Exposure to acute stress enhances decision-making competence: Evidence for the role of DHEA

A rank ordering and analysis of four cognitive-behavioral stress-management competencies suggests that proactive stress management is especially valuable

The main objective of this study was to determine the relative value of four cognitive-behavioral competencies that have been shown in empirical studies to be associated with effective stress management. Based on a review of relevant psychological literature, we named the competencies as follows: Manages or Reduces Sources of Stress, Manages Thoughts, Plans and Prevents, and Practices Relaxation Techniques. We measured their relative value by examining data obtained from a diverse convenience sample of 18,895 English-speaking participants in 125 countries (65.0% from the U.S. and Canada) who completed a new inventory of stress-management competencies. We assessed their relative value by employing a concurrent study design, which also allowed us to assess the validity of the new instrument. Regression analyses were used to rank order the four competencies according to how well they predicted desirable outcomes. Both regression and factor analyses pointed to the importance of proactive stress-management practices over reactive methods, but we note that the correlational design of our study has no implications for the possible causal effects of these methods. Questionnaire scores were strongly associated with self-reported happiness and also significantly associated with personal success, professional success, and general level of stress. Data were collected between 2007 and 2022, but we found no effect for time. The study supports the value of stress-management training, and it also suggests that moderate levels of stress may not be as beneficial as previously thought.

Decision-making under stress: A psychological and neurobiological integrative model

Understanding the impact of stress on cognitive processes, particularly decision-making, is crucial as it underpins behaviors essential for survival. However, research in this domain has yielded disparate results, with inconsistencies evident across stress-induction paradigms and drug administration protocols designed to investigate specific stress pathways or neuromodulators. Building upon empirical studies, this research identifies a multifaceted matrix of variables contributing to the divergent findings. This matrix encompasses factors such as the temporal proximity between stressors and decision tasks, the nature of stressors and decision contexts, individual characteristics including psychobiological profiles and affective states at the time of decision-making and even cultural influences. In response to these complexities, we propose a comprehensive model that integrates these relevant factors and their intricate interplay to elucidate the mechanisms governing decision-making during stressful events. By synthesizing these insights, our model not only refines existing paradigms but also provides a framework for future study designs, offering avenues for theoretical advancements and translational developments in the field of stress's impact on cognitive functions. This research contributes to a deeper understanding of the nuanced relationship between stress and decision-making, ultimately advancing our knowledge of cognitive processes under challenging conditions.

Examination-related anticipatory levels of dehydroepiandrosterone and cortisol predict positive affect, examination marks and support-seeking in college students

Dehydroepiandrosterone (DHEA) and cortisol release appear to have contrasting effects on stress perception during stressful tasks. This study aimed to investigate anticipatory examination stress in college students by considering DHEA, cortisol, psycho-emotional aspects and examination performance. Seventy-six students (66 females, 10 males; age range 18-25 years) provided saliva samples and completed questionnaires in two sessions 48 hours apart. During the second session, the students performed the examination. The questionnaires used were the State-Trait Anxiety Inventory, the Positive and Negative Affect Scale, and the Brief-Coping Orientation to Problems Experienced Inventory. DHEA, cortisol, anxiety and negative affect showed an anticipatory rise before the examination (all ps < 0.001). This rise of DHEA and cortisol was associated with lower positive affect (p = 0.001 and p = 0.043, respectively). However, only the DHEA anticipatory levels were linked to poorer examination marks (p = 0.020). Higher levels of the DHEA/cortisol ratio in anticipation of the examination were related to lower scores on the support-seeking strategy (p = 0.022). There was no association between DHEA and cortisol levels and anxiety, negative affect, active and avoidant coping strategies, or academic record. These results suggest that how DHEA and cortisol respond in anticipation of examination stress significantly impacts students' emotional well-being during examination periods and how they cope with stress. They also suggest that levels of DHEA in anticipation of an academic stressor have detrimental effects on stress management.

Relationship between COVID-related stressors and internalizing symptoms: Gendered neuroendocrine risk profiles

The COVID-19 pandemic generated significant life stress and increases in internalizing disorders. Moreover, COVID-related stressors disproportionately impacted women, consistent with outcomes showing a gender gap in stress-related disorders. Gender-related stress vulnerability emerges in adolescence alongside gender-specific changes in neuroendocrine signaling. Most research on the neuroendocrinology of stress-related disorders has focused on differences in the hypothalamic-pituitary-adrenal (HPA) axis effector hormone cortisol. More recent studies, however, emphasize dehydroepiandrosterone (DHEA), a neuroprotective and neuroactive hormone released concurrently with cortisol that balances its biobehavioral actions during stress. Notably, women show lower cortisol responses and higher DHEA responses to stress. However, lower cortisol and higher DHEA are associated with internalizing disorders in women, while those associations are opposite in men. Thus, gender-specific factors perhaps result in a neuroendocrine profile that places women at greater risk for stress-related disorders. The current study prospectively examined socially evaluated cold-pressor task (SECPT) induced neuroendocrine responses at age 15 and internalizing symptoms during the COVID-19 pandemic at age 21 in a cohort of 175 primarily Black low-socioeconomic status participants, while controlling for internalizing symptoms at age 15. The association between COVID-related stress and internalizing symptoms was not stronger in women. Lower DHEA-cortisol ratios were associated with a weaker relationship between COVID-related stress and internalizing symptoms in women, while higher ratios were associated with a weaker relationship in men. These findings suggest gender differences in the relationship between DHEA and cortisol and internalizing outcomes during a stressful period, and support differential neuroendocrine protective and risk pathways for young men and women.

When stress enhances memory encoding: The beneficial effects of changing context

The effects of acute stress on memory encoding are complex, and we do not yet know all of the conditions that can determine whether stress at encoding improves or impairs memory. Recent work has found that changing contexts between encoding and stress can abolish the effects of post-encoding stress on memory, suggesting that context may play an important role in the effects of stress on memory. However, the role of context in the effects of stress on memory encoding is not yet known. We addressed this gap by examining the effects of context on the influence of acute stress on memory encoding. In a 2 × 2 experimental design, participants (N = 103) completed either a stressor (i.e., Socially Evaluated Cold Presser Test) or control task (i.e., warm water control) before completing a memory encoding task, which occurred in either in the same room as or a different room from the stressor or control task. Memory retrieval was tested for each participant within the context that they completed the encoding task. We found that, relative to nonstressed (i.e., control) participants, stressed participants who switched contexts prior to encoding showed better memory for both negative and neutral images. In contrast, when the stressor or control task occurred in the same room as memory encoding, stress had no beneficial effect on memory. These results highlight the importance of the ongoing context as a determinant of the effects of stress on memory encoding and present a challenge to current theoretical accounts of stress and memory.

From threat to challenge-Improving medical students' stress response and communication skills performance through the combination of stress arousal reappraisal and preparatory worked example-based learning when breaking bad news to simulated patients: study protocol for a randomized controlled trial

BACKGROUND

Breaking bad news (BBN; e.g., delivering a cancer diagnosis) is perceived as one of the most demanding communication tasks in the medical field and associated with high levels of stress. Physicians' increased stress in BBN encounters can negatively impact their communication performance, and in the long term, patient-related health outcomes. Although a growing body of literature acknowledges the stressful nature of BBN, little has been done to address this issue. Therefore, there is a need for appropriate tools to help physicians cope with their stress response, so that they can perform BBN at their best. In the present study, we implement the biopsychosocial model of challenge and threat as theoretical framework. According to this model, the balance between perceived situational demands and perceived coping resources determines whether a stressful performance situation, such as BBN, is experienced as challenge (resources > demands) or threat (resources < demands). Using two interventions, we aim to support medical students in shifting towards challenge-oriented stress responses and improved communication performance: (1) stress arousal reappraisal (SAR), which guides individuals to reinterpret their stress arousal as an adaptive and beneficial response for task performance; (2) worked examples (WE), which demonstrate how to BBN in a step-by-step manner, offering structure and promoting skill acquisition.

METHODS

In a randomized controlled trial with a 2 (SAR vs. control) x 2 (WE vs. control) between-subjects design, we will determine the effects of both interventions on stress response and BBN skills performance in N = 200 third-year medical students during a simulated BBN encounter. To identify students' stress responses, we will assess their perceived coping resources and task demands, record their cardiovascular activity, and measure salivary parameters before, during, and after BBN encounters. Three trained raters will independently score students' BBN skills performances.

DISCUSSION

Findings will provide unique insights into the psychophysiology of medical students who are tasked with BBN. Parameters can be understood more comprehensively from the challenge and threat perspective and linked to performance outcomes. If proven effective, the evaluated interventions could be incorporated into the curriculum of medical students and facilitate BBN skills acquisition.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT05037318), September 8, 2021.

Effects of psychological stress and cortisol on decision making and modulating factors: a systematic review

Evidence suggests that psychological stress has effects on decision making, but the results are inconsistent, and the influence of cortisol and other modulating factors remains unclear. Based on the PRISMA criteria, 18 studies carried out between 2015 and 2020 that examined the effects of psychological stress on decision making and measured cortisol levels were selected. Eight studies employed uncertainty-based economic tasks, five studies used decision-making tasks in hypothetical situations that can be encountered in real life or in a specific setting, and five studies employed prosocial decision tasks. Seventeen studies assessed acute stress, and two assessed chronic stress; eight evaluated the influence of sex. Most of the studies that explored the association between stress and decision making using uncertainty-based economic tasks found statistically significant differences as a function of stress exposure and the cortisol response to stress, whereas most of the studies that employed non-economic decision-making tasks in hypothetical situations did not find statistically significant differences. When prosocial decision making was evaluated, more altruistic decisions were found after acute stress, and these decisions were positively associated with cortisol. Half of the studies that assessed the role of sex observed a greater impact on decision making after stress in women. Results suggest that it is important to consider modulating factors - the type of decision-making task, the cortisol response to stress, the characteristics of the psychological stressor, or the subject's sex - when trying to understand psychosocial stress phenomena.

Decision fatigue among clinical nurses during the COVID-19 pandemic

AIMS AND OBJECTIVES

The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS).

BACKGROUND

Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID-19 pandemic on psychological well-being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue.

DESIGN

This study was a secondary analysis of a parent study using a cross-sectional descriptive design.

METHODS

A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample.

RESULTS

The EFA yielded a single factor, 9-item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency.

CONCLUSIONS

This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID-19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision-making among registered nurses.

RELEVANCE TO CLINICAL PRACTICE

Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision-making among clinical nurses.

Risky Decision Making Under Stressful Conditions: Men and Women With Smaller Cortisol Elevations Make Riskier Social and Economic Decisions

Men often make riskier decisions than women across a wide range of real-life behaviors. Whether this sex difference is accentuated, diminished, or stable under stressful conditions is, however, contested in the scientific literature. A critical blind spot lies amid this contestation: Most studies use standardized, laboratory-based, cognitive measures of decision making rather than complex real-life social simulation tasks to assess risk-related behavior. To address this blind spot, we investigated the effects of acute psychosocial stress on risk decision making in men and women (N = 80) using a standardized cognitive measure (the Iowa Gambling Task; IGT) and a novel task that simulated a real-life social situation (an online chatroom in which participants interacted with other men and women in sexually suggestive scenarios). Participants were exposed to either an acute psychosocial stressor or an equivalent control condition. Stressor-exposed participants were further characterized as high- or low-cortisol responders. Results confirmed that the experimental manipulation was effective. On the IGT, participants characterized as low-cortisol responders (as well as those in the Non-Stress group) made significantly riskier decisions than those characterized as high-cortisol responders. Similarly, in the online chatroom, participants characterized as low-cortisol responders (but not those characterized as high-cortisol responders) were, relative to those in the Non-Stress group, significantly more likely to make risky decisions. Together, these results suggest that at lower levels of cortisol both men and women tend to make riskier decisions in both economic and social spheres.

Acute stress influences strategy preference when dealing with high intensity emotions in men

Stress has been shown to initiate a shift from flexible to rigid, less demanding cognitive processes. Reappraisal and distraction are two emotion regulation strategies varying in their cognitive demands. Previous studies indicate that stress improves regulatory performances of high arousal stimuli. We thus investigated whether acute stress alters the preference for reappraisal or distraction when downregulating emotions of different intensities and further explored its influence on regulatory outcomes. Eighty males were either socially stressed (n=40) or exposed to a control condition (n=40) prior to an emotion regulation choice paradigm. Stress increased the probability to prefer distraction for downregulating high intensity emotions. Stressed (vs. control) participants reported to be generally more successful in regulating high intensity emotions, which was positively associated with cortisol but not alpha-amylase increases. Our findings provide initial evidence that stress fosters a preference for less demanding regulatory options, suggesting favorable strategy choices in response to acute stressors. DATA AVAILABILITY: The data that support the findings of this study are available at the Open Science Framework (OSF) under https://osf.io/b9ae3/.

Consideration of sex as a biological variable in the translation of pharmacotherapy for stress-associated drug seeking

Stress is a frequent precipitant of relapse to drug use. Pharmacotherapies targeting a diverse array of neural systems have been assayed for efficacy in attenuating stress-induced drug-seeking in both rodents and in humans, but none have shown enough evidence of utility to warrant routine use in the clinic. We posit that a critical barrier in effective translation is inattention to sex as a biological variable at all phases of the research process. In this review, we detail the neurobiological systems implicated in stress-induced relapse to cocaine, opioids, methamphetamine, and cannabis, as well as the pharmacotherapies that have been used to target these systems in rodent models, the human laboratory, and in clinical trials. In each of these areas we additionally describe the potential influences of biological sex on outcomes, and how inattention to fundamental sex differences can lead to biases during drug development that contribute to the limited success of large clinical trials. Based on these observations, we determine that of the pharmacotherapies discussed only α₂-adrenergic receptor agonists and oxytocin have a body of research with sufficient consideration of biological sex to warrant further clinical evaluation. Pharmacotherapies that target β-adrenergic receptors, other neuroactive peptides, the hypothalamic-pituitary-adrenal axis, neuroactive steroids, and the endogenous opioid and cannabinoid systems require further assessment in females at the preclinical and human laboratory levels before progression to clinical trials can be recommended.

DHEA as a Biomarker of Stress: A Systematic Review and Meta-Analysis

Background: Psychosocial stress is a significant public health problem inducing consequences for quality of life. Results about the use of dehydroepiandrosterone (DHEA) as a biomarker of acute stress are conflicting. We conducted a systematic review and meta-analysis to demonstrate that DHEA levels could be a biomarker of stress. Methods: PubMed, Cochrane Library, Embase, and ScienceDirect databases were searched on March 19, 2021 using the keywords "acute stress" AND "DHEA" OR "Dehydroepiandrosterone." Articles needed to describe our primary outcome, i.e., induction of acute stress and at least two measures of DHEA. Results: We included 14 studies, with a total of 631 participants, in our meta-analysis. The DHEA levels increased overtime after acute stress [standardized mean difference (SMD) = 1.56, 95%CI = 1.13-1.99]. Stratification by time showed a main peak at the end of stress (SMD = 2.43, 95%CI = 1.59-3.27), followed by a progressive decrease (coefficient = -0.11, 95%CI = -0.19 to -0.17, p = 0.020). There was no significant change 1 h after the end of acute stress. Metaregressions showed an impact of mental stress (SMD = 2.04, 95%CI = 1.43-2.65), sex (SMD = 0.02, 95%CI = 0.00-0.04), age (SMD = -0.12, 95%CI = -0.2 to -0.05), and obesity (SMD = 0.31, 95%CI = -0.00 to 0.63). There was no difference whatever the type of fluid (blood or saliva) and the measurement technique used. Conclusions: DHEA is a biomarker of acute stress, with a short-term increase (1 h). DHEA increases following acute mental stress, whatever the type and duration of mental stress. Women, young people, and obese individuals had a higher response. Blood and saliva measures were comparable.

Hair cortisol and dehydroepiandrosterone concentrations: Associations with executive function in early childhood

Chronic stress during childhood negatively impacts cognition and physical and mental health. Exposure to stressors over time can cause hypothalamic-pituitary-adrenal (HPA) axis dysregulation, leading to abnormal stress hormone levels, which can be reflected in hair cortisol concentration (HCC) and hair dehydroepiandrosterone (DHEA) concentration. Although the use of HCC and DHEA to measure chronic stress in children is increasing, their effects on cognition (as indexed by executive function) remain unexplored. Accordingly, we aimed to investigate the associations of HCC, DHEA, and their ratio with measures of executive function (cognitive flexibility and working memory) in a sample of kindergarten children (N=100). We found that the expected negative association between HCC and working memory approached significance, and DHEA was significantly and positively related to cognitive flexibility. We discuss possible interpretations of our findings. Our results suggest promising areas for future investigation and encourage further exploration into HCC and DHEA as measures of chronic stress.

Personality, Stress, and Intuition: Emotion Regulation Abilities Moderate the Effect of Stress-Dependent Cortisol Increase on Coherence Judgments

Objective

Findings on the relationship between hypothalamus-pituitary-adrenocortical (HPA) activity and cognitive performance are inconsistent. We investigated whether personality in terms of emotion regulation abilities (ERA) moderates the relationship between stress-contingent HPA activity and accuracy of intuitive coherence judgments.

Method

ERA and cortisol responses to social-evaluative stress as induced by a variant of the Trier Social Stress Test were measured in N = 49 participants (32 female, aged 18 to 33 years, M = 22.48, SD = 3.33). Subsequently, in a Remote Associates Task they provided intuitive judgments on whether word triples, primed by either stress-reminding or neutral words, are coherent or not.

Results

Under relative cortisol increase participants low in ERA showed reduced performance whereas individuals high in ERA showed increased performance. By contrast, under conditions of low cortisol change, individuals low in ERA outperformed those high in ERA.

Conclusion

Personality can moderate the link between stress and cognition such as accurate intuition. This can happen to a degree that existing effects may not be become apparent in the main effect (i.e. without considering personality), which highlights the necessity to consider personality in stress research, ERA in particular. We discuss the findings with respect to individual differences in neurobehavioral mechanisms potentially underlying ERA and corresponding interactions with cognitive processing.

Stress and cognition: A user's guide to designing and interpreting studies

Fueling the rapid growth in our understanding of how stress influences cognition, the number of studies examining the effects of stress on various cognitive processes has grown substantially over the last two decades. Despite this growth, few published guidelines exist for designing these studies, and divergent paradigm designs can diminish typical effects of stress or even reverse them. The goal of this review, therefore, is to survey necessary considerations (e.g., validating a stress induction), important considerations (e.g., specifying the timing of the stressor and cognitive task), and best practices (e.g., using Bayesian analyses) when designing a study that aims at least in part to examine the effects of acute stress on some cognitive process or function. These guidelines will also serve to help readers of these studies interpret what may otherwise be very confusing, anomalous results. Designing and interpreting studies with these considerations and practices in mind will help to move the field of stress and cognition forward by clarifying how, exactly, stress influences performance on a given cognitive task in a population of interest.

Verbal performance during stress in healthy older people: Influence of dehydroepiandrosterone (DHEA) and cortisol reactivity

The impact of stress on the dehydroepiandrosterone (DHEA) response in older population is understudied. This study investigated, in healthy older people, whether the DHEA and cortisol responses to the Trier Social Stress Test (TSST) was related to performance on this task. Both speech (rated by committee and self-rated) and arithmetic (number of mistakes) performance were assessed. Sixty-five participants (55-77 years old) were exposed to the TSST. Increases in negative affect, state anxiety, and cortisol levels could be observed, but there were no significant changes in positive affect or DHEA levels. Interestingly, a larger DHEA response was related to better verbal performance after controlling for the cortisol's reactivity. No relationships were found between hormonal responses and the arithmetic task performance. Our results suggest that, in healthy older people, an increase in DHEA levels in response to acute psychosocial stress may help them to cope with this stressor by increasing verbal performance.

Greater Lifetime Stress Exposure Predicts Blunted Cortisol but Heightened DHEA Responses to Acute Stress

Although prior research has examined how early adversity and chronic stress exposure relate to hypothalamic-pituitary-adrenal (HPA) axis responses to acute stress, to date, no studies have examined how stressors occurring over the entire lifespan predict such responses. To address this issue, we recruited 61 healthy young adults and measured their exposure to 55 different types of acute life events and chronic difficulties occurring over the lifespan. In addition, we characterized differences in participants' HPA axis responses to acute stress by measuring their salivary cortisol and DHEA responses to the Trier Social Stress Test for Groups. Greater cumulative stress exposure was associated with a blunted cortisol response, but a heightened DHEA response, to the acute stressor. Moreover, it was participants' exposure to these stressors (i.e., lifetime count), not their perceived severity, which predicted their cortisol and DHEA responses to acute stress. Furthermore, differential effects were observed by stress exposure domain. Notably, only adulthood and marital/partner stressors significantly predicted cortisol responses to acute stress, whereas stress was more uniformly associated with DHEA responses to the acute stressor. These results thus reveal how cumulative stress exposure is associated with HPA axis responsivity to acute stress, while highlighting the fact that different stressors may have substantially different associations with these biological outcomes.

Sex-specific contribution of DHEA-cortisol ratio to prefrontal-hippocampal structural development, cognitive abilities and personality traits

Although dehydroepiandrosterone (DHEA) may exert neuroprotective effects in the developing brain, prolonged or excessive elevations in cortisol may exert neurotoxic effects. The ratio between DHEA and cortisol (DC ratio) has been linked to internalising and externalising disorders, as well as cognitive performance, supporting the clinical relevance of this hormonal ratio during development. However, the brain mechanisms by which these effects may be mediated have not yet been identified. Furthermore, although there is evidence that the effects of cortisol in the central nervous system may be sexually dimorphic in humans, the opposite is true for DHEA, with human studies showing no sex-specific associations in cortical thickness, cortico-amygdalar or cortico-hippocampal structural covariance. Therefore, it remains unclear whether sex moderates the developmental associations between DC ratio, brain structure, cognition and behaviour. In the present study, we examined the associations between DC ratio, structural covariance of the hippocampus with whole-brain cortical thickness, and measures of personality, behaviour and cognition in a longitudinal sample of typically developing children, adolescents and young adults aged 6-22 years (N = 225 participants [F = 128]; 355 scans [F = 208]), using mixed effects models that accounted for both within- and between-subject variances. We found sex-specific interactions between DC ratio and anterior cingulate cortex-hippocampal structural covariance, with higher DC ratios being associated with a more negative covariance between these structures in girls, and a more positive covariance in boys. Furthermore, the negative prefrontal-hippocampal structural covariance found in girls was associated with higher verbal memory and mathematical ability, whereas the positive covariance found in boys was associated with lower cooperativeness and reward dependence personality traits. These findings support the notion that the ratio between DHEA and cortisol levels may contribute, at least in part, to the development of sex differences in cognitive abilities, as well as risk for internalising/externalising disorders, via an alteration in prefrontal-hippocampal structure during the transition from childhood to adulthood.

Role of DHEA and cortisol in prefrontal-amygdalar development and working memory

There is accumulating evidence that both dehydroepiandrosterone (DHEA) and cortisol play an important role in regulating physical maturation and brain development. High DHEA levels tend to be associated with neuroprotective and indirect anabolic effects, while high cortisol levels tend to be associated with catabolic and neurotoxic properties. Previous literature has linked the ratio between DHEA and cortisol levels (DC ratio) to disorders of attention, emotional regulation and conduct, but little is known as to the relationship between this ratio and brain development. Due to the extensive links between the amygdala and the cortex as well as the known amygdalar involvement in emotional regulation, we examined associations between DC ratio, structural covariance of the amygdala with whole-brain cortical thickness, and validated report-based measures of attention, working memory, internalizing and externalizing symptoms, in a longitudinal sample of typically developing children and adolescents 6-22 years of age. We found that DC ratio predicted covariance between amygdalar volume and the medial anterior cingulate cortex, particularly in the right hemisphere. DC ratio had a significant indirect effect on working memory through its impact on prefrontal-amygdalar covariance, with higher DC ratios associated with a prefrontal-amygdalar covariance pattern predictive of higher scores on a measure of working memory. Taken together, these findings support the notion, as suggested by animal and in vitro studies, that there are opposing effects of DHEA and cortisol on brain development in humans, and that these effects may especially target prefrontal-amygdalar development and working memory, in a lateralized fashion.

The first multi-zoo application of an allostatic load index to western lowland gorillas (Gorilla gorilla gorilla)

Vertebrate stress responses are highly adaptive biological functions, maximizing survival probability in life-threatening situations. However, experiencing repeated and/or chronic stressors can generate physiological dysregulation and lead to disease. Because stress responses are multi-systemic and involve a wide range of physiological functions, identifying responses to stressors is best accomplished using integrated biomarker models. Allostatic load, defined as the physiological dysregulation that accumulates over the lifespan due to stressful experiences, is one such model. Allostatic load is measured using allostatic load indices, which are composites of biomarkers from multiple somatic systems. Previously, we reported the use of a 7-biomarker allostatic load index (albumin, CRH, cortisol, DHEA-S, glucose, IL-6, TNF-α) in western lowland gorillas housed at a single zoo. Herein, this index is expanded to examine allostatic load responses to lifetime stressors in gorillas from two additional zoos (n = 63) as well as two pooled samples. The index was created using quartile cut-points for each biomarker. Significant associations were observed between multiple predictor variables and allostatic load, including sex, age, number of stressful events (anesthetic events, zoo transfers, agonistic interactions with wounding, pregnancies), and rearing history (mother-reared, nursery-reared, wild-caught). Additionally, allostatic load was associated with indicators of morbidity (creatinine, cholesterol, triglycerides), age at death, and mortality risk. These results are consistent with those reported in human allostatic load research, suggesting allostatic load indices have potential as an investigative and clinical tool for gorillas and other great apes.

Decision-Making Competence, Social Orientation, Time Style, and Perceived Stress

Peoples' decision-making competence, defined as tendency to follow normative rational principles in their decision making, is important as it may influence the extent that requirements are met and levels of perceived stress. In addition, perceived stress could be influenced by social orientation and time style; for example, decisions need to comply with given deadlines and the expectations of others. In two studies, with students (n = 118) and professionals (police investigators, n = 90), we examined how the three individual difference features: decision-making competence, social orientation, and time approach relate to perceived stress. Results showed that social orientation and time approach were related to levels of perceived stress, but decision-making competence was not. These results indicate that social orientation and time approach are important to consider in relation to perceived stress, but the role of decision-making competence may be less important for perceived stress. However, the role of decision-making competence for perceived stress needs to be further researched.

Inflammation, Self-Regulation, and Health: An Immunologic Model of Self-Regulatory Failure

Self-regulation is a fundamental human process that refers to multiple complex methods by which individuals pursue goals in the face of distractions. Whereas superior self-regulation predicts better academic achievement, relationship quality, financial and career success, and lifespan health, poor self-regulation increases a person's risk for negative outcomes in each of these domains and can ultimately presage early mortality. Given its centrality to understanding the human condition, a large body of research has examined cognitive, emotional, and behavioral aspects of self-regulation. In contrast, relatively little attention has been paid to specific biologic processes that may underlie self-regulation. We address this latter issue in the present review by examining the growing body of research showing that components of the immune system involved in inflammation can alter neural, cognitive, and motivational processes that lead to impaired self-regulation and poor health. Based on these findings, we propose an integrated, multilevel model that describes how inflammation may cause widespread biobehavioral alterations that promote self-regulatory failure. This immunologic model of self-regulatory failure has implications for understanding how biological and behavioral factors interact to influence self-regulation. The model also suggests new ways of reducing disease risk and enhancing human potential by targeting inflammatory processes that affect self-regulation.

The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress

BACKGROUND AND OBJECTIVES

Prior research suggests that altering situation-specific evaluations of stress as challenging versus threatening can improve responses to stress. The aim of the current study was to explore whether cognitive, physiological and affective stress responses can be altered independent of situation-specific evaluations by changing individuals' mindsets about the nature of stress in general.

DESIGN

Using a 2 × 2 design, we experimentally manipulated stress mindset using multi-media film clips orienting participants (N = 113) to either the enhancing or debilitating nature of stress. We also manipulated challenge and threat evaluations by providing positive or negative feedback to participants during a social stress test.

RESULTS

Results revealed that under both threat and challenge stress evaluations, a stress-is-enhancing mindset produced sharper increases in anabolic ("growth") hormones relative to a stress-is-debilitating mindset. Furthermore, when the stress was evaluated as a challenge, a stress-is-enhancing mindset produced sharper increases in positive affect, heightened attentional bias towards positive stimuli, and greater cognitive flexibility, whereas a stress-is-debilitating mindset produced worse cognitive and affective outcomes.

CONCLUSIONS

These findings advance stress management theory and practice by demonstrating that a short manipulation designed to generate a stress-is-enhancing mindset can improve responses to both challenging and threatening stress.

Acute stress impairs cognitive flexibility in men, not women

Psychosocial stress influences cognitive abilities, such as long-term memory retrieval. However, less is known about the effects of stress on cognitive flexibility, which is mediated by different neurobiological circuits and could thus be regulated by different neuroendocrine pathways. In this study, we randomly assigned healthy adults to an acute stress induction or control condition and subsequently assessed participants' cognitive flexibility using an open-source version of the Wisconsin Card Sort task. Drawing on work in rodents, we hypothesized that stress would have stronger impairing effects on cognitive flexibility in men than women. As predicted, we found that stress impaired cognitive flexibility in men but did not significantly affect women. Our results thus indicate that stress exerts sex-specific effects on cognitive flexibility in humans and add to the growing body of research highlighting the need to consider sex differences in effects of stress.

The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisol

Core executive functions such as working memory, inhibition, and cognitive flexibility are integral to daily life. A growing body of research has suggested that acute stress may impair core executive functions. However, there are a number of inconsistencies in the literature, leading to uncertainty about how or even if acute stress influences core executive functions. We addressed this by conducting a meta-analysis of acute stress effects on working memory, inhibition, and cognitive flexibility. We found that stress impaired working memory and cognitive flexibility, whereas it had nuanced effects on inhibition. Many of these effects were moderated by other variables, such as sex. In addition, we compared effects of acute stress on core executive functions to effects of cortisol administration and found some striking differences. Our findings indicate that stress works through mechanisms aside from or in addition to cortisol to produce a state characterized by more reactive processing of salient stimuli but greater control over actions. We conclude by highlighting some important future directions for stress and executive function research.