis, and (b) these effects are more dependent on the disruption of a social bond between a significant pair than objective isolation per se. The relational factors and neuroendocrine, neurobiological, and genetic mechanisms that may contribute to the association between perceived isolation and mortality are reviewed. Expected final online publication date for the Annual Review of Psychology Volume 66 is November 30, 2014. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
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The present review examines the English-language literature published between the years 1990 and 2000 concerning psychological factors and their relationship with the course of Inflammatory bowel disease (IBD). The literature is concerned with: (1) the relationship between psychological stress and symptom exacerbation or relapse in patients with IBD; (2) the relationship between psychological distress (anxiety, depression) and symptomatology of IBD; and (3) the impact of psychological treatment of IBD. Methodology of the studies was critically examined and two main conclusions are made. First, there is a trend emerging such that daily hassles are more significantly associated with exacerbation of symptoms in IBD than major life events. The second conclusion, which is less secure as a result of a lack of appropriate research, is that such increases in disease activity appear to influence mood and this is demonstrated in the intensity of anxiety and depression experienced by participants. It is, therefore, tentatively suggested that a bi-phasic process is evident where perceived stress, typically in the form of daily hassles, increases disease activity which in turn induces psychological distress in IBD patients. The implications of the findings are discussed with reference to future research methodology.
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Perception informs people about the opportunities for action and their associated costs. To this end, explicit awareness of spatial layout varies not only with relevant optical and ocular-motor variables, but also as a function of the costs associated with performing intended actions. Although explicit awareness is mutable in this respect, visually guided actions directed at the immediate environment are not. When the metabolic costs associated with walking an extent increase-perhaps because one is wearing a heavy backpack-hills appear steeper and distances to targets appear greater. When one is standing on a high balcony, the apparent distance to the ground is correlated with one's fear of falling. Perceiving spatial layout combines the geometry of the world with behavioral goals and the costs associated with achieving these goals. © 2006 Association for Psychological Science.
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Results Among women who were married or cohabiting with a male partner (n=187), marital stress was associated with a 2.9-fold (95% confidence interval (CI), 1.3-6.5) increased risk of recurrent events after adjustment for age, estrogen status, education level, smoking, diagnosis at index event, diabetes mellitus, systolic blood pressure, smok- ing, triglyceride level, high-density lipoprotein cholesterol level, and left ventricular dys- function. Among working women (n=200), work stress did not significantly predict recurrent coronary events (hazard ratio, 1.6; 95% CI, 0.8-3.3).
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Uncertainty about a possible future threat disrupts our ability to avoid it or to mitigate its negative impact and thus results in anxiety. Here, we focus the broad literature on the neurobiology of anxiety through the lens of uncertainty. We identify five processes that are essential for adaptive anticipatory responses to future threat uncertainty and propose that alterations in the neural instantiation of these processes result in maladaptive responses to uncertainty in pathological anxiety. This framework has the potential to advance the classification, diagnosis and treatment of clinical anxiety.
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Contexts surround and imbue meaning to events; they are essential for recollecting the past, interpreting the present and anticipating the future. Indeed, the brain's capacity to contextualize information permits enormous cognitive and behavioural flexibility. Studies of Pavlovian fear conditioning and extinction in rodents and humans suggest that a neural circuit including the hippocampus, amygdala and medial prefrontal cortex is involved in the learning and memory processes that enable context-dependent behaviour. Dysfunction in this network may be involved in several forms of psychopathology, including post-traumatic stress disorder, schizophrenia and substance abuse disorders.
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Both social isolation and loneliness are associated with increased mortality, but it is uncertain whether their effects are independent or whether loneliness represents the emotional pathway through which social isolation impairs health. We therefore assessed the extent to which the association between social isolation and mortality is mediated by loneliness. We assessed social isolation in terms of contact with family and friends and participation in civic organizations in 6,500 men and women aged 52 and older who took part in the English Longitudinal Study of Ageing in 2004-2005. A standard questionnaire measure of loneliness was administered also. We monitored all-cause mortality up to March 2012 (mean follow-up 7.25 y) and analyzed results using Cox proportional hazards regression. We found that mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality (hazard ratio 1.26, 95% confidence interval, 1.08-1.48 for the top quintile of isolation), but loneliness did not (hazard ratio 0.92, 95% confidence interval, 0.78-1.09). The association of social isolation with mortality was unchanged when loneliness was included in the model. Both social isolation and loneliness were associated with increased mortality. However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation. Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.
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Individuals in adult attachment relationships regulate one another via overt emotional and social behavior. Attachment-related styles of utilizing social support moderate these regulatory effects. In recent years, the social and affective neurosciences have begun to clarify how these processes are instantiated in the brain, including the likely neural mechanisms of long-term felt security following past attachment experiences and the neural circuitry supporting the regulation of emotion by relational partners. In this brief review, I describe the neural systems involved in the formation and maintenance of adult attachment relationships and review the small amount of work to date on the neuroscience of adult attachment style. I then offer my own speculations about how adult attachment relationships conserve the brain’s metabolic resources, especially those of the prefrontal cortex.
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Many of the body's adaptive responses, such as pain, fever, and fear, are defenses that remain latent until they are aroused by cues that indicate the presence of a threat. Natural selection should shape regulation mechanisms that express defenses only in situations where their benefits exceed their costs, but defenses are often expressed in situations where they seem unnecessary, with much resulting useless suffering. An explanation emerges from a signal detection analysis of the costs and benefits that shaped defense regulation mechanisms. Quantitative modeling of optimal regulation for all-or-none defenses and for continuously variable defenses leads to several conclusions. First, an optimal system for regulating inexpensive all-or-none defenses against the uncertain presence of large threats will express many false alarms. Second, the optimum level of expression for graded defenses is not at the point where the costs of the defense and the danger are equal, but is instead where the marginal cost of additional defense exceeds the marginal benefit. Third, in the face of uncertainty and skewed payoff functions, the optimal response threshold may not be the point with the lowest cost. Finally, repeated exposures to certain kinds of danger may adaptively lower response thresholds, making systems vulnerable to runaway positive feedback. While we await quantitative data that can refine such models, a general theoretical perspective on the evolution of defense regulation can help to guide research and assist clinical decision making.
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The aims of this study were to examine reciprocal longitudinal associations between exposure to workplace bullying and symptoms of psychological distress and to investigate how self-labeled victimization from bullying explains the effects of bullying on health. Logistic regression analysis was employed to examine the longitudinal relationships between workplace bullying and psychological distress in a representative cohort sample of 1775 Norwegian employees. The time-lag between baseline and follow-up was two years. Exposure to bullying behavior was measured with the revised version of the Negative Acts Questionnaire. Perceived victimization from bullying was measured by a single self-labeling question. Psychological distress was measured with the 25-item Hopkins Symptom Checklist. All variables were measured at both baseline and follow-up. After adjustment for psychological distress at baseline, exposure to bullying behavior [odds ratio (OR) 1.68, 95% confidence interval (95% CI) 1.07-2.62) was found to predict subsequent psychological distress. This effect of bullying behaviors disappeared when victimization from bullying (OR 2.47, 95% CI 1.17-5.22) was entered into the regression. Both psychological distress (OR 2.49, 95% CI 1.64-3.80) and victimization (OR 2.61, 95% CI 1.42-4.81) at baseline were associated with increased risks of being a target of bullying behaviors at follow-up. Psychological distress (OR 2.51, 95% CI 1.39-4.52) and bullying behaviors (OR 2.95, 95% CI 1.39-4.52) at follow-up were associated with victimization. The mutual relationship between bullying and psychological distress indicates a vicious circle where bullying and distress reinforce their own negative effects. This highlights the importance of early interventions to stop workplace bullying and provide treatment options to employees with psychological distress.
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Experiential factors shape the neural circuits underlying social and emotional behavior from the prenatal period to the end of life. These factors include both incidental influences, such as early adversity, and intentional influences that can be produced in humans through specific interventions designed to promote prosocial behavior and well-being. Here we review important extant evidence in animal models and humans. Although the precise mechanisms of plasticity are still not fully understood, moderate to severe stress appears to increase the growth of several sectors of the amygdala, whereas the effects in the hippocampus and prefrontal cortex tend to be opposite. Structural and functional changes in the brain have been observed with cognitive therapy and certain forms of meditation and lead to the suggestion that well-being and other prosocial characteristics might be enhanced through training.
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The concept that the gut and the brain are closely connected, and that this interaction plays an important part not only in gastrointestinal function but also in certain feeling states and in intuitive decision making, is deeply rooted in our language. Recent neurobiological insights into this gut-brain crosstalk have revealed a complex, bidirectional communication system that not only ensures the proper maintenance of gastrointestinal homeostasis and digestion but is likely to have multiple effects on affect, motivation and higher cognitive functions, including intuitive decision making. Moreover, disturbances of this system have been implicated in a wide range of disorders, including functional and inflammatory gastrointestinal disorders, obesity and eating disorders.
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