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Ko K, Jones A, Francis D, Robidoux S, McArthur G. Physiological correlates of anxiety in childhood and adolescence: A systematic review and meta-analysis. Stress Health 2024; 40:e3388. [PMID: 38451702 DOI: 10.1002/smi.3388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/18/2023] [Accepted: 02/07/2024] [Indexed: 03/09/2024]
Abstract
Anxiety is one of the most prevalent problems that affects children and adolescents. The vast majority of diagnostic tools for anxiety depend on written or verbal reports from children and adolescents or their significant others. The validity and reliability of such reports can be compromised by their subjective nature. Thus, there is growing interest in whether anxiety can be indexed with objective physiological measures. The key aim of this systematic review and meta-analysis was to determine which physiological measures are most reliably associated with elevated levels of anxiety amongst children and adolescents. Online databases (e.g., PsycINFO, Embase, Medline) were searched for relevant studies according to pre-determined criteria. Twenty-five studies comprising 2502 participants (N = 1160 with high anxiety) met inclusion, identifying 11 groups of physiological measures. Our meta-analysis revealed that skin conductance level is the most sensitive measure of anxiety (d = 0.83), followed by electromyography (EMG) measures (d = 0.71) and skin conductance response (d = 0.58). However, the included studies varied in terms of subjective measures, study designs, experimental task measures, and physiological measures. Consideration of these differences in methodology offer potential directions for future research.
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Affiliation(s)
- Katherine Ko
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alana Jones
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
- Lifespan Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Deanna Francis
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Serje Robidoux
- Macquarie University Centre for Reading, School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Genevieve McArthur
- Australian Centre for the Advancement of Literacy, Australian Catholic University, Sydney, New South Wales, Australia
- Dyslexia-SPELD Foundation Literacy and Clinical Services, South Perth, Western Australia, Australia
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Maier T, Rappel M, Rhee DS, Brill S, Maderner J, Pijahn F, Gündel H, Radermacher P, Friemert B, Becker HP, Waller C. Mental but no bio-physiological long-term habituation to repeated social stress: A study on soldiers and the influence of mission abroad. Front Psychiatry 2022; 13:1011181. [PMID: 36590640 PMCID: PMC9797525 DOI: 10.3389/fpsyt.2022.1011181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Soldiers regularly participate in missions abroad and subjectively adapt to this situation. However, they have an increased lifetime cardiovascular risk compared to other occupational groups. To test the hypothesis that foreign deployment results in different stress habituation patterns, we investigated long-term psychological and bio-physiological stress responses to a repeated social stress task in healthy soldiers with and without foreign deployment. Ninety-one female and male soldiers from the BEST study (German armed forces deployment and stress) participated three times in the Trier Social Stress Test for groups (TSST-G) prior to, 6-8 weeks after and 1 year after the mission abroad and were compared to a control group without foreign deployment during the study period. They completed the State-Trait-Anxiety Inventory scale (STAI), the Primary Appraisal Secondary Appraisal questionnaire (PASA) and the Multidimensional Mood State Questionnaire (MDBF). Salivary cortisol and α-amylase, blood pressure, heart rate and heart rate variability were determined. Soldiers showed mental habituation over the three times with a significant decrease after the TSST-G in anxiousness (STAI) and cognitive stress appraisal (PASA), they were calmer and reported better mood (MDBF). Prior to the social stress part, the mood (MDBF) declined significantly. None of the biological and physiological markers showed any adaptation to the TSST-G. Mission abroad did not significantly influence any measured psychobiological marker when compared to soldiers without foreign deployment. Foreign deployment does not result in alterations in psychobiological social stress response patterns over 1 year after mission abroad which indicates that adaptation to acute social stress is highly maintained in healthy soldiers. The discrepancy between subjective perception and objective stress response has numerous clinical implications and should receive more attention.
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Affiliation(s)
- Tanja Maier
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | - Manuela Rappel
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | - Dae-Sup Rhee
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | | | - Julia Maderner
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | - Friederike Pijahn
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | - Harald Gündel
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany
| | - Peter Radermacher
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University, Ulm, Germany
| | | | | | - Christiane Waller
- Clinic for Psychosomatics and Psychotherapeutic Medicine, Ulm University Medical Center, Ulm, Germany.,Department of Psychosomatics and Psychotherapeutic Medicine, Paracelsus Medical University, Nuremberg, Germany
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Stress and inflammation - The need to address the gap in the transition between acute and chronic stress effects. Psychoneuroendocrinology 2019; 105:164-171. [PMID: 30826163 DOI: 10.1016/j.psyneuen.2019.02.021] [Citation(s) in RCA: 173] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 02/13/2019] [Accepted: 02/19/2019] [Indexed: 12/19/2022]
Abstract
Stress responses help us navigate our environment and respond appropriately to threats. Stress systems communicate threats to the entire organism, and as such, also stimulate inflammatory mechanisms. This modulation might serve protective functions in the short term, but sustained low-grade inflammation has severe long-term health consequences. While we have reached a reasonable level of understanding of acute, as well as chronic stress effects on inflammatory mechanisms, there is a significant gap in our understanding of the transitional phase between acute and chronic stress. The purpose of this review is to first summarize current knowledge of our understanding of acute stress effects on inflammation, as well as of chronic stress effects on inflammation, and to then analyze the state of knowledge about the transitional phase between acute and chronic stress. Research discussed here shows that we are beginning to understand the early phase of repeated acute stress, but lack information on longer term exposure to repeated acute stress experiences. More research is needed to bridge this important gap und our conceptualization and understanding of the stress and health relationship.
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Abstract
PURPOSE OF REVIEW The purpose of this paper is to provide a current review of the recent literature (2015-2018) on psychophysiological markers of fear and anxiety. RECENT FINDING Relative to healthy controls, fear-based disorders are characterised by heightened physiological reactivity to circumscribe threat salient stimuli, whereas anxiety-related disorders are associated with a more blunted pattern of physiological reactivity. Fear and anxiety disorders are marked by abnormal patterns of physiological reactivity, characterised by hyper- and hypo-reactivity in response to stimuli varying in threat salience.
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Affiliation(s)
- Jamiah Hyde
- School of Applied Psychology, Griffith University, Mt. Gravatt, Australia
| | - Katherine M Ryan
- School of Applied Psychology, Griffith University, Mt. Gravatt, Australia
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Mt. Gravatt, Australia.
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Altamura M, Iuso S, Balzotti A, Francavilla G, Dimitri A, Cibelli G, Bellomo A, Petito A. Salivary alpha-amylase and cortisol responsiveness to stress in first episode, drug-naïve patients with panic disorder. Neurosci Res 2018; 137:49-56. [PMID: 29550536 DOI: 10.1016/j.neures.2018.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 01/03/2023]
Abstract
Reported findings on reactivity to stress of the sympathetic-adreno-medullar (SAM) and hypothalamic-pituitary-adrenal (HPA) systems in panic disorder (PD) are very variable. This inconsistency may be explained by differences in treatment exposure, illness duration and emotion regulation strategies. The present study examined the reactivity to mental stress of the SAM and HPA axes in a sample of first episode, drug naïve patients with PD which avoids confounds of medications exposure and illness chronicity. Activation of the SAM axis was evaluated by dosage of salivary alpha-amylase (sAA) and heart rate. Activation of the HPA axis was tested by dosage of salivary cortisol. Psychological assessments were done by the Self-Rating Depression Scale, the Self-Rating Anxiety Scale, the State-Trait Anxiety Inventory, the Cope Orientation to Problems Experienced (COPE) Inventory and the 16 Personality Factor Questionnaire (16PF). Patients showed reduced sAA stress reactivity, higher baseline cortisol levels and a more rapid decrease in stress cortisol levels as compared with controls. A significant correlation was found between active coping strategies and cortisol levels (response to stress). The findings suggest that blunted SAM stress reactivity and a rapid decrease in stress cortisol levels reflect traits that may enhance vulnerability to psychopathology in patients with PD.
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Affiliation(s)
- Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy.
| | - Salvatore Iuso
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
| | - Angela Balzotti
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
| | - Girolamo Francavilla
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
| | - Andrea Dimitri
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Section of Human Physiology, Foggia, Italy
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
| | - Annamaria Petito
- Department of Clinical and Experimental Medicine, University of Foggia, Psychiatry Unit, Foggia, Italy
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Marchand A, Juster RP, Lupien SJ, Durand P. Psychosocial determinants of diurnal alpha-amylase among healthy Quebec workers. Psychoneuroendocrinology 2016; 66:65-74. [PMID: 26799849 DOI: 10.1016/j.psyneuen.2016.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/08/2015] [Accepted: 01/05/2016] [Indexed: 12/20/2022]
Abstract
Salivary alpha-amylase (sAA) is a stress-sensitive biomarker the shows promise as an indirect proxy of sympathetic-adrenal-medullary axis activities that are otherwise difficult to discern non-invasively. This comprehensive study investigated diurnal sAA in association with numerous psychosocial characteristics related to mental health, work stress, and non-work stress. Participants included 395 workers (56.1% women, age: M=41.3, SD=10.81) from across 34 distinct workplaces. Diurnal sAA was sampled over two non-consecutive work days at awakening, 30 min after awakening, 14h00, 16h00, and bedtime. Well-validated psychometrics and survey items were used to measure mental health (psychological distress, depression, burnout, work characteristics) (task design, demands, social relations, gratifications), and non-work characteristics (marital/parental status, economic statuses, marital and parental stress, work-family conflicts). Preliminary results revealed that men showed occasionally higher sAA concentrations than women. Multilevel regressions were used to analyze sAA concentrations nested according to levels (i) for each time-point, (ii) between workers, and (iii) across workplaces while covarying for time of awakening, sex, age, cigarette smoking, alcohol consumption, regular physical activity, psychotropic drug use, and body mass index. Main results revealed that psychological demands, support from colleagues, interpersonal conflicts, job recognition and job insecurity appear to be associated with diurnal sAA, while non-work factors did not. Our findings showing a distinct diurnal profile for sAA replicate and expand those of Nater et al. (2007, Psychoneuroendocrinology 32, 392-401), providing further evidence that sAA is associated to subjective psychosocial factors.
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Affiliation(s)
- Alain Marchand
- School of Industrial Relations, University of Montreal, C.P. 6128, Succ Centre-Ville, Montreal, Quebec H3C 3J7, Canada.
| | - Robert-Paul Juster
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Sonia J Lupien
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Pierre Durand
- School of Industrial Relations, University of Montreal, C.P. 6128, Succ Centre-Ville, Montreal, Quebec H3C 3J7, Canada
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