Reflections on the interaction of psychogenic stress systems in humans: the stress coherence/compensation model

Acute stress negatively impacts on-task behavior and lecture comprehension

Acute stress has been shown to disrupt cognitive and learning processes. The present study examined the effects of acute stress on mind wandering during a lecture and subsequent lecture comprehension in young adults. Forty participants were randomized to acute stress induction via the Trier Social Stress Test or rest prior to watching a twenty-minute video lecture with embedded mind wandering probes, followed by a lecture comprehension assessment. Stress responses were assessed via heart rate, blood pressure, salivary cortisol, and state anxiety. Individuals exposed to acute stress endorsed greater mind wandering at the first checkpoint and lower lecture comprehension scores. Moreover, state anxiety post stress was positively associated with mind wandering at the first and second checkpoint and negatively associated with lecture comprehension. Only mind wandering at the third checkpoint was negatively correlated with overall lecture comprehension. Taken together, these data suggest that acute stress, mind wandering, and lecture comprehension are inextricably linked.

Do deficits in subjective stress recovery predict subsequent stress sensitivity and symptoms in schizophrenia spectrum disorders?

High levels of stress play a crucial role in the development of psychotic symptoms, such as paranoia, and may stem in part from recovery deficits after stress exposure. However, it remains unclear whether deficient recovery causes a build-up of heightened stress levels that increases stress sensitivity and symptoms when exposed to another stressor. To test this, we investigated the effect of subjective stress recovery on the response to a subsequent stressor and paranoia. We applied two consecutive runs of the same combined physical and cognitive stressor separated by a recovery phase of 60 min in individuals with schizophrenia spectrum disorders (n = 49). We repeatedly assessed self-reported stress, negative affect, heart rate, heart rate variability, salivary cortisol, and paranoia. Recovery of self-reported stress was defined as the geometric mean of the percentage changes of self-reported stress during recovery after the first stressor, and was regressed on the response to the second stressor controlling for self-reported stress during the first stressor. Lower subjective stress recovery predicted higher levels of self-reported stress, negative affect, and paranoia in response to the second stressor. The subjective stress recovery was not predictive of the physiological stress response (heart rate, heart rate variability, or salivary cortisol). Taken together, the findings indicate that recovery deficits could contribute to high levels of self-reported stress, negative affect, and paranoia in schizophrenia spectrum disorders and that the improvement of stress recovery could be a promising approach for interventions.

Optimal timing of oral metyrapone intake for the suppression of cold-pressor stress-induced cortisol release

BACKGROUND

Pharmacological manipulation of cortisol levels is instrumental in elucidating mechanisms underlying acute stress effects and for distinguishing the physiological and behavioral effects of cortisol from those of the adrenergic system. Administration (oral or IV) of hydrocortisone is a direct and efficient method to elevate cortisol, and thus, frequently used in psychobiological stress research. However, lowering of cortisol (i.e. blockade of stress cortisol) requires a more sophisticated approach, such as the administration of the corticostatic compound metyrapone (MET). However, there is insufficient knowledge about the temporal dynamics of MET for the blocking of stress-induced cortisol reactivity. Thus, the present study aimed to build up an experimental protocol suitable to suppress acute behavioral stress-induced cortisol secretion by MET.

METHODS

50 healthy young men were randomly assigned to one of five treatment groups. They received 750 mg oral MET either 30 (n = 9), 45 (n = 11), or 60 (n = 10) minutes before exposure to a combined cold pressor and mental arithmetic test (stress induction), or were subjected to two different control treatments (placebo 60 min before stress (n = 10) or MET 30 min before non-stressful warm-water condition (n = 10)). Salivary cortisol concentration, hemodynamics, and subjective ratings were assessed.

RESULTS

Suppression of cold stress-induced cortisol release was strongest when MET intake was scheduled 30 min prior to stress onset. Cardiovascular stress-responses and subjective ratings remained unaffected by MET.

CONCLUSION

In healthy young males, 750 mg of MET efficiently block cold stress-induced cortisol release when oral administration is scheduled 30 min prior to stress onset. This finding may guide future research in improving timing of suppression of stress-induced cortisol secretion.

Role of hippocampus and orbitofrontal cortex in the association of interdependent self-construal with an acute stress response

Empirical evidence indicates that high interdependent self-construal (InterSC) is correlated with exaggerated acute stress responses; however, the underlying neural correlates remain unclear. Considering the regulatory effect of the prefrontal cortex and limbic system on the acute stress response, the primary aim of this study was to investigate the role of the orbitofrontal cortex (OFC) and hippocampus (HIP) in the relationship between InterSC and acute stress responses. Forty-eight healthy college students underwent a modified version of the Montreal imaging stress task (MIST), while brain activity was recorded using functional magnetic resonance imaging (fMRI). Participants' saliva samples and subjective stress feelings were collected before, during, and after the MIST. Additionally, participants' self-construal was measured using questionnaires. Results revealed that InterSC was positively correlated with the activation of OFC, which, in turn, was associated with higher subjective stress feelings. A higher InterSC was also significantly associated with an enhanced salivary cortisol response in those with lower HIP activity. Furthermore, the HIP moderated the indirect effect of InterSC on subjective stress feelings by moderating the effect of InterSC on neural activity in the OFC. This indicated the mediation of the OFC was stronger in those with higher neural activity in the HIP than in those with lower activity in the HIP. In summary, the current study proposed an important role of the OFC-HIP regions in the relationship between InterSC and acute stress responses, making contribution to broadening the field of personality and stress and deepening our understanding of individual differences in acute stress responses.

Effects of Fasting on the Physiological and Psychological Responses in Middle-Aged Men

Tracking changes in the body during fasting takes into account indicators of mental well-being and physiological parameters. The aim of the study was to measure psychological and physiological reactions, along with their mutual relations, caused by 8 days of water-only fasting. Fourteen men aged 35 to 60 participated in the study, divided into two groups, younger and elder. In addition to physiological parameters, psychological data were collected using four different tests. The obtained results confirmed reduction in body weight, systolic blood pressure, resting diastolic blood pressure and glucose level, and increase in resting heart rate, cortisol and β-hydroxybutyrate concentration. However, no significant psychological changes were observed under the influence of fasting intervention. A significant interaction effect occurred for the state anxiety variable determined before and after the fasting intervention for both groups. Moreover, negative correlations between physiological (cortisol) and psychological factors of subjectively assessed stress were revealed. The only effect on cognitive ability was seen when responding to simple tasks. The study confirmed the beneficial effect of 8 days of water-only fasting on physiological variables without affecting mental well-being. The relatively high level of well-being after fasting intervention was independent of the physiological indicators of stress.

Multi-trajectory analysis uncovers latent associations between psychological and physiological acute stress response patterns

Encounter with an acute stressor elicits multiple physiological and psychological response trajectories that spread at different times-scales and directions. Associating a single physiological response trajectory with a specific psychological response has remained a challenge, due to putative interactions between the different stress response pathways. Hence, multidimensional analysis of stress response trajectories may be better suited to account for response variability. To test this, 96 healthy female participants underwent a robust acute laboratory stress induction procedure while their psychological [positive and negative affect (PANAS)] and physiological [heart rate (HR), heart rate variability (HRV), saliva cortisol (CORT)] responses were recorded before, during and after stress. Combining these data using unsupervised group-based multi-trajectory modelling uncovered three latent classes that best accounted for variability across psychological and physiological stress response trajectories. These classes were labelled based on their psychological response patterns as: A prototypical response group that depict a moderate increase in negative and decrease in positive affect during stress, with both patterns recovering after stress offset (n = 55); A heightened response group that depict excessive affective responses during stress that recover after stress offset (n = 24); and a lack of recovery group that depict a moderate increase in negative and decrease in positive affect during stress, with both patterns not recovering after stress offset (n = 17). With respect to physiological acute stress trajectories, all three groups exhibited comparable increases in HR and CORT during stress that recovered after stress offset, yet only the prototypical group expressed the expected stress-induced reduction in HRV, while the other two groups exhibited blunted HRV response. Critically, focusing on a single physiological stress response trajectory, including HRV, did not account for psychological response variability and vice versa. Taken together, a multi-trajectory approach may better account for the multidimensionality of acute stress response and uncover latent associations between psychological and physiological response patterns. Compared to the other two groups, the prototypical group also exhibited significantly lower overall stress scores based on the DASS-21 scale. This, alongside the uncovered response patterns, suggest that latent psycho-physiological associations may shed light on stress response adaptivity or lack thereof.

Stress and Stress-Induced Glucocorticoids Facilitate Empathic Accuracy in Men but Have No Effects for Women

Empathy, the ability to understand the feelings of other people, is critical for navigating our social world and maintaining social connections. Given that acute stress, and resulting increased glucocorticoids, triggers a shift in two large-scale brain networks, prioritizing salience over executive control, we predicted that acute psychosocial stress would facilitate empathic accuracy. We also investigated the moderating role of gender, given that men typically show a more robust glucocorticoid response to acute stress than women. As predicted, results from two independent experiments ( N = 267 college-age participants; 2,256 observations) showed that acute psychosocial stress facilitated empathic accuracy for men, an effect related to their glucocorticoid response in the stress condition. Conversely, psychosocial stress had no effect on empathic accuracy for women, who also showed a smaller cortisol response to stress than men. Exploratory analyses further revealed that women taking oral contraceptives performed worse on the empathic-accuracy task than regularly cycling women. This research highlights the important, but complex, role of stress in cognitive empathy.

Biological markers in clinical psychological research - A systematic framework applied to HPA axis regulation in PTSD

Biological markers, particularly endocrine measurements, are increasingly being integrated into clinical psychological research. We introduce a systematic framework that classifies different functions of such biomarkers. The framework distinguishes between diagnostic biomarkers which add a biological perspective to conventional clinical assessments, prognostic biomarkers that inform about an individual’s risk to develop or maintain a mental health disorder, and intervention-related biomarkers. Regarding interventions, including prevention and treatment, it further distinguishes between prescriptive biomarkers which predict an individual’s response to an intervention, outcome biomarkers which evaluate intervention-related changes on a biological level and indicators of change mechanisms. We demonstrate how to apply the framework by exemplarily classifying and describing previously published systematic reviews and primary empirical studies on endogenous, peripheral cortisol concentrations as a biomarker for posttraumatic stress disorder (PTSD). The evidence on cortisol’s diagnostic and prognostic value is heterogeneous and still sparse regarding parameters based on multiple cortisol measurements, such as the cortisol awakening response. With regard to interventions, most research focused on trauma-focused psychotherapy and cortisol reactivity to trauma reminders. This field of research appears to be growing and very promising due to its potential to optimize PTSD-related interventions. The proposed framework can help in gaining a systematic overview of existing research. It can assist in structuring, comparing, summarizing and evaluating empirical studies, and in identifying research gaps.

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Iagnostic biomarkers can inform about biological alterations in mental disorders.

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Prognostic biomarkers can help to predict the development of a mental disorder.

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Biomarkers can indicate the outcome, differential effects, or mechanisms of change of clinical psychological interventions.

Inducing and Recording Acute Stress Responses on a Large Scale With the Digital Stress Test (DST): Development and Evaluation Study

Background

Valuable insights into the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, are labor-intensive, and cannot be scaled to larger cohorts or transferred to daily life scenarios.

Objective

We aimed to provide a scalable digital tool that enables the standardized induction and recording of acute stress responses in outside-the-laboratory settings without any experimenter contact.

Methods

On the basis of well-described stress protocols, we developed the Digital Stress Test (DST) and evaluated its feasibility and stress induction potential in a large web-based study. A total of 284 participants completed either the DST (n=103; 52/103, 50.5% women; mean age 31.34, SD 9.48 years) or an adapted control version (n=181; 96/181, 53% women; mean age 31.51, SD 11.18 years) with their smartphones via a web application. We compared their affective responses using the international Positive and Negative Affect Schedule Short Form before and after stress induction. In addition, we assessed the participants’ stress-related feelings indicated in visual analogue scales before, during, and after the procedure, and further analyzed the implemented stress-inducing elements. Finally, we compared the DST participants’ stress reactivity with the results obtained in a classic stress test paradigm using data previously collected in 4 independent Trier Social Stress Test studies including 122 participants overall.

Results

Participants in the DST manifested significantly higher perceived stress indexes than the Control-DST participants at all measurements after the baseline (P<.001). Furthermore, the effect size of the increase in DST participants’ negative affect (d=0.427) lay within the range of effect sizes for the increase in negative affect in the previously conducted Trier Social Stress Test experiments (0.281-1.015).

Conclusions

We present evidence that a digital stress paradigm administered by smartphone can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.

The social transmission of stress in animal collectives

The stress systems are powerful mediators between the organism's systemic dynamic equilibrium and changes in its environment beyond the level of anticipated fluctuations. Over- or under-activation of the stress systems' responses can impact an animal's health, survival and reproductive success. While physiological stress responses and their influence on behaviour and performance are well understood at the individual level, it remains largely unknown whether-and how-stressed individuals can affect the stress systems of other group members, and consequently their collective behaviour. Stressed individuals could directly signal the presence of a stressor (e.g. via an alarm call or pheromones), or an acute or chronic activation of the stress systems could be perceived by others (as an indirect cue) and spread via social contagion. Such social transmission of stress responses could then amplify the effects of stressors by impacting social interactions, social dynamics and the collective performance of groups. As the neuroendocrine pathways of the stress response are highly conserved among vertebrates, transmission of physiological stress states could be more widespread among non-human animals than previously thought. We therefore suggest that identifying the extent to which stress transmission modulates animal collectives represents an important research avenue.

'Doctor, I am so stressed out!' A descriptive study of biological, psychological, and socioemotional markers of stress in individuals who self-identify as being 'very stressed out' or 'zen'

Surveys report that about three-quarters of visits to general practitioners in America are for stress-related complaints. Animal and human studies have consistently demonstrated that exposure to acute and/or chronic stress leads to the activation of the autonomic nervous system (ANS) and/or hypothalamic-pituitary-adrenal (HPA) axis, and to the production of catecholamines and glucocorticoids. Yet, many studies performed in humans do not report significant associations between subjective feelings of stress and increases in these stress biomarkers. Consequently, it is not clear whether the stress-related complaints of individuals are associated with significant increases in these stress biomarkers. In the present study, we measured whether individuals who self-identify as being 'very stressed out' or 'zen' present differences in psychological (depression and anxiety symptoms), biological (basal and reactive levels of glucocorticoids and alpha-amylase) and socioemotional (emotion regulation, mind wandering, personality, resilience and positive mental health) factors associated with stress. Salivary levels of cortisol and alpha-amylase were obtained in the home environment and in reaction to the Trier Social Stress Test in 123 adults aged between 19 and 55 years. All participants completed questionnaires assessing the psychological and socioemotional factors described above. The results showed that groups significantly differed on almost all psychological and socioemotional factors, although we found no significant group differences on biological markers of stress (cortisol or alpha-amylase). These results suggest that when people complain of being 'very stressed out', what they may really be alluding to is an experience of psychological distress that is related to poor emotion regulation capacities. It is thus possible that the construct of stress used by people to discuss their internal state of 'stress' is quite different than the construct of stress measured in animal and human laboratories using biomarkers of 'stress'.

Stress system dysfunction revealed by integrating reactivity of stress pathways to psychological stress in lean and overweight/obese men

While the patterns of response within the sympatho-adrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems that is not evident when considering either system alone. Age matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary alpha amylase, systolic blood pressure, diastolic blood pressure and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. While analysis of reactivity of individual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Further, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation of the other.

The association between self-reported stress and cardiovascular measures in daily life: A systematic review

BACKGROUND

Stress plays an important role in the development of mental illness, and an increasing number of studies is trying to detect moments of perceived stress in everyday life based on physiological data gathered using ambulatory devices. However, based on laboratory studies, there is only modest evidence for a relationship between self-reported stress and physiological ambulatory measures. This descriptive systematic review evaluates the evidence for studies investigating an association between self-reported stress and physiological measures under daily life conditions.

METHODS

Three databases were searched for articles assessing an association between self-reported stress and cardiovascular and skin conductance measures simultaneously over the course of at least a day.

RESULTS

We reviewed findings of 36 studies investigating an association between self-reported stress and cardiovascular measures with overall 135 analyses of associations between self-reported stress and cardiovascular measures. Overall, 35% of all analyses showed a significant or marginally significant association in the expected direction. The most consistent results were found for perceived stress, high-arousal negative affect scales, and event-related self-reported stress measures, and for frequency-domain heart rate variability physiological measures. There was much heterogeneity in measures and methods.

CONCLUSION

These findings confirm that daily-life stress-dynamics are complex and require a better understanding. Choices in design and measurement seem to play a role. We provide some guidance for future studies.

Stress response asymmetries in African American emerging adults exposed to chronic social adversity

Chronic stress is linked to social adversity and underlies many health disparities among ethnic minorities. Cortisol and salivary alpha-amylase (sAA) reflect sensitivity to adversity and are related to health outcomes. Our aim was to understand how social adversity influences biological responses to experimental and daily stressors in a sample of low-income African American emerging adults. In the three-week study, participants completed questionnaires, the Trier Social Stress Task (TSST), and provided four salivary samples. In week 2, participants collected saliva at home immediately after waking and just before bed for three days. Results demonstrated an asymmetrical pattern between cortisol and sAA reactivity that was related to experiences with racism and interpersonal trauma. Further, daily stress was related to lower morning and higher nighttime cortisol, indicating atypical diurnal rhythm. These findings are consistent with other forms of social adversity that lead to long-term changes in the HPA axis response pattern.LAY SUMMARYAfrican American emerging adults showed divergent cortisol and sAA responses.Social adversity predicted an asymmetrical response pattern for sAA and cortisol.Atypical diurnal rhythms were found for participants reporting high daily stress.

Influence of stress on physiological synchrony in a stressful versus non-stressful group setting

Physiological synchrony (PS) is defined as the co-occurrence and interdependence of physiological activity between interaction partners. Previous research has uncovered numerous influences on the extent of PS, such as relationship type or individual characteristics. Here, we investigate the influence of acute stress on PS. We do so in a setting in which PS was not promoted, but contact between group members was explicitly minimized. We reanalyzed cortisol, alpha-amylase, and subjective stress data from 138 participants (mean age = \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$23.48 \pm 3.99$$\end{document}23.48±3.99, 47.1% female) who previously underwent the Trier Social Stress Test for groups (TSST-G) or a non-stressful control task together, collected as part of a larger project by Popovic et al. (Sci Rep 10: 7845, 2020). Using a stability and influence model, an established method to test for synchrony, we tested whether individuals’ cortisol and alpha-amylase concentrations could be predicted by group members’ levels. We found cortisol PS in participants who were in the same group, the extent of which was stronger in the non-stressful control condition. For alpha-amylase, participants were synchronized as well; furthermore, there was an interaction between previous stress levels and PS. This suggests that while synchrony of both stress markers can occur in group settings even with spurious interaction, stressor exposure might attenuate its extent. We argue that if PS occurs in a sample where interaction was minimal, the phenomenon might be more widespread than previously thought. Furthermore, stressor exposure might influence whether a situation allows for PS. We conclude that PS should be investigated within group settings with various degrees of social interaction to further expose mechanisms of and influence on PS.

Interpersonal Synchrony in the Context of Caregiver-Child Interactions: A Document Co-citation Analysis

Social interactions accompany individuals throughout their whole lives. When examining the underlying mechanisms of social processes, dynamics of synchrony, coordination or attunement emerge between individuals at multiple levels. To identify the impactful publications that studied such mechanisms and establishing the trends that dynamically originated the available literature, the current study adopted a scientometric approach. A sample of 543 documents dated from 1971 to 2021 was derived from Scopus. Subsequently, a document co-citation analysis was conducted on 29,183 cited references to examine the patterns of co-citation among the documents. The resulting network consisted of 1,759 documents connected to each other by 5,011 links. Within the network, five major clusters were identified. The analysis of the content of the three major clusters-namely, "Behavioral synchrony," "Towards bio-behavioral synchrony," and "Neural attunement"-suggests an interest in studying attunement in social interactions at multiple levels of analysis, from behavioral to neural, by passing through the level of physiological coordination. Furthermore, although initial studies on synchrony focused mostly on parent-child interactions, new hyperscanning paradigms are allowing researchers to explore the role of biobehavioral synchrony in all social processes in a real-time and ecological fashion. Future potential pathways of research were also discussed.

The impact of maternal care and blood glucose availability on the cortisol stress response in fasted women

Individuals with a history of low maternal care (MC) frequently present a blunted, yet sometimes also show an increased cortisol stress response. Fasted individuals with low blood glucose levels who are exposed to acute stress typically show an attenuated response pattern in this endocrine marker. Despite well-documented metabolic dysregulations after low MC, a possible interaction of both factors has not been investigated yet. Here, we examined the effects of MC and blood glucose concentration on various aspects of the stress response. Fasted women (N = 122, mean_age = 22.12, sd_age = 2.56) who experienced either very high, high, or low MC (based on the Parental Bonding Instrument) were randomly assigned to consume grape juice (condition sugar), or water (condition water) prior to being exposed to the Trier-Social-Stress-Test for groups. Salivary cortisol and alpha amylase, blood glucose, and mood ratings were assessed repeatedly. Using multilevel mixed models, we replicated the boosting effect of glucose on the cortisol stress response. While we found neither an effect of MC, nor an interaction between MC and blood glucose availability on the cortisol stress response, we observed an effect of MC on the amylase stress response. We discuss the results in the light of links between various stress/energy systems that possibly mediate health-related MC effects.

Cognitive disengagement and biological stress responses in early adolescence

Individual differences in biological responses to stress increase risk for the onset and exacerbation of health and psychiatric conditions. Biases in cognitive disengagement are hypothesized to underlie these individual differences in biological responses to stress. However, no studies have examined which cognitive disengagement bias has the strongest relation with biological responses to stress, and no studies have examined this relation during early adolescence, despite evidence that this is a critical developmental window in which patterns of cognition and biological responses to stress influence trajectories of health throughout life. The current study is the first to test whether difficulty disengaging attention versus working memory from valenced stimuli is associated with biological responses to stress in early adolescence. Youth between 11 and 13 years of age completed two computer-based tasks to assess biases in attention and working memory disengagement to valenced stimuli, and then completed a standardized psychosocial stressor. Consistent with expectations, attention and working memory disengagement biases were associated with stress responses of both the neuroendocrine and autonomic nervous systems, but bias valence and cognitive system influenced the directionality of results. These findings inform our understanding of cognitive mechanisms that influence biological stress reactivity.

Examining the role of ethnic microaggressions and ethnicity on cortisol responses to an acute stressor among young adults

Objective: This study examined whether the frequency of experiences of ethnic microaggressions and the sensitivity to such experiences were associated with cortisol responses to an acute social stressor (Trier Social Stress Test; TSST) among an ethnically diverse sample of young adults (N = 109, Mage = 18.82 years, SD = 1.40 years, 74% female, 44% Latinx). Method: Self-reported experiences of and sensitivity to microaggressions were assessed using the Everyday Microaggressions Scale. Participants' salivary cortisol was collected before, immediately after, and at three 15-min intervals after the TSST (for a total of 5 salivary samples) to assess their cortisol responses to an acute social stressor. Results: Mixed model analyses revealed that experiencing a higher frequency of microaggressions (p = .005) and being more sensitive to those experiences (p = .001) were associated with a more blunted cortisol response (i.e., lower cortisol reactivity and recovery) to the TSST, relative to experiencing a lower frequency of microaggressions and being less sensitive to them. Furthermore, this blunted cortisol response to the TSST was more prominent among young adults of Latinx and other ethnic backgrounds (i.e., biracial, African American, and Native American) compared to their Asian American and non-Hispanic White peers (p = .034). Conclusion: Findings provide insight into the different ways in which experiences of ethnic microaggressions can be associated with biological markers of stress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Acute Physiological and Psychological Stress Response in Youth at Clinical High-Risk for Psychosis

Deficits in stress-response systems are a characteristic of schizophrenia and psychosis spectrum illnesses, and recent evidence suggests that this impairment may be evident in those at clinical high-risk (CHR) for the development of a psychotic disorder. However, there is limited research specifically investigating biological and subjective stress reactivity in CHR individuals. In the present study, 38 CHR individuals and group of 38 control individuals participated in the Trier Social Stress Test (TSST), an experimentally induced psychosocial stressor. Changes in salivary cortisol and alpha amylase, as well as self-reported units of distress (SUDS), were evaluated. Interestingly, the TSST did not induce a change in cortisol levels in either group, though the CHR group did show higher overall cortisol levels throughout the TSST (pre-anticipation period through recovery period). However, indicative of an effective task manipulation, the TSST did illicit an increase in alpha amylase in both groups. CHR participants exhibited higher levels of subjective stress prior to the stressor compared to the control group and CHR SUDs did not significantly increase in response to the stressor. In contrast, the control group showed an increase in SUDS in response to the stressor. Notably, SUDS for the control group post task mirrored the levels CHR youth endorsed prior to the stressor. Taken together, these findings suggest that there may be a functional relationship between persistently elevated cortisol and chronic high levels of subjective distress in CHR individuals.

Human Stress Detection: Cortisol Levels in Stressed Speakers Predict Voice-Based Judgments of Stress

Despite recent evidence of a positive relationship between cortisol levels and voice pitch in stressed speakers, the extent to which human listeners can reliably judge stress from the voice remains unknown. Here, we tested whether voice-based judgments of stress co-vary with the free cortisol levels and vocal parameters of speakers recorded in a real-life stressful situation (oral examination) and baseline (2 weeks prior). Hormone and acoustic analyses indicated elevated salivary cortisol levels and corresponding changes in voice pitch, vocal tract resonances (formants), and speed of speech during stress. In turn, listeners' stress ratings correlated significantly with speakers' cortisol levels. Higher pitched voices were consistently perceived as more stressed; however, the influence of formant frequencies, vocal perturbation and noise parameters on stress ratings varied across contexts, suggesting that listeners utilize different strategies when assessing calm versus stressed speech. These results indicate that nonverbal vocal cues can convey honest information about a speaker's underlying physiological level of stress that listeners can, to some extent, detect and utilize, while underscoring the necessity to control for individual differences in the biological stress response.

A Systematic Review of the Association Between Psychological Stress and Dementia Risk in Humans

Background: It has been estimated that one third of dementia cases may be preventable through modifiable lifestyle interventions. Epidemiological evidence suggests a link between stressful life events and aging-related cognitive decline and dementia; however, inherent methodological limitations in examining subjective and biological measures of stress separately leads to interpretive constraints. Objective: The aim of the current study was to conduct a systematic review of the research literature investigating the effect of perceived and biological measures of stress on dementia risk. Methods: A systematic review was conducted of cohort, case-control, longitudinal prospective or retrospective studies examining the association between stress and risk of developing dementia. Studies were identified from a systematic search across major electronic databases from inception to February 2020. Results: Overall, 22 studies were identified including a total of 496,556 participants, approximately 50% were females, with sample sizes ranging from 62–270,977. There was considerable heterogeneity in the definition and measurement of stress. Most of the identified studies reported a significant positive association between stress and dementia risk. Conclusion: Evidenced from the current review is that personality traits linked to increased perceived stress and elevated reported perceived stress, are associated with greater statistical risk for dementia. However, this review highlights that caution must be exhibited in interpreting these findings, as methodological issues with confounding adjustment may mediate these results. Future research should focus on the investigation of stress on dementia risk with a full range of confounding adjustment, and on biological measures of stress.

Associations between brain activity and endogenous and exogenous cortisol - A systematic review

To arrive at a coherent understanding of the relation between glucocorticoids and the human brain, we systematically reviewed the literature for studies examining the associations between endogenous or exogenous cortisol and human brain function. Higher levels of endogenous cortisol during psychological stress were related to increased activity in the middle temporal gyrus and perigenual anterior cingulate cortex (ACC), decreased activity in the ventromedial prefrontal cortex, and altered function (i.e., mixed findings, increased or decreased) in the amygdala, hippocampus and inferior frontal gyrus. Moreover, endogenous cortisol response to psychological stress was related to increased activity in the inferior temporal gyrus and altered function in the amygdala during emotional tasks that followed psychological stress. Exogenous cortisol administration was related to increased activity in the postcentral gyrus, superior frontal gyrus and ACC, and altered function in the amygdala and hippocampus during conditioning, emotional and reward-processing tasks after cortisol administration. These findings were in line with those from animal studies on amygdala activity during and after stress.

An integrated model of chronic trauma-induced insomnia

Insomnia is the most commonly reported symptom of posttraumatic stress disorder (PTSD), with at least 70% of patients with PTSD reporting disturbed sleep. Although posttraumatic insomnia has traditionally been conceptualized as a consequence of PTSD, it is the most likely symptom to not remit following otherwise successful PTSD treatment. This suggests that the relationship between PTSD and insomnia is more complex, such that they likely share underlying pathological mechanisms and that factors non-specific to PTSD maintain chronic trauma-induced insomnia. Although several theories and hypotheses have been presented to explain the relationship between PTSD and insomnia, neurobiological and psychological models have not been integrated, thereby limiting their comprehensiveness and abilities to inform effective intervention. Further, existing models have not addressed how acute trauma-induced insomnia becomes chronic. The present review examined models of PTSD and insomnia separately, as well as existing theorized mechanisms of their co-morbidity. The distinct characteristics of trauma-induced insomnia were also reviewed and presented to describe the unique clinical presentation of trauma-induced insomnia. Review and integration of the literature were used to propose an integrated model of chronic trauma-induced insomnia informed by a neuropsychobiological framework. Clinical implications and future research directions are presented and discussed.

The relationship between sleep and autonomic health

Objective: To examine the relationship between sleep and resting autonomic nervous system (ANS) functioning in college students. Participants: Participants were 141 undergraduate students (52 males) recruited from a large southeastern university during September-October 2017. Methods: Participants completed self-report inventories (demographic and sleep characteristics). Resting state skin conductance (SC) and heart rate variability (HRV) were measured in a laboratory setting for ANS functioning. Results: SC was positively associated with sleep quality (p = 0.027), sleep latency (p = 0.040), and use of sleep medication (p < 0.001). Analyses yielded a negative association between the standard deviation of the normal-normal interval of heart beats (SDNN) and the self-reported amount of time to fall asleep each night (p = 0.041). Sleep efficiency was negatively correlated with low frequency HRV (p = 0.002). Conclusions: Sleep components are associated with resting ANS activity, and targeted interventions focused on improved ANS functioning may benefit sleep quality in college students.

Early posttraumatic autonomic and endocrine markers to predict posttraumatic stress symptoms after a preventive intervention with oxytocin

BACKGROUND

Efficient prevention of posttraumatic stress disorder (PTSD) needs to target individuals with an increased risk for adverse outcome after trauma. Prognostic or prescriptive biological markers assessed early posttrauma may inform personalized treatment recommendations.

OBJECTIVE

To test prognostic and prescriptive effects of early (posttraumatic) autonomic and endocrine markers on PTSD symptom development.

METHOD

Autonomic and endocrine markers were assessed within 12 days posttrauma and before treatment initiation within a randomized placebo-controlled trial investigating repeated oxytocin administration as preventive intervention for PTSD. Linear mixed effects models were used to test the effects of heart rate (variability), resting cortisol, morning cortisol and cortisol awakening response (CAR), cortisol suppression by dexamethasone and resting oxytocin on PTSD symptoms 1.5, 3 and 6 months posttrauma in men (n = 54), women using hormonal contraception (n = 27) and cycling women (n = 19).

RESULTS

We found significant prognostic effects of resting oxytocin and cortisol suppression. In women using hormonal contraception, higher oxytocin was associated with higher PTSD symptoms across follow-up. Stronger cortisol suppression by dexamethasone, reflecting increased glucocorticoid receptor feedback sensitivity, was associated with lower PTSD symptoms across follow-up in men, but with higher symptoms at 1.5 months in women using hormonal contraception. These effects were independent of treatment condition. No further significant prognostic or prescriptive effects were detected.

CONCLUSION

Our exploratory study indicates that resting oxytocin and glucocorticoid receptor feedback sensitivity early posttrauma are associated with subsequent PTSD symptom severity. Notably, prognostic effects depended on sex and hormonal contraception use, emphasizing the necessity to consider these factors in biomedical PTSD research.

Hippocampal seed connectome-based modeling predicts the feeling of stress

Although the feeling of stress is ubiquitous, the neural mechanisms underlying this affective experience remain unclear. Here, we investigate functional hippocampal connectivity throughout the brain during an acute stressor and use machine learning to demonstrate that these networks can specifically predict the subjective feeling of stress. During a stressor, hippocampal connectivity with a network including the hypothalamus (known to regulate physiological stress) predicts feeling more stressed, whereas connectivity with regions such as dorsolateral prefrontal cortex (associated with emotion regulation) predicts less stress. These networks do not predict a subjective state unrelated to stress, and a nonhippocampal network does not predict subjective stress. Hippocampal networks are consistent, specific to the construct of subjective stress, and broadly informative across measures of subjective stress. This approach provides opportunities for relating hypothesis-driven functional connectivity networks to clinically meaningful subjective states. Together, these results identify hippocampal networks that modulate the feeling of stress.

Effects of stress on functional connectivity during verbal processing

Effects of stress on functional connectivity (FC) in specific language processing regions of the brain during verbal fluency tasks were explored. Roles of gender and serotonin transporter gene polymorphisms (5-HTTLPR), associated with stress susceptibility, were also examined to understand their effect. Forty-five healthy volunteers (Mean age: 19.6 ± 1.6 years; 28 females) participated. Functional magnetic resonance imaging was carried out while participants performed letter and category fluency tasks. These tasks were interposed with the Montreal Imaging Stress Test to induce stress or a no-stress control task. Buccal swabs collected were used to genotype for the presence of polymorphisms on the SLC6A4 gene known to contribute to atypical stress responses. Significant variations in strength of FC were noted between several ROIs, including left inferior frontal gyrus and left middle temporal gyrus. Overall, males showed regional increases in FC strength over long and short distances during task under stress. Additionally, variability in effects of stress on task performance was associated with effects of stress on FC. Results suggest that long distance FC may be strengthened to compensate for additional cognitive load of the stressor but that specific short distance functional connections may be strengthened in a gender specific manner. Additionally, FC may serve as a marker for effects of stress on performance. This is the first study exploring stress effects on language tasks with imaging markers. Future studies will need to explore stress susceptible populations and establish the role of FC as a marker, with implications for targeted therapeutic interventions.

Social-evaluative threat: Stress response stages and influences of biological sex and neuroticism

Social-evaluative threat (SET) - when the self could be negatively judged by others - can cause pronounced responses in the different stress systems: threat/challenge appraisal, the sympathetic (SNS) and parasympathetic (PNS) nervous systems, experienced motivation and affect, and the hypothalamus-pituitary-adrenal (HPA) axis. Here, we utilize a four-stage stress response model to shed light on the complex associations between different stress responses, where earlier stages are hypothesized to predict later stages. Additionally, we take into account important moderators, such as biological sex (controlling for menstrual cycle phase), personality traits (neuroticism and extraversion), and baseline stress levels. Thirty-seven men and 30 women in their luteal phase participated in an impromptu public speaking task to induce SET. Stress responses in four different stages were measured using: self-reported appraisal (threat or challenge, stage 1: S1), cardiovascular measures (pre-ejection period as SNS index, respiratory sinus arrhythmia as PNS index, S2), self-reported motivation and affect (state approach motivation, state anxiety, S3) and endocrine measures (cortisol as HPA index, S4). Stress reactivity was calculated by subtracting individual peaks from baseline. Results showed that SET induced pronounced stress reactivity in stages two to four. Against expectations, self-reported appraisal (S1) or motivation and affect (S3) did not predict later stress reactivity. As hypothesized, increased SNS (but not PNS) reactivity (S2) predicted increased HPA reactivity (S4). Bayesian model comparison confirmed the absence of sex differences in stress reactivity, likely due to controlling for menstrual cycle phase and sex differences in neuroticism levels. Higher trait neuroticism predicted blunted SNS (S2) and HPA (S4) reactivity, while higher baseline stress levels predicted blunted stages two and three reactivity overall. In conclusion, this rigorously controlled experiment partly supports and partly contradicts previous findings regarding associations between stress response stages, and offers new insight into the causes of blunted HPA responses in women.

Recovery from daily-life stressors in early and chronic psychosis

Initial affective and psychotic reactivity to daily stressors is altered in psychosis, and most notably in early psychosis. In addition to altered initial stress reactivity, results from studies using Experience Sampling Methodology (ESM) and psychophysiological measures indicate that impaired recovery from mild stressors may also be a risk factor for mental illness. The current ESM study investigated affective recovery from daily stressors in chronic psychosis patients (CP; n = 162), individuals at early stages of psychosis (EP; n = 127), and healthy volunteers (HV; n = 220) assessing fluctuations in negative affect (NA), tension, and suspiciousness ten times a day on six consecutive days. Recovery was operationalized for all three variables as the return to baseline (i.e., level at t_-1) following the first stressful event of a day (i.e., t₀). The EP group showed a delayed recovery of NA (t₁-t₃: B = 0.185; p = .007 and B = 0.228; p = .002) and suspiciousness (t₁: B = 0.223; p = .010 and B = 0.291; p = .002) compared to HV and CP, respectively. Delayed recovery was detected for tension as well (t₁-t₂: EP > HV: B = 0.242; p = .040 and EP > CP: B = 0.284; p = .023), but contrary to both other momentary states, this effect disappeared when controlling for subsequent stressful events. There were no significant differences in recovery between HV and CP. These results suggest that in EP, stressful daily events have longer-lasting effects on overall negative affect and subclinical psychotic-like experiences. Future studies should incorporate physiological and endocrine measures in order to integrate recovery patterns of the different stress systems.

Lifestyle Choices and Brain Health

This article is largely based on the recommendations of the AARP's Global Council on Brain Health (GCBH) and aims to provide an overview of evidence from current literature and expert opinion on key elements known to be relevant in preserving brain health as people age. Although we realize that there may be other lifestyle choices of importance to brain health, the GCBH has decided to initially focus on the issues below based on the preferences and concerns of its members. The areas to be discussed are: mental well-being, exercise, cognitively stimulating activities, sleep, nutrition, and social connectedness. Our review concluded that each of these areas offer opportunities for aging individuals to make lifestyle adjustments to positively impact brain health.

Canine-Assisted Therapy Improves Well-Being in Nurses

As nursing is one of the most stressful occupations worldwide, its management warrants more attention to identify possible ways to cope with its pressures. This study aims to evaluate whether animal-assisted therapy (AAT) with the presence of a dog affects the stress level of nurses. As a stress biomarker, we used salivary cortisol level testing. Twenty female nurses (mean age: 30) in physical medicine (PMR) (n = 11) and the department of internal medicine and long-term care (IM < C) (n = 9). On each of the three observed days, saliva was collected at 10 a.m. and then again after 50 min. The first sampling was performed during a normal working process without a break (Condition A), the second was carried out during a normal working process with a break of choice (Condition B), and the third sampling was performed during a normal working process with a break with AAT (Condition C). All participants were enrolled in all three interventional conditions in a randomized order. The results demonstrated the effect of a reduction of cortisol levels in Condition C, where AAT was included (p = 0.02) only in nurses recruited from the IM < C department. By way of explanation, nurses from the PMR department already showed low cortisol levels at baseline. We propose including AAT with a dog in healthcare facilities where nurses are at a high risk of stress.

Acute psychosocial stress and working memory performance: the potential of physical activity to modulate cognitive functions in children

Background

Research suggests that physical activity (PA) enhances cognitive performance and prevents stress-related impairments of higher order cognitive functions like working memory (WM) performance. The aim of the current study was to investigate the effect of PA on WM performance after acute stress exposure in preadolescent children.

Methods

Regular PA was assessed for seven consecutive days during a typical school week using accelerometers in a sample of 44 preadolescent children (14 girls, M_age = 11.29 years, SD_age = 0.67). Following this period, participants performed an automated operational span (OSPAN) task immediately after being exposed to the Trier Social Stress Test for Children (TSST-C).

Results

Children exhibited prototypical response slopes in salivary cortisol and salivary α-amylase as markers of the endocrine and autonomic stress response immediately after psychosocial stress induction. A subsequent two-way ANOVA comparing high- and low-stress responders revealed a significant interaction between group affiliation and PA level on WM performance for both stress markers. Interestingly, best WM performance was demonstrated in children showing both high PA levels and high cortisol (or low α-amylase, respectively) stress responses.

Conclusions

Though patterns differed for salivary cortisol and salivary α-amylase, overall findings suggest that PA buffers the negative effects of stress on cognitive performance in children.

Does Emotional Intelligence Buffer the Effects of Acute Stress? A Systematic Review

People with higher levels of emotional intelligence (EI: adaptive emotional traits, skills, and abilities) typically achieve more positive life outcomes, such as psychological wellbeing, educational attainment, and job-related success. Although the underpinning mechanisms linking EI with those outcomes are largely unknown, it has been suggested that EI may work as a "stress buffer." Theoretically, when faced with a stressful situation, emotionally intelligent individuals should show a more adaptive response than those with low EI, such as reduced reactivity (less mood deterioration, less physiological arousal), and faster recovery once the threat has passed. A growing number of studies have begun to investigate that hypothesis in respect to EI measured as both an ability (AEI) and trait (TEI), but results are unclear. To test the "stress-buffering" function of EI, we systematically reviewed experimental studies that explored the relationship between both types of EI and acute stress reactivity or recovery. By searching four databases, we identified 45 eligible studies. Results indicated that EI was only adaptive in certain contexts, and that findings differed according to stressor type, and how EI was measured. In terms of stress reactivity, TEI related to less mood deterioration during sports-based stressors (e.g., competitions), physical discomfort (e.g., dental procedure), and cognitive stressors (e.g., memory tasks), but did not appear as helpful in other contexts (e.g., public speaking). Furthermore, effects of TEI on physiological stress responses, such as heart rate, were inconsistent. Effects of AEI on subjective and objective stress reactivity were often non-significant, with high levels detrimental in some cases. However, data suggest that both higher AEI and TEI relate to faster recovery from acute stress. In conclusion, results provide mixed support for the stress-buffering effect of EI. Limitations and quality of studies are also discussed. Findings could have implications for EI training programmes.

Multimodal stress detection: Testing for covariation in vocal, hormonal and physiological responses to Trier Social Stress Test

Examining the effects of acute stress across multiple modalities (behavioral, physiological, and endocrinological) can increase our understanding of the interplay among stress systems, and may improve the efficacy of stress detection. A multimodal approach also allows for verification of the biological stress response, which can vary between individuals due to myriad internal and external factors, thus allowing for reliable interpretation of behavioral markers of stress. Here, controlling for variables known to affect the magnitude of the stress response, we utilized the Trier Social Stress Test (TSST) to elicit an acute stress response in 80 healthy adult men and women. The TSST involves an interview-style oral presentation and critical social evaluation, and is highly effective in inducing psychosocial stress. Participants completed the study in individual 2 h sessions, during which we collected voice, polygraph and salivary hormone measures in baseline, stress, and relaxation phases. Our results show sizeable systematic increases in voice pitch (mean, minimum and variation in fundamental frequency, F0), hormone levels (cortisol) and decreases in skin temperature and hand movement during psychosocial stress, with striking similarities between men and women. However, cortisol and skin temperature only weakly predicted changes in voice pitch during stress, in either women or men, respectively. Thus, while our results provide compelling evidence that psychosocial stress manifests itself behaviorally by increasing voice pitch and its variability alongside simultaneous activation of physiological and endocrinological stress systems, our results also highlight a relatively weak degree of intra-individual 'response coherence' across these stress systems, with dissociations among different stress measures related most strongly to sex.

Overall cortisol, diurnal slope, and stress reactivity in psychosis: An experience sampling approach

OBJECTIVE

Results from experimental studies suggest that psychosis and psychosis liability are associated with increased cortisol levels and blunted cortisol reactivity, and that use of antipsychotics may reduce these aberrations. Here, we report on overall cortisol, diurnal slope, and cortisol stress reactivity in everyday life in psychosis and psychosis liability using the experience sampling method (ESM).

METHODS

Our sample consisted of individuals diagnosed with psychotic disorder currently on (MPD; n = 53) or off antipsychotic medication (NMPD; n = 20), first-degree relatives of psychotic patients (REL; n = 47), and healthy volunteers (HV; n = 67). Saliva samples were collected throughout the day on six consecutive days and analyzed for cortisol levels. Simultaneously, stressfulness of the current activity was assessed with ESM questionnaires.

RESULTS

We found no group differences in overall cortisol level between groups, but REL had a steeper diurnal slope than HV; in MPD a trend was found in the same direction. Regarding reactivity to stressful activities, results indicated attenuation of the cortisol response in both patient groups compared to HV.

CONCLUSION

These results do not confirm reports of increased cortisol levels in psychosis, but provide evidence of stress-related cortisol alterations in everyday life.

The brain's hemodynamic response function rapidly changes under acute psychosocial stress in association with genetic and endocrine stress response markers

Ample evidence links dysregulation of the stress response to the risk for psychiatric disorders. However, we lack an integrated understanding of mechanisms that are adaptive during the acute stress response but potentially pathogenic when dysregulated. One mechanistic link emerging from rodent studies is the interaction between stress effectors and neurovascular coupling, a process that adjusts cerebral blood flow according to local metabolic demands. Here, using task-related fMRI, we show that acute psychosocial stress rapidly impacts the peak latency of the hemodynamic response function (HRF-PL) in temporal, insular, and prefrontal regions in two independent cohorts of healthy humans. These latency effects occurred in the absence of amplitude effects and were moderated by regulatory genetic variants of KCNJ2, a known mediator of the effect of stress on vascular responsivity. Further, hippocampal HRF-PL correlated with both cortisol response and genetic variants that influence the transcriptional response to stress hormones and are associated with risk for major depression. We conclude that acute stress modulates hemodynamic response properties as part of the physiological stress response and suggest that HRF indices could serve as endophenotype of stress-related disorders.

Stigma Consciousness Modulates Cortisol Reactivity to Social Stress in Women

The aim of the current study was to examine whether stigma consciousness shapes cortisol responses to social stress among women in the lab. Undergraduate women (N = 45) completed background measures and then participated in a public speaking task, with assessments of cortisol prior to the stressor as well as 20- and 40-minutes post stressor onset. Results from multilevel models revealed that women higher in stigma consciousness evidenced blunted cortisol reactivity following social stress across the study session compared to women lower in stigma consciousness. This interaction was robust to adjustment for a number of covariates, including demographic (e.g., age), physiological (e.g., menstrual cycle) and psychological (e.g., depressive symptomatology) factors. Potential explanations for observed cortisol patterns are discussed, including hypo-reactivity of the hypothalamic-pituitary-adrenal (HPA) axis and elevated anticipatory stress. To conclude, implications for health disparities research are considered.

Conceptual endophenotypes: A strategy to advance the impact of psychoneuroendocrinology in precision medicine

Psychobiological research has generated a tremendous amount of findings on the psychological, neuroendocrine, molecular and environmental processes that are directly relevant for mental and physical health, but have overwhelmed our capacity to meaningfully absorb, integrate, and utilize this knowledge base. Here, we reflect about suitable strategies to improve the translational success of psychoneuroendocrinological research in the era of precision medicine. Following a strategy advocated by the National Research Council and the tradition of endophenotype-based research, we advance here a new approach, termed "conceptual endophenotypes". We define the contextual and formal criteria of conceptual endophenotypes, outline criteria for filtering and selecting information, and describe how conceptual endophenotypes can be validated and implemented at the bedside. As proof-of-concept, we describe some of our findings from research that has adopted this approach in the context of stress-related disorders. We argue that conceptual endophenotypes engineer a bridge between the bench and the bedside. This approach readily lends itself to being continuously developed and implemented. Recent methodological advances, including digital phenotyping, machine learning, grassroots collaboration, and a learning healthcare system, may accelerate the development and implementation of this conceptual endophenotype approach.

Stress-related salivary alpha-amylase (sAA) activity in alcohol dependent patients with and without a history of childhood maltreatment

RATIONALE

Alcohol-dependent (AD) patients with a history of childhood maltreatment (CM) have shown a more severe clinical profile and a higher risk of relapse than those without CM. It was hypothesized that stress responsivity plays an important role in moderating the relationship between CM and AD. Surprisingly, systematic investigations about the stress responsivity in AD patients with CM are rare.

OBJECTIVE

This study compared physiological and subjective stress responses in AD patients with and without CM as well as in healthy controls with and without CM.

METHODS

A total of 130 participants performed the Trier Social Stress Test (TSST). Physiological stress reactivity related to the noradrenergic system was assessed by salivary alpha-amylase (sAA) activity. Subjective ratings of anxiety, nervousness, distress, and mood were rated on visual analogue scales.

RESULTS

AD patients showed significantly lower stress-related sAA activity than healthy controls (p ≤ 0.024; z ≥ 1.97). A different pattern was found in the subjective ratings. In particular, anticipatory anxiety revealed a clear effect of CM (p ≤ 0.005; z ≥ 2.43) but no difference between AD patients and healthy controls (p > 0.05). After the TSST, distress ratings differed between AD patients with CM and AD patients without CM (p ≤ 0.009; z ≥ 2.61).

CONCLUSION

The discrepancy between physiological responsivity and subjective stress experiences may account for an increased inability to cope with stressful situations, which in turn might explain the enhanced risk of relapse in AD patients with a history of CM during early abstinence.

Testing the ecological validity of the Trier Social Stress Test: Association with real-life exam stress

The Trier Social Stress Test (TSST) is the most widely used laboratory stress protocol in psychoneuroendocrinology. Despite its popularity, surprisingly few attempts have been made to explore the ecological validity of the TSST. In the present study, 31 young healthy subjects (24 females) were exposed to the TSST about 4 weeks before completing an oral exam on a separate day. Salivary cortisol levels increased significantly in response to both stimuli (TSST: F(2.21, 66.33)=5.73, p=0.004; oral exam: F(1.98, 59.28)=4.38, p=0.017) with similar mean response curves and significant correlations between cortisol increases and areas under the response curves (increase: r=0.67; AUC: r=0.56; both p≤0.01). Correspondingly, changes in positive and negative affect did also show significant correlations between conditions (increase: positive affect: r=0.36; negative affect: r=0.50; both: p≤0.05; AUC: positive affect: r=0.81; negative affect: r=0.70; both p≤0.01) while mean time course dynamics were significantly different (positive affect: F(2.55, 76.60)=10.15, p=0.001; negative affect: F(1.56, 46.82)=23.32, p=0.001), indicating that the oral exam had a more pronounced impact on affect than the TSST. Our findings provide new evidence for the view that cortisol as well as subjective stress responses to the TSST are indeed significantly associated with acute stress responses in real life.

Stress in Persons with Dementia: Benefits of a Memory Center Day Program

Most persons with dementia are cared for by family members who are so overwhelmed that their mental and physical health declines. Adult day care programs (ADC) are growing in number to meet caregivers' needs for respite but little is known about their effect on enrollee mental health. We examined mental health of enrollees (stress, anxiety, mood, emotions) and arousal (blood pressure and salivary cortisol) from day program enrollment to 3 months following enrollment. Results showed significant decreases in morning cortisol level at 1 and 3 months (p=.047). Perceived stress decreased at 1 and 3 months measured by Perceived Stress Scale (p=.03) and Index of Clinical Stress (p=.01). Results provide support for ADC as a stress-reducing environment for individuals with mild to moderate cognitive impairment. Future studies should be conducted to examine which elements of ADC are beneficial.

Stress Physiology in Infancy and Early Childhood: Cortisol Flexibility, Attunement and Coordination

Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic-pituitary-adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within-subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of "flexibility," the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregiver's physiological function. Infant-mother "attunement" is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the "coordination" of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between-subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model..

Salivary stress biomarkers of recent nicotine use and dependence

BACKGROUND

Although stress plays a critical role in vulnerability to nicotine use and dependence, the stress response factors that contribute to smoking behaviors remain poorly elucidated. To minimize the confounding effects of chronic nicotine use, assessing individuals with relatively short smoking histories is critical for characterizing the neurobiological substrates associated with nicotine dependence early in the course of illness.

OBJECTIVES

This pilot study examined sympathetic nervous system (alpha-amylase) and hypothalamic-pituitary-adrenal axis (cortisol, dehydroepiandrosterone) responses to the Trier Social Stress Test (TSST) in young adult smokers. Associations among objective indices of recent smoking (salivary cotinine, carbon monoxide in the breath [CO]), behavioral measures of nicotine dependence and withdrawal, and salivary biomarkers in response to the TSST were investigated.

METHODS

Smokers (N = 64; 28 males, 36 females) provided saliva samples at 30 min intervals for 2 h prior to the TSST and every 10 min for 1 h following the TSST.

RESULTS

Alpha-amylase responses to the TSST were positively associated with salivary cotinine levels but negatively associated with CO levels. Individuals with a lower level of nicotine dependence had increased cortisol responses to the stressor, whereas those with a higher level of nicotine dependence did not show any cortisol changes in response to the stressor.

CONCLUSIONS

These findings indicate that different mechanisms may be involved at different levels of nicotine dependence severity. Recent nicotine use and lower dependence severity may be associated with increased activation of the stress response systems. In contrast, more severe levels of dependence may downregulate stress response systems.

Computations of uncertainty mediate acute stress responses in humans

The effects of stress are frequently studied, yet its proximal causes remain unclear. Here we demonstrate that subjective estimates of uncertainty predict the dynamics of subjective and physiological stress responses. Subjects learned a probabilistic mapping between visual stimuli and electric shocks. Salivary cortisol confirmed that our stressor elicited changes in endocrine activity. Using a hierarchical Bayesian learning model, we quantified the relationship between the different forms of subjective task uncertainty and acute stress responses. Subjective stress, pupil diameter and skin conductance all tracked the evolution of irreducible uncertainty. We observed a coupling between emotional and somatic state, with subjective and physiological tuning to uncertainty tightly correlated. Furthermore, the uncertainty tuning of subjective and physiological stress predicted individual task performance, consistent with an adaptive role for stress in learning under uncertain threat. Our finding that stress responses are tuned to environmental uncertainty provides new insight into their generation and likely adaptive function.

Acute stress has broad physiological and behavioural consequences, yet the precise factors that generate stress responses are not known. Here, de Berker and colleagues demonstrate that acute stress responses dynamically track environmental uncertainty and predict ability to learn under uncertain threat.

The Association of Hair Cortisol with Self-Reported Chronic Psychosocial Stress and Symptoms of Anxiety and Depression in Women Shortly after Delivery

BACKGROUND

Psychosocial stress during pregnancy including anxiety and depression is known to have adverse health effects on newborns. However, measuring these psychological constructs is complex with psychological, endocrinological, and physiological systems being affected. Hair cortisol concentrations (HCC), assumed to reflect long-term endocrine consequences of stress exposure, represent a promising instrument for epidemiological research. However, the association between HCC and questionnaire-based instruments is unclear.

METHODS

In the Ulm SPATZ Health Study, mothers were recruited shortly after delivery in the University Medical Centre Ulm, Germany between April 2012 and May 2013. HCC of 768 participants were determined in scalp-near 3 cm maternal hair segments, assumed to reflect cortisol exposure over the last trimester of pregnancy. Chronic stress, anxiety, and depressive symptomatology were self-reported in questionnaire-based instruments. Spearman correlation coefficients between HCC and these instruments as well as means of HCC in highly and low stressed subgroups were calculated.

RESULTS

HCC were not correlated with self-reported chronic stress, anxiety, or depressive symptomatology. Furthermore, the investigation of sub-populations did not reveal substantial differences of HCC across highly and low stressed women.

CONCLUSIONS

HCC were not found to correlate with self-reports of chronic stress, anxiety, or depressive symptomatology. Among other things, these findings could reflect problems with questionnaire-based assessments obtained shortly after delivery such as recall bias and/or suggest that associations between cortisol secretion and psychosocial stress are difficult to detect due to, e.g. a strong physiological increase of cortisol in the last trimester.

Early childhood cortisol reactivity moderates the effects of parent-child relationship quality on the development of children's temperament in early childhood

Positive parenting has been related both to lower cortisol reactivity and more adaptive temperament traits in children, whereas elevated cortisol reactivity may be related to maladaptive temperament traits, such as higher negative emotionality (NE) and lower positive emotionality (PE). However, no studies have examined whether hypothalamic-pituitary-adrenal axis activity, as measured by cortisol reactivity, moderates the effect of the quality of the parent-child relationship on changes in temperament in early childhood. In this study, 126 3-year-olds were administered the Laboratory Temperament Assessment Battery (Lab-TAB; Goldsmith et al., 1995) as a measure of temperamental NE and PE. Salivary cortisol was collected from the child at 4 time points during this task. The primary parent and the child completed the Teaching Tasks battery (Egeland et al., 1995), from which the quality of the relationship was coded. At age 6, children completed the Lab-TAB again. From age 3 to 6, adjusting for age 3 PE or NE, a better quality relationship with their primary parent predicted decreases in NE for children with elevated cortisol reactivity and predicted increases in PE for children with low cortisol reactivity. Results have implications for our understanding of the interaction of biological stress systems and the parent-child relationship in the development of temperament in childhood.

Depression history as a moderator of relations between cortisol and shame responses to social-evaluative threat in young adults

Changes in cortisol and shame are commonly elicited by psychosocial stressors involving social-evaluative threat. According to social self preservation theory, this coordinated psychobiological response is adaptive. Individuals with a history of depression, however, may exhibit diminished cortisol reactivity to acute stressors, which could interfere with coordinated cortisol and shame responses. The present study examined temporal relations between cortisol and shame responses to a psychosocial stress task in young adults who varied in their history of depression (56 remitted-depressed, 46 never-depressed). Lagged effects multilevel models revealed that depression history moderated relations between cortisol levels and shame ratings 25-55min later. The pattern of these interactions was similar: whereas higher cortisol levels predicted increases in shame in never-depressed individuals, cortisol levels were unrelated to shame responses in remitted-depressed individuals. Findings suggest a dissociation between cortisol and shame responses to stress in individuals with a history of depression.