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Exposed to events that never happen: Generalized unsafety, the default stress response, and prolonged autonomic activity
... Theoretically, the presence of multiple underlying vulnerability factors could be explained by the Generalized Unsafety Theory of Stress (GUTS; Brosschot et al., 2017Brosschot et al., , 2018. This theory posits that unsafety is experienced when safety signals are lacking and is not necessarily evoked by a specific threatening stimulus. ...
... This theory posits that unsafety is experienced when safety signals are lacking and is not necessarily evoked by a specific threatening stimulus. Rather, such generalized perceived unsafety results from chronic compromises in important life domains, namely, health and functioning (compromised bodies), social engagement (compromised social network), and overall environment (compromised contexts) (Brosschot et al., 2017(Brosschot et al., , 2018. Consequently, deficits in any of these life domains indicate vulnerability for perceived unsafety. ...
... In LPA, the latent profiles are identified based on preselected indicator variables (Wang & Wang, 2020). For the current study, the selection of indicator variables was theoretically guided by the GUTS (Brosschot et al., 2017(Brosschot et al., , 2018, as well as environmental gerontology perspective (Wahl & Gitlin, 2019) and the social capital theory (De Donder et al., 2012). Specifically, variables corresponding to potentially compromised life domains that were relevant in the ageing context were selected for the analysis. ...
Objectives: Feeling safe in the daily environment is important in late life. However, research on configuration of vulnerability factors for perceived unsafety in older adults is scarce. The current study aimed to identify latent subgroups of older adults based on their vulnerability for perceived unsafety.Method: We analyzed the data from a cross-sectional survey of residents in senior apartments in a mid-sized Swedish municipality (N = 622).Results: The results of the latent profile analysis based on frailty, fear of falling, social support, perceived neighborhood problems, and trust in others in the neighborhood indicated the presence of three profiles. These profiles were labelled as compromised body and social networks (7.2%), compromised context (17.9%) and non-vulnerable (74.9%). Profile membership was statistically predicted by age, gender, and family status and profiles differed in perceived unsafety, anxiety and life satisfaction.Conclusion: Overall, the study findings suggested the existence of latent subgroups of older people based on patterns of vulnerability.
... However, the mere absence of threat is not sufficient (Brosschot et al., 2017;Porges, 2015). ...
... Even without threats being present, animals and humans can feel uncomfortable and exhibit a stress response, a circumstance referred to as 'intolerance of uncertainty' (Brosschot et al., 2017). An organism needs to feel safe to optimally engage in restorative and vegetative processes (Porges, 2022). ...
... On the cerebral level, the ventromedial PFC plays an integral role in the processing of negative and positive affective stimuli (Koban et al., 2021), fear extinction and conditioning (Battaglia et al., 2022) as well as the search for and processing of safety signals (Harrison et al., 2017;Yao et al., 2018). In the presence of safety signals, the ventromedial PFC inhibits the limbic stress network (Brosschot et al., 2017), and activates the PNS (Hänsel & von Känel, 2008). Consequently, PNS dominates over SNS outflow (O'Connor et al., 2021;Porges, 2007). ...
... The Generalized Unsafety Theory of Stress (GUTS) is a relatively recent stress framework that highlights the role of cognitive salience and the interpretative mind in stress response, beyond the simple emphasis on stress physiology. 62,63 Specifically, GUTS posits that since neurobiological stress response is an evolutionary conserved physiological mechanism, it is not limited to being simply reactive to stressful stimuli, where it is likened to a light switch. Rather the stress response remains continuously active, but largely outside of conscious awareness (akin to temperature regulation or metabolism). ...
... [123][124][125][126][127] A recently introduced model of stress, the Generalized Unsafety Theory of Stress (GUTS), centers cognitive tendencies as having a key role in regulating the biological stress response. 62,63 According to GUTS, while adaptive cognitive tendencies (e.g., active coping and reappraisal) help downregulate the neurobiological stress response, maladaptive cognitive tendencies (e.g., vigilance, avoidant coping or suppression) can perpetuate this neurobiological response even in the absence of external stressors or experiences. 63 In sum, the GUTS formulation emphasizes that cognitive and emotional processes play a key mediating role between stress and disease by buffering or mitigating potential stress impact. ...
... However, they can also affect the neurobiological stress response independently from external stressors through a self-perpetuating process mediated by cognitive tendencies such as vigilance. 62 A developing body of research has demonstrated mixed and sometimes unexpected results on how these cognitive tendencies may contribute to stress-related health disparities, especially with respect to variations by race and socioeconomic status (SES Results further vary with respect to reported physical health outcomes. For example, using the EHDIC sample, Hines et al., 130 found that both vigilance and race-related discrimination were associated with a lower odds of hypertension among White but not Black adults. ...
There is growing recognition that chronic psychosocial stress may accelerate aging, increase risk of diseases, and contribute to health disparities. Variability across findings and methodological challenges limit our ability to examine chronic stress as a key mechanism driving health disparities at the population scale. In an effort to clarify some of these dimensions and methodological challenges, this dissertation (1) explored definitional and measurement-related issues around the construct of stress, and by employing uniquely positioned epidemiologic sources of data and life course analytical methods, (2) examined the impact of psychosocial stress on cardiometabolic health across structural and socioeconomic differences. Aim 1 relied on quasi-experimental design features of the Richmond Stress and Sugar study (RSASS) to examine whether two common self-report measures of psychosocial stress reflect neurobiological stress response assessed by changes in salivary cortisol before and after an acute stress challenge. Adjusted linear spline mixed-effects models revealed that both perceived stress and domain-specific stress measures were inversely associated with neurobiological stress reactivity. Neighborhood SES, but not race/ethnicity, modified these associations. In Aim 2, we applied a novel stress framework to examine associations between stress-related cognitive tendencies (i.e., vigilance and avoidant/adaptive stress coping) and metabolic risk in a prospective cohort from the Healthy Aging in Neighborhoods of Diversity across the Lifespan Study (HANDLS). Contrary to our expectations, vigilance was not associated with metabolic risk in any of our mixed-effects linear models, while both types of stress coping were negatively associated with metabolic risk. Findings suggest that a higher level of engagement in any form of stress coping may be beneficial and help temper stress impact on metabolic health. Evidence for stress coping varied by race and lifecourse SES, suggesting that activation of a particular coping style may be context-specific and depend on the availability of psychosocial resources. Aim 3 sought to clarify the role of stress as a contributor to type 2 diabetes incidence, with attention to inequities in diabetes risk. Two separate time-to-event analyses using data from RSASS and HANDLS showed that stress was not associated with incident diabetes, but the estimates of association were in the hypothesized direction and comparable across the studies. This was consistent across two distinct measures of stress: perceived stress and acute stress reactivity. Subgroup analyses in HANDLS revealed that compared to White adults with low levels of perceived stress, White adults with high stress and Black adults (both high and low stress) had higher diabetes incidence. Convergent results from two longitudinal samples underscored the importance of replicating evidence across studies with shared features and design, an effort that provides a more robust understanding of the substantive question than what could be obtained from a single cohort. In sum, collective evidence generated from this work contributes toward efforts aimed at improving stress measures in population research and considering stress as a potentially modifiable factor of social health disparities.
... The Generalized Unsafety Theory of Stress (GUTS) model holds that individuals with a generalized perception of unsafety have increased physiological hyperarousal, even during objectively safe or neutral environments (Brosschot et al., 2017). Thus, generalized perceptions of unsafety should be most apparent during objectively safe, but negatively conditioned contexts (Bouton, 2004;Brosschot et al., 2016Brosschot et al., , 2017. ...
... The Generalized Unsafety Theory of Stress (GUTS) model holds that individuals with a generalized perception of unsafety have increased physiological hyperarousal, even during objectively safe or neutral environments (Brosschot et al., 2017). Thus, generalized perceptions of unsafety should be most apparent during objectively safe, but negatively conditioned contexts (Bouton, 2004;Brosschot et al., 2016Brosschot et al., , 2017. Discriminant conditioning paradigms provide a laboratory assessment by which generalized perceptions of unsafety can be examined as startle response inhibition to "safe" cues (Bouton, 2004;Brosschot et al., 2016Brosschot et al., , 2017. ...
... Thus, generalized perceptions of unsafety should be most apparent during objectively safe, but negatively conditioned contexts (Bouton, 2004;Brosschot et al., 2016Brosschot et al., , 2017. Discriminant conditioning paradigms provide a laboratory assessment by which generalized perceptions of unsafety can be examined as startle response inhibition to "safe" cues (Bouton, 2004;Brosschot et al., 2016Brosschot et al., , 2017. ...
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.
... 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. ...
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).
... 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. ...
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.
... 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). ...
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.
... 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. ...
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.
... Phylogenetic theories suggest that determined biological factors may predispose humans to be social (e.g., Porges, 2007). One such factor is resting vagally mediated heart rate variability (vmHRV), which derives from the synergistic actions of the sympathetic and parasympathetic autonomic nervous systems (ANS) that enable the cardiovascular system to adapt to the changing demands of the environment by regulating appropriate behavioral responses and modulating physiological states to support social behavior (Berntson et personality trait (Lane et al., 1990;Weinberger, 1990) and diminished inhibition of the physiological stress responses to safe or ambiguous stimuli (e.g., Brosschot et al., 2017). ...
... Higher vmHRV has been associated with better adaptability and flexibility in coping with various situational demands, as well as with prosocial motives and emotions that help alleviate and prevent psychological distress (Petrocchi & Cheli, 2019). On the other hand, lower vmHRV has been associated with the release of the default physiological defensive response in a safe environment (e.g., Brosschot et al., 2017). Current data suggest that resting vmHRV contributes to shape social attributions about strangers such that individuals with higher vmHRV tend to perceive others as more caring and trustworthy, and therefore being more willing to approach and bond with others. ...
Phylogenetic theories suggest resting vagally mediated heart rate variability (vmHRV) as a biomarker for adaptive behav- ior in social encounters. Until now, no study has examined whether vmHRV can predict individual differences in inferring personality traits and intentions from facial appearance. To test this hypothesis, resting vmHRV was recorded in 83 healthy individuals before they rated a series of faces based on their first impression of trustworthiness, dominance, typicality, familiarity, caring, and attractiveness. We found an association between individual differences in vmHRV and social attri- butions from facial appearance. Specifically, higher levels of vmHRV predicted higher scores on ratings of caring and trustworthiness, suggesting that strangers’ faces are more likely to be perceived as safer. The present results suggest that higher levels of vmHRV (compared with lower levels of vmHRV) are associated with the tendency to minimize social evaluative threat and maximize affiliative social cues at a first glance of others’ faces.
... Every time we perceive something as stressful, our bodies respond with a wellcoordinated stress response eliciting a cascade of psychological and physiological changes (Chrousos, 2009). The natural stress-induced physiological action tendency, promoting adaptation and energy mobilization, has been postulated to be a default response to uncertainty, novelty, and threat (Brosschot et al., 2017), which is under continuous inhibition by the ventromedial prefrontal cortex (vmPFC; Motzkin et al., 2015). When this default stress response becomes disinhibited, and prefrontal inhibition of amygdalar activity decreases (Motzkin et al., 2015;Thayer & Lane, 2000), changes in autonomic nervous system activity arise (Thayer & Lane, 2000). ...
... As such, parasympathetic activation swiftly decreases (i.e., parasympathetic withdrawal) and, relatively slower, sympathetic activity increases (i.e., sympathetic arousal) resulting in, for instance, increased heart rate and skin conductance (i.e., $ght-"ight response, Gaab et al., 2003;Kemeny, 2003). Crucially, however, as soon as the source of stress has disappeared, and the situation is perceived as safe, we should be able to inhibit this response allowing for physiological stress recovery (Brosschot et al., 2017;Thayer, 2006). Yet, stressful events might trigger perseverative cognitions, referring to negative thoughts that mentally represent such event and that are di%cult to suppress (Brosschot et al., 2005(Brosschot et al., , 2006. ...
Perseverative cognitions can provoke psychophysiological stress in the absence of an actual stressor and are considered important transdiagnostic vulnerability factors for several (mental) health issues. These stress-related cognitive processes are reflected by both cognitive (assessed by self-reports) and autonomic inflexibility (assessed by heart rate variability; HRV), with a key role attributed to the vagus nerve. Interestingly, modulation of the afferent branches of the vagus can be achieved with transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive technique that employs a low-intensity electrical current applied to the ear. In a sample of healthy individuals, we investigated the effects of taVNS of the left concha, compared to sham (earlobe) stimulation, on the cognitive and autonomic correlates of perseverative cognition following a psychosocial stress task. Interestingly, taVNS significantly reduced cognitive rigidity, reflected by reduced subjective perseverative thinking after psychosocial stress. Although there were no direct effects on autonomic correlates of perseverative cognition, individual differences in perseverative thinking after the stressor significantly affected the effects of taVNS on HRV. Specifically, more autonomic inflexibility during the stress task (i.e., reduced HRV) was associated with increases in perseverative thinking afterward for the sham condition, but not the active taVNS condition. Additional exploratory analyses revealed no significant moderation of stimulation intensity. Overall, the study findings endorse the association between perseverative cognitions and vagus nerve functioning.
... However, assessments of the relationship between stress and HRV are diverse. Currently, the literature highlights the role of the parasympathetic activity as a brake on stress [35,[41][42][43][44], especially parasympathetic activity has been associated with a vulnerability to depression [44]. Literature [45,46] noted that the root mean square successive difference (RMSSD) is one of the most useful HRV index for the activity of the parasympathetic nervous system and the quality of the stress response. ...
... Recently, the generalized unsafety theory of stress claims that the stress response is considered as default. Brosschot et al. [42] note "the stress response is a default response of the organism, and that it is the response the organism automatically falls back upon when no other information is available". Submariners on board a SSBN live with nuclear arm and fear of lethal damage. ...
Extreme and unusual, and isolated and confined environments (EUE/ICE) are characterized by unique sensory stimulation. They are known to adversely affect human psychology and physiology, and threaten the outcome of spatial, polar, or submarine missions. This exploratory study evaluates the negative impact of a submarine patrol on the psychological and sensory performances according to heart rate variability (HRV). Nineteen submariners were classified into high parasympathetic activity (HPa) and low parasympathetic activity (LPa) groups using their pre-patrol parasympathetic level. The impacts of the mission on emotional health, interoception and exteroception were evaluated at baseline, twice during the patrol, and once at recovery one month later. Emotional health was assessed using the scale of positive and negative experience (SPANE) questionnaire. Interoception and exteroception were evaluated using other questionnaires and sensorial assessments, respectively. In all cases, no significant inter-group difference was found for emotional health. Exteroceptive and interoceptive functioning was better among the HPa group compared to the LPa group, both during the patrol and at recovery. HRV measures for the HPa group indicated a more adaptable profile, marked by greater cardiac vagal tone during the patrol and at recovery. Our results are the first to highlight the impact of physiological differences in HRV profile on adaptability in an ecological constraint environment. Such research would open perspectives for submariners’ preparation, but also the design of countermeasures that bring us closer to Mars.
... Later in life, the presence of actual threat will no longer be requiredthe mere lack of an effective safety system suffices to trigger threat perception and prompt the associated responses 9,28,29 . This activation can be unconscious, invoking a chronic activation of the stress response even when people are unable to identify a specific stressor 29,104 . ...
... However, insecure attachments or adversity, if present, can have long-term detrimental effects and constitute one of many potential vulnerability factors. Once established, the imbalance between threat and soothing might feed hypervigilance to, and amplification of, other potential alarm signals, as well as ruminative and anticipatory processes, thus 'refuelling' the system and increasing the perception of threat and unsafety 29,104 (Fig. 3). ...
Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances and other symptoms, and has a substantial socioeconomic impact. Current biomedical and psychosocial treatments are unsatisfactory for many patients, and treatment progress has been hindered by the lack of a clear understanding of the pathogenesis of fibromyalgia. We present here a model of fibromyalgia that integrates current psychosocial and neurophysiological observations. We propose that an imbalance in emotion regulation, reflected by an overactive ‘threat’ system and underactive ‘soothing’ system, might keep the ‘salience network’ (also known as the midcingulo-insular network) in continuous alert mode, and this hyperactivation, in conjunction with other mechanisms, contributes to fibromyalgia. This proposed integrative model, which we term the Fibromyalgia: Imbalance of Threat and Soothing Systems (FITSS) model, should be viewed as a working hypothesis with limited supporting evidence available. We hope, however, that this model will shed new light on existing psychosocial and biological observations, and inspire future research to address the many gaps in our knowledge about fibromyalgia, ultimately stimulating the development of novel therapeutic interventions. In this Perspective, the authors propose a model in which an imbalance of threat and soothing systems leads to hyperactivation of the brain’s salience network, which, in conjunction with other mechanisms, contributes to fibromyalgia.
... The recently introduced generalized unsafety theory of stress (GUTS; Brosschot et al., 2017Brosschot et al., , 2018 proposes that stress is a default mode state that is chronically inhibited by the prefrontal cortex when the environment is considered safe. As unsafety is potentially dangerous to the organism, it disinhibits the stress response, ultimately ensuring survival of the organism. ...
... Of note, this latter effect could not solely be attributed to parasympathetic efference, since controlling for RMSSD did not eliminate it. Although the findings generally support the idea that feeling safe is associated with dampened cardiac activity as suggested by the polyvagal theory (Porges, 2022) and the GUTS (Brosschot et al., 2017), it seems that vagal efference was not the main driver of this effect. ...
Feeling safe has been suggested to reflect a state of beneficial autonomic regulation, which might facilitate physical and mental health. We aimed to examine the relationship between the perception of safety in everyday life and cardiac activity (heart rate, heart rate variability) via ecological momentary assessment (EMA). Sixty participants volunteered in a 3-day EMA protocol with parallel recordings of the ECG and subjective ratings of safety. Higher experienced safety in everyday life was associated with better sleep quality, being at home (vs. other locations), being surrounded by close others, as well as more positive and less negative social interactions, thus suggesting valid assessment. Moreover, perceived safety was positively associated with heart rate variability, although this association vanished when controlling for heart rate. Conversely, perceived safety was significantly negatively associated with heart rate, even after controlling for heart rate variability. Findings suggest that feeling safe is associated with attenuated cardiac activity and this effect is probably mediated by sympathetic nervous system activity.
... HRV represents the peripheral output of the central autonomic network (CAN) . The CAN modulates on a moment-to-moment basis not only somatic responses to adapt to internal or external challenges, ultimately to maintain homeostasis (Benarroch, 2014;Bernard, 1867;Thayer and Lane, 2000;Wulsin et al., 2018) but also shapes emotional appraisal (i.e., emotional regulation) and behavioral adaption (Brosschot et al., 2017;Thayer et al., 2021;Thayer and Lane, 2000). Thus, the function of the CAN is complex and defining an index can be described as measuring the capacity of the body to adapt to environmental challenges and its improper functioning has been suggested to accelerate aging processes and thus increase morbidity and mortality . ...
... Under conditions of uncertainty or threat, these critical areas of the vmPFC rapidly become hypoactive and the so-called fight-or-flight response can unfold . It has been suggested that this fight-or-flight response is actively inhibited by default due to perception of safety (Brosschot et al., 2017;O'Connor et al., 2021), unless it becomes disinhibited due to the perception of danger . Measures of HRV are suggested to index the extent of this vmPFC inhibitory function. ...
Measures of heart rate variability (HRV) as a predictor of risk of disease and mortality have been investigated from various perspectives for more than six decades. The aim of the present comprehensive meta-analysis is to examine eight different HRV parameters to determine their association with all-cause and cardiac mortality. A total of 32 studies and two individual participant datasets (IPD) with 37 samples and 38,008 participants were included. Lower HRV parameter values were significant predictors of higher mortality across different ages, sex, continents, populations and recording lengths. Most of the examined parameters showed comparable hazard ratios (HR). IPD sub-analysis for heart rate corrected HRV parameters confirmed the strong association between HRV and all-cause mortality. Meta-regressions revealed no effect modifier for HRs extracted from covariate-adjusted studies. Sub-analyses of studies comparing the lowest quartile of 5-min root mean square of successive differences (RMSSD) vs. the other quartiles yielded a combined HR of 1.56 (95% CI: 1.32-1.85). The applicability of HRV measurement in preventive settings is discussed.
... 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). ...
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.
... 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. ...
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.
... 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. ...
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.
... In another study, a large-scale examination of both subjective experiences of maltreatment and court-reported maltreatment, objective records of the events that occurred were most likely to predict later psychopathology when individuals also self-reported maltreatment (Danese & Widom, 2020). While this research is still nascent and subject to alternative interpretations, it aligns with an extensive body of literature in adults and nonhuman animals indicating that variability in how individuals interpret and perceive events in their environments drives responses to psychological, behavioral, and physiological stress (Brosschot et al., 2017;McEwen & Akil, 2020). ...
... Stress is conceptualized classically as the presence of perceived threat (McEwen & Akil, 2020). However, an alternative view is that stress represents the absence of perceived safety (Brosschot et al., 2017; see Figure 1). This distinction is nuanced, but it has implications for understanding the underlying developmental mechanisms associated with childhood adversity. ...
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.
... (The Netherlands,7). The most accepted theories postulate that some kind of stimulus, denominated the stressor, must be present in order to trigger a response or reaction expressed as stress (8)(9). Hence we can define academic stress as the kind of stress produced in any educational context, especially the university context, affecting both teachers and students. ...
... This result is consistent with the findings of other studies (13,22) which identify fear of being assessed and fear of failure in examinations as the most frequently perceived contributors to academic stress. In this respect, researchers such as Brosschot et al., (9), Salavarani et al. (12) and Cabanach et al. (13) also highlight academic overload as a highly significant factor in stress levels, as was the case with the students in this study. ...
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.
... Une approche théorique récente a été proposée pour enrichir les modèles dans le cadre du stress chronique. Elle complète les approches précédemment présentées avec un changement de perspective (Brosschot 2017;Brosschot, Verkuil, et Thayer 2017;. Plus précisément, le cadre théorique est celui d'un modèle de stress basé sur les mécanismes et processus suivants : (i) Le stress est une réponse par défaut qui est toujours présente dans l'organisme ; elle n'est pas générée en réponse à un stresseur mais désinhibée (réponse rigide) dès lors que l'environnement est perçu comme non sécure par le sujet ; (ii) Les compétences inhibitrices impliquent les zones préfrontales et la régulation du SNA parasympathique pour permettre l'ajustement aux changements de l'environnement perçus ; Concernant le SNA parasympathique, il a notamment été montré qu'un haut niveau de complexité des systèmes neurophysiologiques permet à des individus de répondre avec flexibilité aux différents stimuli de l'environnement, sans perturber leur homéostasie à plus long terme ; (iii) Les conditions dans lesquelles l'environnement est perçu comme sécurisant pour permettre une récupération post stresseurs sont apprises par l'organisme au cours de son développement. ...
Pre and postnatal phases are thought to be associated with physiological, biological, et psychical upheavals. The perinatal period constitutes a time of psychical vunerability during which women are at risk of developping a mental illness.Postpartum depression (PPD) forms one of the major complications of postpartum and affects 20% of women. It's considered to be one of the great model of chronic stress.This thesis' main aim is to study the physiopathological mechanisms inducing the emergence of a PPD, with the help of psychological, physiopathological, biological and genetical measures of pregnancy monitoring. More precisely, we want to identify a predictive value for the emergence of PPD by evaluating if the mindfulness disposition is a protecting factor in the occurence of PPD.Indeed, numerous studies have shown that mindfulness is an asset for overall health, especially in the scope of stress prevention and its consequences.Results underline the protective role of the mindfulness functioning on the risk of PPD occurence. Psychological factors linked with mood and perceived social support are also suggested for pregnancy monitoring.Concomitantly, we've sought to evaluate the perinatal healthcare providers' scope of knowledge of post-partum psychical complications, especially on PPD. The results highlight that these professionals are poorly trained in the identification and management of these complications and there are a number of personal and organizational obstacles to this observation.Considering these results, we've proposed preventing counter measures of PPD by targeting pregnant women and perinatal health providers.In this context, we've started the inception of a training tool for healthcare providers in order to assist them in better prevention, screening and undertaking one of the gravest psychical complications of PPD, with the help of Virtual Reality environment. This thesis work is part of the current consideration of the deleterious consequences of PND on the family unit and on the development of the child.
... A key difference is that Social Safety Theory extends beyond psychosocial processes affecting health to describe a complete set of biologically plausible mechanisms linking social experiences with human health and behavior. Second, Social Safety Theory shares some similarities with the Generalized Unsafety Theory (GUTS; Brosschot et al., 2017), but differs from GUTS with respect to its descriptions of threat preparedness as well as basal, stress-related biology. Whereas GUTS posits that basal biological states are designed for threat preparedness, for example, Social Safety Theory hypothesizes that threat-related biological processes should only be activated for individuals who have experienced their early-life environment as being socially threatening. ...
Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that in turn affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.
... (i) strengthening parasympathetic inhibition; and (ii) strengthening prefrontal control (13)(14)(15). In this context, the literature highlights the bene ts of cognitive therapies such as mindfulness to strengthen ANS regulation (75), cognitive exibility (76), and interoceptive abilities (77). ...
Background: While professionals working in chemical, biological, radiological, and nuclear (CBRN) environments have underlined the need to improve the psychological and operational safety of personnel, there are few data regarding the stress induced in responders who must wear CBRN equipment. These conditions are particularly restrictive, both due to the risk of exposure to life-threatening toxic agents, and the need to wear equipment that places demand on their psychological, cognitive, and physiological capacities. Inter-individual variability remains poorly understood. Current research recognizes that the activity of the parasympathetic system (PSS) can be used as an objective marker of stress adaptation, measured as heart rate variability (HRV).
Methods:28 members of the Paris Fire Brigade medical team attended to three simulated scenarios requiring CBRN management of casualties. We examine: (i) anxiety, emotions, coping, body awareness, cognitive load, HRV, and exteroception impacts of working in CBRN environment; (ii) the role of PSS functioning in stress responses; and (iii) recovery. We recorded for three days: before the simulations (baseline), simulations’ day (pre- and post-training), and the following day.
Results show: (i) a high level of anxiety at baseline (Median 51 [46;56]) which decreased between pre- and post-training (p = 0.02); (ii) a post-simulation decrease in negative affect (p = 0.03); (iii) a tendency to decrease in body awareness during simulation (p = 0.06), which returned to the initial level at follow-up (p = 0.07); and (iv) decrease in mean RR between baseline and post-simulation n°1 (p = 0.04), and between baseline and post-training (p= 0.01). Clustering analysis based on the post-training median RMSSD: (i.e., stress-adapted subject versus non-stress-adapted subject) shows that stress-adapted subject tends to have more positive affect (p=0.006), a higher mean RR (p = 0.014) and SDNN (p = 0.005). The autonomic nervous system (ANS) shows different kinetics: the PSS activity increases post simulation in stress-adapted subject, and collapse between baseline, pre- and post-training in non-stress-adapted subject (p = 0.002). The sympathetic activity tends to increase in stress-adapted subject between baseline, pre- and post-simulation and tend to decrease in non-stress-adapted subject.
Conclusion: stress-adapted subject has a hardiness psycho-physiological response under CBRN stress.
... The latter is categorized based on the experience of high job demands and low levels of control and is said to promote the development of new adaptive behaviours. Importantly, the model is underpinned by several existing theories within the stress literature (cf., Cohen et al., 2016;Brosschot et al., 2016Brosschot et al., , 2017Brosschot et al., , 2018 informed by the concept of 'allostatic load' (McEwen, 1998); attesting that the wear and tear that the body experiences is due to repeated and long-term exposure to stress. It would therefore follow that actions to meet work demands yield short-term psychological (e.g. ...
Objective:
Job strain has been implicated in a variety of adverse health outcomes, particularly cardiometabolic and inflammatory diseases. However, the mechanisms underlying these effects remain largely unknown. One possibility is that the maladaptive coping response to stress, (perseverative cognition (PC); the cognitive representation of past stressful events (rumination) or feared future events (worry)), either in work or more generally, mediates the relationship between job strain and physical disease. The aim of this study was thus to test the potential role of both general, and work- related PC as a mediating, or potentially moderating, mechanism between job strain and ill- health outcomes.Design & Measures:Using an online cross- sectional design, 650 full- time employees completed measures of job strain, general and work- related PC (rumination & worry) and health outcomes (burnout, somatization, health behaviours & sleep quality).
Results:
General and work- related worry and rumination significantly mediated, often independently, the relationship between job strain and burnout, somatization, and sleep quality. No significant mediation effects were observed for health behaviours and no type of PC (general or work- related) moderated job strain- health outcome relations.
Conclusion:
Both general and work- related worry and rumination are likely to play important, and partly independent, roles in understanding the adverse relationships between job strain and various health outcomes.
... Subjective experiences of adversity may also be important for the development of psychopathology, in addition to objective exposures. Individual perception of the environment is an essential feature of chronic stress & anxiety responses (Brosschot et al., 2017). For example, Danese & Widom (2020) found that adults with objective, courtsubstantiated maltreatment in childhood, but without retrospective reports of abuse/neglect, had similar levels of psychopathology than matched controls with no objective or subjective experience of maltreatment. ...
This PhD thesis investigates how adversity impacts a broad range of child development outcomes – ranging from depression, drug use, and cognitive development. The first study is a validation study for a series of novel cognitive assessments created for the Cambridge-based RED longitudinal study, which are utilized in later chapters (adapted from Bignardi et al. 2020). The second study investigates whether ratings of anxiety and depression symptoms have changed relative to before the COVID-19 lockdown, in a sample of 9-11 year-olds (adapted from Bignardi et al. 2020). The final two studies investigate how adversity impacts child development through the lens of specificity theories. These theories propose that specific aspects of the environment (e.g. exposure to a richer linguistic environment) have specific consequences for children’s development (e.g. better language skills). The third study investigates whether socioeconomic status, a widely used marker of potential adversity, is associated with specific cognitive skills (e.g. language skills, executive functions). SEM models are used to test if SES predicts specific skills after controlling for general cognitive ability (GCA). This study utilizes data from the three large-scale cohort studies, including the RED study first introduced in the thesis. The final study takes a data-driven approach, to test whether different risk factors measured in infancy are associated with specific developmental outcomes in adolescence, using longitudinal data from the UK Millennium Cohort Study. Across both studies, we found evidence of strong, broad effects of SES and other risk factors across most outcomes in addition to more minor, specific associations with outcomes. Whilst SES is broadly associated with cognition and behaviour, we found in chapter 3 that vocabulary skills are particularly susceptible, even when controlling for GCA. In the final chapter, we found that SES and other risk factors have broad associations with outcomes, a different set of risk factors better predicts adolescent drug use and self-rated wellbeing.
... The concept of "generalized unsafety" is more significant when it comes to the causes of prolonged activity than the stress responses to specific unsafeties as they appear in the conventional stress theory. 31,32 Clearly, sleep is a state when someone cannot consciously worry or ruminate. Our results may show that worrying or rumination continues in an unconscious fashion due to the experience of threat to personal safety and life, and thus the physiological stress effects that lead to sleep disturbance continue to be present. ...
Purpose:
Child maltreatment may be linked with long-term sleeping disorders and limited coping with stress. Yet, the potential relationships are only marginally studied.
Patients and methods:
Based on a sample of young adults (n = 312) this study aims at exploring the effects of child maltreatment and the experience of threat to personal safety and life in childhood on sleep disturbances in early adulthood. Data were collected at the two study sites, Ulm University and Bielefeld University, by an online survey. For both risk factors, child maltreatment and the experience of threat to personal safety and life in childhood, a direct impact on sleep disturbances and an indirect path via psychological distress were tested using Structural Equation Modelling (SEM).
Results:
In these models, the direct path to sleep disturbances turned out to be significant for the experience of threat to personal safety and life (Path C: b = 0.18, p = 0.013), but not for child maltreatment (Path C: b = 0.05, p = 0.491). However, the current level of psychological distress was found to have a mediating effect on sleep disturbances for both risk factors, thereby confirming indirect significant effects.
Conclusion:
Considering that the etiological pathway of child maltreatment on sleeping disturbances is mediated via psychological distress, this provides a venue to test in future research whether stress reduction interventions can reduce the negative consequences of child maltreatment on sleep disorders.
... 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. ...
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). ...
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.
... Social baseline theory, for example, suggests that the human brain is tuned to a default position of expecting to be in the presence of others who can act as potential support figures in times of threat or stress (Coan & Sbarra, 2015); the absence of supportive others is then viewed as decreasing the individual's sense of relative safety. Theories regarding the role of social safety note the significant stress that occursand the adverse physiological effects that followwhen individuals perceive the social environment to be potentially threatening, for example in the face of interpersonal conflict (Brosschot et al., 2017;Slavich, 2020). Attachment theory has also long noted the importance of felt security in human functioning across the lifespan (Bowlby, 1980;Main et al., 1985), and variations in attachment have been associated with physiological risk factors such as altered immune function (Picardi et al., 2013) and cortisol responses (Pietromonaco et al., 2013). ...
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.
... 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). ...
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.
... 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). ...
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.
... Subjective experiences of adversity may also be important for the development of psychopathology, in addition to objective exposures. Individual perception of the environment is an essential feature of chronic stress and anxiety responses (Brosschot et al., 2017). For example, Danese and Widom (2020) found that adults with objective, court-substantiated maltreatment in childhood, but without retrospective reports of abuse or neglect, had similar levels of psychopathology to matched controls with no objective or subjective experience of maltreatment. ...
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.
... 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. ...
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.
... 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). ...
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). ...
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.
... 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. ...
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.
... 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). ...
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.
Racial disparities in health are a major public health problem in the United States, especially when comparing chronic disease morbidity and mortality for Black versus White Americans. These health disparities are primarily due to insidious anti-Black racism that permeates American history, current culture and institutions, and interpersonal interactions. But how does racism get under the skull and the skin to influence brain and bodily processes that impact the health of Black Americans? In the present article, we present a model describing the possible neural and inflammatory mechanisms linking racism and health. We hypothesize that racism influences neural activity and connectivity in the salience and default mode networks of the brain and disrupts interactions between these networks and the executive control network. This pattern of neural functioning in turn leads to greater sympathetic nervous system signaling, hypothalamic-pituitary-adrenal axis activation, and increased expression of genes involved in inflammation, ultimately leading to higher levels of proinflammatory cytokines in the body and brain. Over time, these neural and physiological responses can lead to chronic physical and mental health conditions, disrupt well-being, and cause premature mortality. Given that research in this area is underdeveloped to date, we emphasize opportunities for future research that are needed to build a comprehensive mechanistic understanding of the brain-body pathways linking anti-Black racism and health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Intolerance of uncertainty (IU) has gained widespread interest as a construct of broad interest from both transdiagnostic and trans-situational perspectives. We have approached this article inspired by the curiosity, clinical observation, consideration of different theoretical perspectives, speculation, optimism and indeed fun that can be seen in S. J. Rachman's work. We address some of what we know about IU before considering one way of conceptualizing IU from the standpoint of a felt sense or embodied experience.
In the first part, we start with Woody and Rachman's (1994) observations of people with GAD. Second, we consider some key findings from the literature. Third, we consider two important perspectives on uncertainty, namely, Brosschot et al.’s (2016, 2018) influential Generalized Unsafety Theory of Stress and uncertainty as an emotion.
In the second part, backing our clinical hunch about the importance of the felt sense of uncertainty, we consider IU from the perspective of interoception and the somatic error theory of anxiety (Khalsa & Feinstein, 2018). We propose the somatic error theory of intolerance of uncertainty, which places the experience of uncertainty at the heart of our understanding of intolerance of uncertainty. This is followed by predictions, unresolved questions, and potential clinical implications.
Finally, we revisit Woody and Rachman's (1994) suggestions for treatment as internalizing “a sense of safety in a range of circumstances (p. 750)” and update this from the perspective of the felt sense of uncertainty. We finish by suggesting that uncertainty can be tolerated, perhaps accepted, and even embraced.
Objective:
To test whether expectations of respect and appreciation from others, assessed in daily life, are associated with preclinical vascular disease.
Method:
Participants were an urban community sample of 483 employed adults (47% male, 17% Black, mean age = 42.8 years). Carotid intima-media thickness (IMT) was measured using B-mode ultrasound. Expectations of being treated with respect and appreciation were measured using the average of hourly assessments over the course of 4 days, and home and work averages were also examined separately.
Results:
Expectations of greater respect and appreciation from others were associated with significantly less carotid IMT even after adjustment for demographic factors, general positivity and negativity of social interactions, neuroticism, optimism, perceived discrimination, and concurrent biological risk factors. This association was similar across social contexts of work and home and also when expectations of respect and appreciation were examined separately. Lower expectations of respect and appreciation and more negative social interactions were both independently associated with greater IMT in fully adjusted models and effect sizes were similar to traditional biological risk factors such as BMI.
Conclusions:
Midlife adults who anticipate greater respect and appreciation from others in everyday life evidence less preclinical vascular disease. Consistent with the literature showing that anticipation of social threats and unfair treatment may increase cardiovascular risk, expectations of being valued and treated with respect by others is associated with decreased risk. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Chronic psychosocial stress increases disease risk and mortality, but the underlying mechanism remain largely unclear. Here we outline an energy-based model for the transduction of chronic stress into disease over time. The energetic model of allostatic load (EMAL) emphasizes the energetic cost of allostasis and allostatic load, where the “load” is the additional energetic burden required to support allostasis and stress-induced energy needs. Living organisms have a limited capacity to consume energy. Overconsumption of energy by allostatic brain-body processes leads to hypermetabolism, defined as excess energy expenditure above the organism’s optimum. In turn, hypermetabolism accelerates physiological decline in cells, laboratory animals, and humans, and may drive biological aging. Therefore, we propose that the transition from adaptive allostasis to maladaptive allostatic states, allostatic load, and allostatic overload arises when the added energetic cost of stress competes with longevity-promoting growth, maintenance, and repair. Mechanistically, the energetic restriction of growth, maintenance and repair processes leads to the progressive wear-and-tear of molecular and organ systems. The proposed model makes testable predictions around the physiological, cellular, and sub-cellular energetic mechanisms that transduce chronic stress into disease risk and mortality. We also highlight new avenues to quantify allostatic load and its link to health across the lifespan, via the integration of systemic and cellular energy expenditure measurements together with classic allostatic load biomarkers.
Uric acid, an end product of the purinergic system, plays a role in several physiological systems that are responsive to stress. However, few studies have examined whether (1) uric acid concentrations change in response to acute stress, and (2) there are cross-system associations where uric acid might influence other physiological system responses to acute physical stress. The present study measured indices of the purinergic, hypothalamic-pituitary-adrenal axis, sympathetic, and parasympathetic systems (uric acid, cortisol, pre-ejection period, and root mean square of successive differences, respectively) in response to a standardized acute physical pain stressor, the cold pressor task. A diverse sample of participants (n = 67; mean age = 20.5 years, 52% female; 48% male) from a larger study completed anthropometric measurements and took part in a room temperature water task followed by the cold pressor task and sociodemographic questionnaires. Throughout the study, electrocardiography and impedance cardiography were measured continuously, and five saliva samples were collected that were later assayed for cortisol and uric acid. Descriptively, uric acid increased about 32 minutes following completion of the cold pressor. Resting uric acid concentrations were not associated with the autonomic nervous system response, but higher resting uric acid concentrations were associated with increased cortisol concentrations. Future research should examine the extent to which the purinergic system influences, and is influenced by, other types of stress and other physiological systems. The current findings highlight the potential role of an understudied biomarker and physiological system in the stress literature and have implications for basic and mechanistic researchers who study psychoneuroendocrinology, stress, and health.
Objective:
While stress is posited to play a key role in health disparities, the extent to which commonly used self-report psychosocial stress measures are related to neurobiological stress processes, especially across diverse populations, is unresolved. This study examined how two measures of psychosocial stress, perceived stress and domain-specific stress, covary with the acute neurobiological stress response.
Methods:
The Richmond Stress and Sugar Study includes a racially and socioeconomically diverse cohort of adults at risk for type 2 diabetes (n = 125; mean age 57 years, 48% black, and 61% high neighborhood socioeconomic status (SES)). Hypothalamic pituitary adrenal (HPA) axis reactivity was assessed by salivary cortisol response to the Trier Social Stress Test (TSST), a laboratory stressor.
Results:
Higher perceived stress was associated with a lower cortisol response to the TSST [-7.5%; 95% CI: -13.1%, -1.5%], but was not associated with cortisol recovery after the TSST [3%; 95% CI: -0.6%, 6.8%]. In contrast, domain-specific stress was not associated with cortisol response [-2.1%; 95%CI: -20.7%, 20.9%], but was inversely associated with cortisol recovery [3.7%; 95%CI: 0.6%, 7.0%]. SES modified these associations: both perceived stress and domain-specific stress were associated with TSST cortisol response only among participants from high SES neighborhoods. There was minimal evidence of effect-modification by race.
Conclusions:
Both self-report measures of psychosocial stress were associated with HPA-axis reactivity to an acute stressor. These associations varied by perceived vs. domain-specific measurement scales and by neighborhood SES. Further efforts to refine stress measures and clarify biological linkages between social status and health are needed.
We tested the feasibility of automated discrimination of patients with panic disorder (PD) from healthy controls (HCs) based on multimodal physiological responses using machine learning. Electrocardiogram (ECG), electrodermal activity (EDA), respiration (RESP), and peripheral temperature (PT) of the participants were measured during three experimental phases: rest, stress, and recovery. Eleven physiological features were extracted from each phase and used as input data. Logistic regression (LoR), k-nearest neighbor (KNN), support vector machine (SVM), random forest (RF), and multilayer perceptron (MLP) algorithms were implemented with nested cross-validation. Linear regression analysis showed that ECG and PT features obtained in the stress and recovery phases were significant predictors of PD. We achieved the highest accuracy (75.61%) with MLP using all 33 features. With the exception of MLP, applying the significant predictors led to a higher accuracy than using 24 ECG features. These results suggest that combining multimodal physiological signals measured during various states of autonomic arousal has the potential to differentiate patients with PD from HCs.
The Multiverse theory is one of the most fundamental concepts that might provide a coherent explanation for quantum physics peculiarities such as quantum entanglement and the contentious subject of Consciousness. In a parallel universe, each individual possesses identical pair that affect each other by entanglement or Spooky action at a distance. That might explain epistemological concern about Knowledge's nature. The Dog Cave near Naples, Italy, in ancient is an entrance to the Underworld, presently known as a wormhole (looking through a microscope, not a macroscopic world view, to grasp the idea quickly). That links Earth to Mars in our universe and probably connected to another universe. We hypothesize that the Seven sister cave dark hole on Mars represents the entrance of a wormhole. On 23 September 2022, it will likely coincide with the Solar flare with Iron Kα line emission.
Consequently, it is plausible measuring the Kα iron line in the X-ray reflected spectrum may be confirmed our hypothesis. As deflection light angle measuring with the Sun at Zenith. John Wheeler coined the term "Wormhole" in 1957 (Wheeler 1957); could he deliberately choose to determine the location? Al-Kindi's (801-873 AD) cryptanalysis method is based on the frequency distribution of letters to solve an encrypted message. His approach served as a source of inspiration for our approach to Quran interpretation. Instead, we use frequency distribution analysis for the triliteral root to decode the Quran encryption. As mentioned in the Quran (18:17,18), we suggest that the Seven Sleepers use the Dog cave, which could explain why their quantum state probably will be detected in the dog cave on 23 September 2022. The Sun will be at Zenith in Riau, Indonesia, crossing the celestial equator in a Southward direction. Flavius Josephus [Yosef ben Mattityahu] is the first name of the Seven Sleepers, according to our approach (18:10,13). In addition, the Quran alludes to the spacetime dimension of the parallel universe as (9+ time), which is associated with the Seven Sleepers (18:11). In our approach, we endeavor to illustrate the laws of parallel universes, which are outlined in verse (18:18). In verse (18:12), the Quran challenge, asking how the Seven Sleepers remain in that Spacetime using a mathematical approach. Finally, in verse (18:8), the Quran implies that the destiny of Earth will be similar to Mars, with barren soil devoid of water. Hence, we anticipate a supervolcano in Campi Flegrei in 2028, followed by a magnetic field reversal is the beginning of that destiny.
When evaluating the effects of mindfulness-based interventions (MBIs) on the stress response, several aspects should be considered, such as 1) effects on various response systems, 2) temporal dynamics of the stress response, and 3) differences between programs. This study assesses the stress-attenuating effects of a standard mindfulness-based stress reduction (MBSR) and a second-generation MBI: MBSR with elements of other Buddhist practices (MBSR-B). Ninety-nine healthy volunteers were randomly assigned to the MBSR, MBSR-B, or waitlist control groups and their stress response was evaluated with the Trier Social Stress Test. Changes in the activity of the hypothalamic-pituitary-adrenal (HPA) axis, sympathoadrenomedullary system, the autonomic nervous system (ANS), and affect were measured during distinct phases of the task. Compared to waitlist control, the stress-attenuated effects of MBIs were detected across almost all systems and both negative and positive affect. In the parasympathetic branch of the ANS, the effect of MBIs was present in all stress phases (however, in the recovery phase, only MBSR-B has shown a statistically significant effect in comparison with the waitlist control). The stress-attenuating effects of MBIs were observed already in the anticipatory phase for cortisol, ANS, and negative affect (for negative affect, only the modified MBSR-B program has shown statistically significant effect in comparison with the waitlist control).
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.
Most people assume studying or working abroad would be stressful - but would one ever think that it could be detrimental to the health? Stress literature relates cross-cultural transactions to the chances of gaining higher levels of chronic stress. This paper reports the results of two studies on international students in Moscow in 2018. Specifically, Study 1 assessed how cross-cultural transactions perceived to affect health state during the first 6 months of their relocation. Study 2 aimed to investigate if the psychological stress linked to relocation to a different country can possibly lead to psychobiological effects of chronic stress. In Study 1, qualitative methods were applied to conduct 21 interviews with international students. In Study 2, a longitudinal pilot study was conducted for 10 foreign students during the first 2-5 (M = 3.6) months of their relocation. Stress related to cross-cultural transactions was expected to affect subjective well-being and health variables. The health state was a relatively silent topic in the interview participants of Study 1. The results of Study 2 showed that the participants had changes in the resting heart rate (RHR) baseline. Perceived chronic stress related to cross-cultural transactions may affect psychophysiological state; however, the affect varies depending on a person. Further research is required for the data consistency and for identifying non-invasive objective risk markers and individual stress pathways, with the goal of identifying at-risk students and providing treatment options before any serious harm is done to their health.
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.
Socioeconomic inequities shape physical health and emotional well-being. As such, recent work has examined the neural mechanisms through which socioeconomic position (SEP) may influence health. However, there remain critical gaps in knowledge regarding the relationships between SEP and brain function. These gaps include a lack of research on: (1) the association between SEP and brain functioning in later life, (2) relationships between SEP and functioning of the whole brain beyond specific regions of interest, and (3) how neural responses to positive affective stimuli differ by SEP. The current study addressed these gaps by examining the association between SEP (i.e., education, income) and neural responses to affective stimuli among 122 mid- to late-life adults. During MRI scanning, participants viewed 30 positive, 30 negative, and 30 neutral images; activation and network connectivity analyses explored associations between SEP and neural responses to these affective stimuli. Analyses revealed that those with lower SEP showed greater neural activity to both positive and negative images in regions within the allostatic-interoceptive network, a system of regions implicated in representing and regulating physiological states of the body and the external environment. There were no positive associations between SEP and neural responses to negative or positive images. In addition, graph–theory network analyses showed that individuals with lower SEP demonstrated greater global efficiency within the allostatic-interoceptive network and executive control network, across all task conditions. The findings suggest that lower SEP is associated with enhanced neural sensitivity to affective cues that may be metabolically costly to maintain over time and suggest a mechanism by which SEP might get “under the skull” to influence mental and physical well-being.
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.
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 In ammatory 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 signi cantly 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 in uence 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 ndings are discussed with reference to future research methodology.
Significance
Although much evidence has accrued in research over the past 20 years on the strong causal associations between social relationships and health and longevity, important gaps remain in our understanding of the mechanisms, timing, and duration of these associations. This study integrates social and biological disciplinary perspectives and research to examine how social relationships “get under the skin” to affect physiological well-being as individuals age. By combining data from and harmonizing measurement across four large nationally representative, population-based, contemporary surveys using an innovative longitudinal life course design, this study provides previously unidentified evidence on the biological and life course mechanisms linking social relationship patterns with health. As such, our findings advance explanations of the emergence and progression of diseases across the human life span.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
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.
Prolonged physiological activity is believed to be a key factor mediating between stress and later disease outcomes. Few studies, however, have investigated the crucial psychological factors that cause prolonged activity. This article proposes that conscious as well as unconscious perseverative cognition are the critical factors. Perseverative cognition indicates repetitive or sustained activation of cognitive representations of past stressful events or feared events in the future. In daily life, most prolonged physiological activity is not due to stressful events but to perseverative cognition about them. We and others have already found evidence that conscious perseverative cognition, i.e., worry, has physiological effects, in both laboratory and real life settings, and that perseverative cognition mediates prolonged responses to stressful events. Yet, there are convincing reasons to expect that unconscious perseverative cognition has an even larger role in stress-related prolonged activity. Firstly, since the greater part of cognitive processing operates without awareness, a considerable part of perseverative cognition is likely to be unconscious too. People may not be aware of most of their stress-related cognitive processes. Secondly, our recent studies have shown that increased activity of the autonomic nervous system continues after conscious perseverative cognition has stopped: It goes on for several hours and even during sleep. This and several other findings suggest that a considerable part of increased physiological activity may be due to unconscious perseverative cognition. The article closes with suggesting methods to test unconscious perseverative cognition and ways to change it, and concludes with stating that the notion of unconscious perseverative cognition potentially opens an entirely new area within stress research.
Childhood emotional maltreatment (CEM) has been associated with a profound and enduring negative impact on behavioral and emotional functioning. Animal models have shown that adverse rearing conditions, such as maternal separation, can induce a cascade of long-term structural alterations in the brain, particularly in the hippocampus, amygdala, and prefrontal cortex. However, in humans, the neurobiological correlates of CEM are unknown.
Using high-resolution T1-weighted 3T magnetic resonance imaging, anatomical scans and a whole-brain optimized voxel-based morphometry approach, we examined whether healthy control subjects and unmedicated patients with depression and/or anxiety disorders reporting CEM before age 16 (n = 84; age: mean = 38.7) displayed structural brain changes compared with control subjects and patients who reported no childhood abuse (n = 97; age: mean = 36.6).
We found that self-reported CEM is associated with a significant reduction in predominantly left dorsal medial prefrontal cortex volume, even in the absence of physical or sexual abuse during childhood. In addition, reduced medial prefrontal cortex in individuals reporting CEM is present in males and females, independent of concomitant psychopathology.
In this study, we show that CEM is associated with profound reductions of medial prefrontal cortex volume, suggesting that sustained inhibition of growth or structural damage can occur after exposure to CEM. Given the important role of the medial prefrontal cortex in the regulation of emotional behavior, our finding might provide an important link in understanding the increased emotional sensitivity in individuals reporting CEM.
The ability to regulate emotion is crucial to promote well-being. Evidence suggests that the medial prefrontal cortex (mPFC) and adjacent anterior cingulate (ACC) modulate amygdala activity during emotion regulation. Yet less is known about whether the amygdala–mPFC circuit is linked with regulation of the autonomic nervous system and whether the relationship differs across the adult lifespan. The current study tested the hypothesis that heart rate variability (HRV) reflects the strength of mPFC–amygdala interaction across younger and older adults. We recorded participants' heart rates at baseline and examined whether baseline HRV was associated with amygdala–mPFC functional connectivity during rest. We found that higher HRV was associated with stronger functional connectivity between the amygdala and the mPFC during rest across younger and older adults. In addition to this age-invariant pattern, there was an age-related change, such that greater HRV was linked with stronger functional connectivity between amygdala and ventrolateral PFC (vlPFC) in younger than in older adults. These results are in line with past evidence that vlPFC is involved in emotion regulation especially in younger adults. Taken together, our results support the neurovisceral integration model and suggest that higher heart rate variability is associated with neural mechanisms that support successful emotional regulation across the adult lifespan.