Physiological dynamics of stress contagion

Development and validation of a questionnaire, the REST-Q Fire, to identify teamwork-related resources and stressors in firefighting operations

In the complex work environments of firefighting teams, it is often human error or difficulties in teamwork that lead to dangerous situations. To prevent these, it is essential to know the teamwork-related stressors and resources in firefighting operations. A measurement tool is needed to evaluate these stressors and resources. A successive instrument development process was conducted to identify the relevant teamwork-related stressors and resources in firefighting operations. First, interviews with experienced firefighters, and second, a document analysis were conducted and evaluated to provide an overview of the teamwork-related stressors and resources. Thereupon, a questionnaire, the REST-Q Fire, was developed asking about the experienced frequency and intensity of the identified teamwork-related stressors and resources in firefighting operations. Afterwards, an online study with firefighters was conducted (N = 491). CFAs confirmed the assumed structure of the REST-Q Fire and a positive correlation of the intensity of stressors with stress was shown (r = .19 - .27). Further, the resources were overall more frequently and intensively perceived than the stressors. The most important stressors were 'behavior of leaders' (M (SD)frequency = 2.80 (0.83), M (SD)intensity = 3.59 (1.12)), and 'behavior of team members' (M (SD)frequency = 2.77 (0.75), M (SD)intensity = 3.59 (1.05)). The most important resources, on the other hand, were 'knowledge about skills and behavior of team members' (M (SD)frequency = 3.96 (0.63), M (SD)intensity = 4.24 (0.78)), 'watch out for/ check on each other' (M (SD)frequency = 3.96 (0.70), M (SD)intensity = 4.20 (0.80)), and 'reliability of team members' (M (SD)frequency = 3.96 (0.51), M (SD)intensity = 4.16 (0.73)). As a result, training needs for trainees in the fire service and experienced firefighters were derived.

Is your stress my stress? A standardized, randomized-controlled paradigm to study physiological stress contagion based on direct stress observation

BACKGROUND & OBJECTIVES

Existing research indicates that not only own stress leads to physiological stress reactions, but also observing stress in others. So far, a standardized paradigm to reliably induce physiological stress contagion based on direct face-to-face stress observation compared to an active placebo-stress observing control condition is lacking. Here, we tested a standardized randomized placebo-controlled experimental paradigm to investigate physiological reactivity to direct stress observation and characterized the stress contagion response of the major endocrine stress systems, including full reactivity kinetics.

METHODS

Healthy young male participants were randomly assigned to (1) undergo an adapted version of the Trier Social Stress Test ("TSST participants", n = 20), (2) observe it ("stress observers", n = 36), or (3) observe a corresponding placebo-stress control condition ("placebo-stress observers", n = 30). We repeatedly assessed heart rate, salivary alpha-amylase, salivary cortisol, and salivary aldosterone.

RESULTS

Stress observers exhibited greater physiological reactivity to stress observation as compared to placebo-stress observers to placebo-stress observation in heart rate, salivary alpha-amylase, and cortisol (p's ≤ .027), but not in aldosterone. We observed similar reactivity kinetics in TSST participants and stress observers but less pronounced in stress observers.

DISCUSSION

Extending previous literature, our findings indicate that independent of secondary effects of the observation setting, direct observation of stress in other individuals induces activation of the hypothalamus-pituitary-adrenal axis and the sympathetic-adrenal-medullary axis. Moreover, the physiological stress contagion response resembles the physiological reactivity to first-hand stress but is less pronounced. Potential implications of physiological stress contagion regarding health, cognition, or behavior, as well as modulating factors need to be further elucidated.

Neurophysiological markers of asymmetric emotional contagion: implications for organizational contexts

Emotions play a vital role within organizations, impacting various crucial aspects of work such as job satisfaction, performance, and employee well-being. Understanding how emotional states spread in organizational settings is therefore essential. Recent studies have highlighted that a leader's emotional state can influence their followers, with significant consequences on job performance. Leaders thus possess the ability to influence their employees' psychological state and, consequently, their well-being. However, the biological underpinnings of emotional contagion from leaders to followers remain unexplored. The field of interpersonal (neuro)physiology, which involves recording brain and peripheral activity of multiple individuals during interactions, holds great potential for investigating this phenomenon. Analyzing the time-lagged synchronization of neurophysiological activity during interactions may serve as a measure of the leader's influence on their followers in organizational contexts. In this "mini review," we examine empirical studies that have employed interpersonal (neuro)physiology to quantify the asymmetrical contagion of emotions in different contexts. Asymmetrical contagion was operationalized as the unidirectional influence exerted by one individual (i.e., the "sender") to another one (i.e., the "receiver"), whereby the receiver's state can be predicted by the sender's one. The reviewed literature reveals that delayed synchronization of physiological states is a widespread phenomenon that may underpin the transmission of emotions. These findings have significant implications for various aspects of organizational life, including leader-to-employee communication, and could drive the development of effective leadership training programs. We propose that Organizational Neuroscience may benefit from including interpersonal neurophysiology in its methodological toolkit for laboratory and field studies of leader-follower dynamics.

Maintaining Joy in Orthopaedic Practice

Orthopaedic surgeons may, at times, derive less enjoyment from their work. Limited engagement can arise, on the one hand, from limited autonomy, burdens of care, and reduced reimbursement. On the other hand, surgeons may enjoy their work less if they feel less able to help people. For instance, people with pressing medical, mental, and social health opportunities may place inordinate hope on what an orthopaedic surgeon can do to improve their lives. Pressure to provide tests and treatment with more potential for harm than benefit can, at times, contribute to a sense of futility and emotional exhaustion. There may, at times, be small and large pressures that can induce surgeons to compromise respect for evidence and lapse in adherence to ethical principles, placing them at risk for moral injury. These aspects of orthopaedic practice seem important given the association between limited joy in practice and self-harm, abandoning medical practice, and errors and patient harm. There are things to consider when working on joy in practice, including recognizing and naming the unsavory parts of practice; making improvement in the area for creativity, innovation, and personal growth; and developing strategies to limit and alleviate stress.

The Role of Empathy in Alcohol Use of Bullying Perpetrators and Victims: Lower Personal Empathic Distress Makes Male Perpetrators of Bullying More Vulnerable to Alcohol Use

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N = 1185, 54.9% female). General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse.

Empathic Accuracy and Shared Depressive Symptoms in Close Relationships

Empathic accuracy, the ability to accurately understand others' emotions, is typically viewed as beneficial for mental health. However, empathic accuracy may be problematic when a close relational partner is depressed because it promotes shared depression. Across two studies, we measured empathic accuracy using laboratory tasks that capture the ability to rate others' emotional valence accurately over time: first, in a sample of 156 neurotypical married couples (Study 1; Total N=312), and then in a sample of 102 informal caregivers of individuals with dementia (Study 2). Across both studies, the association between empathic accuracy and depressive symptoms varied as a function of a partner's level of depressive symptoms. Greater empathic accuracy was associated with (a) fewer depressive symptoms when a partner lacked depressive symptoms, but (b) more depressive symptoms when a partner had high levels of depressive symptoms. Accurately detecting changes in others' emotional valence may underpin shared depressive symptoms.

Somatovisceral influences on emotional development

Frameworks of emotional development have tended to focus on how environmental factors shape children's emotion understanding. However, individual experiences of emotion represent a complex interplay between both external environmental inputs and internal somatovisceral signaling. Here, we discuss the importance of afferent signals and coordination between central and peripheral mechanisms in affective response processing. We propose that incorporating somatovisceral theories of emotions into frameworks of emotional development can inform how children understand emotions in themselves and others. We highlight promising directions for future research on emotional development incorporating this perspective, namely afferent cardiac processing and interoception, immune activation, physiological synchrony, and social touch.

From Oxytocin to Compassion: The Saliency of Distress

Compassion is a warm response of care and concern for those who are suffering, which drives individuals to devote their resources for the sake of others. A prominent neuroevolutionary framework grounds compassion in the neurobiology of the mammalian caregiving system. Accordingly, it has been suggested that the oxytocinergic system, which plays a central role in parental caregiving and bonding, provides the neurobiological foundation for compassion towards strangers. Yet, the specific role of oxytocin in compassion is far from clear. The current paper aims to target this gap and offer a theoretical framework that integrates the state-of-the-art literature on oxytocin with research on compassion. We suggest that oxytocin mediates compassion by enhancing the saliency of cues of pain and distress and discuss the plausible underlying neurobiological substrates. We further demonstrate how the proposed framework can account for individual differences in compassion, focusing on the effects of attachment on caregiving and support. The proposed framework integrates the current scientific understanding of oxytocin function with compassion-related processes. It thus highlights the largely ignored attentional processes in compassion and taps into the vast variability of responses in social contexts involving pain and suffering.

The association between acute stress & empathy: A systematic literature review

Empathy is a fundamental component of our social-emotional experience. Over the last decade, there has been increased interest in understanding the effects of acute stress on empathy. We provide a first comprehensive-and systematic-overview identifying emerging patterns and gaps in this literature. Regarding affective empathy, there is abundant evidence for stress contagion-the 'spillover' of stress from a stressed target to an unstressed perceiver. We highlight contextual factors that can facilitate and/or undermine these effects. Fewer studies have investigated the effects of acute stress on affective empathy, revealing a nuanced picture, some evidence suggests acute stress can block contagion of other's emotions; but again contextual differences need to be considered. Regarding cognitive empathy, most studies find no conclusive effects for simplistic measures of emotion recognition; however, studies using more complex empathy tasks find that acute stress might affect cognitive empathy differentially for men and women. This review provides an important first step towards understanding how acute stress can impact social-togetherness, and aims to aid future research by highlighting (in)congruencies and outstanding questions.

Perceived Pain Severity and Disability After the Recurrence of Tennis Elbow Following a Local Corticosteroid Injection

BACKGROUND

We hypothesized that there is no difference in the perceived pain and disability when the tennis elbow symptoms recur after a corticosteroid injection (CSI). Consequently, we secondarily aimed to assess the approximate time from CSI until symptom recurrence. Moreover, we aimed to evaluate factors associated with the time to recurrence.

METHODS

This cross-sectional study was performed during 2018-2019. We enrolled 50 consecutive patients who presented with the recurrence of tennis elbow symptoms and had a history of a single CSI for this condition. We asked the patients to rate the perceived pain and disability by filling the QuickDASH twice, including one by recalling pain and function before the CSI and one for the recent recurrent symptoms to assess the patient's perceived pain and disability at the two-time points.

RESULTS

There was a significant difference in perceived pain VAS and disability QuickDASH between pre-injection and recurrence, showing that the patient's perceived pain and disability were greater when recurred (P<0.001). The mean time between CSI and recurrence of symptoms was 6 (4-7) months, which is shorter than the expected spontaneous resolution of tennis elbow (> 1 year) to offer other invasive treatments. Time to recurrence had no significant association with sex, age, side, education, occupation, pre-injection VAS score, pre-injection QuickDASH, or symptom duration using a linear regression model.

CONCLUSION

Although CSI seems to relieve or mask the pain in the short term, there is a considerable chance of recurrence, and patients may perceive more significant pain and disability that may lead to subsequent injection or precocious surgery. Time is an effective treatment for this illness. Shared decision-making is paramount, and patients have to be counseled regarding the natural history and expected prognosis of different treatments.

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.

Physical and Sociocultural Community-Level Influences on Cigar Smoking among Black Young Adults: An In-Depth Interview Investigation

Black young adults experience disparately high rates of cigar use and its health consequences. Little research has explored community-level influences on cigar smoking in this population, especially concerning product-specific influences and cigar smokers' perceptions. We conducted in-depth interviews with 40 Black young adult (ages 21-29) cigar smokers in the Washington, D.C. area and analyzed themes regarding physical and sociocultural community-level factors perceived to influence cigar use. Themes were further analyzed based on participants' predominant cigar products (cigarillos, large cigars, blunts). Participants reported easy access to affordable cigarillos, widespread cigarillo sales and targeted marketing, norms of cigar and blunt smoking for stress relief, socialization, and cultural participation, and ubiquitous cigar and blunt smoking cues, all of which promoted cigar use in their communities. Future research should further explore how community-level influences contribute to disproportionate cigar use among Black young adults. Our findings suggest that programs and policies addressing physical and sociocultural community-level pro-smoking influences may help mitigate cigar smoking disparities.

Towards a mechanistic understanding of mindfulness-based stress reduction (MBSR) using an RCT neuroimaging approach: Effects on regulating own stress in social and non-social situations

Although much research has shown that mindfulness-based interventions (MBIs) can reduce psychological stress, it is less clear if effects generalize to everyday social situations, which range among the largest stress triggers. Furthermore, mechanisms of MBIs have not been fully established. Emotion regulation (ER) has been suggested as one key mechanism, yet the role of cognitive reappraisal and acceptance strategies is still under debate. To address these questions, a neuroimaging-based randomized controlled trial (RCT) was performed (n=68), comparing mindfulness-based stress reduction (MBSR) with a reading/listening intervention (READ), using a novel dyadic paradigm for self and other emotion regulation under stress as primary outcome on behavior and brain levels and established empathy measures (clinicatrials.gov NCT03035669). Compared to READ, MBSR led to self-reported stress reduction through both cognitive reappraisal and acceptance only when regulating self and not when regulating others' distress. In addition, MBSR led to increased brain activation over time for regulating own (parietal cortex) and others' (precuneus, TPJ) emotions through cognitive reappraisal and acceptance, albeit this effect was also seen for the reading intervention for regulating own stress via reappraisal. Brain changes did not scale with subjective stress reduction and amount of meditation practice. More distant generalization effects of MBSR on socio-emotional functioning (cognitive empathy and compassion) could also not be shown. This study identified both cognitive reappraisal and acceptance as two ER mechanisms of MBSR, but indicates that effects do not extend to social settings.

Vocalization and physiological hyperarousal in infant-caregiver dyads where the caregiver has elevated anxiety

Co-regulation of physiological arousal within the caregiver-child dyad precedes later self-regulation within the individual. Despite the importance of unimpaired self-regulatory development for later adjustment outcomes, little is understood about how early co-regulatory processes can become dysregulated during early life. Aspects of caregiver behavior, such as patterns of anxious speech, may be one factor influencing infant arousal dysregulation. To address this, we made day-long, naturalistic biobehavioral recordings in home settings in caregiver-infant dyads using wearable autonomic devices and miniature microphones. We examined the association between arousal, vocalization intensity, and caregiver anxiety. We found that moments of high physiological arousal in infants were more likely to be accompanied by high caregiver arousal when caregivers had high self-reported trait anxiety. Anxious caregivers were also more likely to vocalize intensely at states of high arousal and produce intense vocalizations that occurred in clusters. High-intensity vocalizations were associated with more sustained increases in autonomic arousal for both anxious caregivers and their infants. Findings indicate that caregiver vocal behavior differs in anxious parents, cooccurs with dyadic arousal dysregulation, and could contribute to physiological arousal transmission. Implications for caregiver vocalization as an intervention target are discussed.

Early life stress and perceived social isolation influence how children use value information to guide behavior

Learning the value of environmental signals and using that information to guide behavior is critical for survival. Stress in childhood may influence these processes, but how it does so is still unclear. This study examined how stressful event exposures and perceived social isolation affect the ability to learn value signals and use that information in 72 children (8–9 years; 29 girls; 65.3% White). Stressful event exposures and perceived social isolation did not influence how children learned value information. But, children with high stressful event exposures and perceived social isolation were worse at using that information. These data suggest alterations in how value information is used, rather than learned, may be one mechanism linking early experiences to later behaviors.

What's Playing in Your Waiting Room? Patient and Provider Stress and the Impact of Waiting Room Media

Patients enter the healthcare space shouldering a lot of personal stress. Concurrently, health care providers and staff are managing their own personalstressors as well as workplace stressors. As stress can negatively affect the patient-provider experience and cognitive function of both individuals, it is imperative to try to uplift the health care environment for all. Part of the healthcare environmental psychology strategy to reduce stress often includes televisions in waiting rooms, cafeterias, and elsewhere, with the intent to distract the viewer and make waiting easier. Although well-intentioned, many select programming which can induce stress (eg, news). In contrast, as positive media can induce desirable changes in mood, it is possible to use it to decrease stress and uplift viewers, including staff. Positive media includes both nature media, which can relax and calm viewers and kindness media, which uplifts viewers, induces calm, and promotes interpersonal connection and generosity. Careful consideration of waiting room media can affect the patient-provider experience.

Shifts in Behavioral Synchrony in Response to an Interaction Partner's Distress in Adolescents With and Without ASD

Individuals with Autism spectrum disorder (ASD) show altered behavioral synchrony and empathic behavior. Yet, an ecologically valid examination of these in adolescents is still required. We employed a social interaction sequence comprising a friendly conversation with a confederate, an expression of distress by her, and a return to friendly conversation. 44 male adolescents (22 with ASD) participated. Socio-emotional behaviors, coded by blind raters and through automated analyses of motion, were analyzed. Results indicated reduced synchrony in the ASD group. Moreover, whereas controls displayed a decrease in synchrony when facing another's distress, adolescents with ASD showed no such change. No group differences were found on empathic behavior. Findings imply gaps between verbal and non-verbal responses of adolescents with ASD to a distressed interaction partner.

Self-disclosure is associated with adrenocortical attunement between new acquaintances

Adrenocortical attunement-similarity in hypothalamic-pituitary-adrenal (HPA) axis activity-has been well-documented in close relationships (e.g., between romantic partners, parents and children, and close friends). However, little is known about adrenocortical attunement during early relationship formation. In the current study, we examine dyadic adrenocortical attunement during a guided conversation in which two new acquaintances (N = 140 people, 70 dyads), who were university students or adults in the community, answered questions about themselves. Dyads were randomly assigned to answer questions designed to elicit dyad members to reveal a high or low amount of personal information (i.e., to self-disclose at high or low levels). We collected saliva samples (assayed for cortisol) before and after the conversation, and we coded behavioral self-disclosure-the extent to which people revealed their thoughts, feelings, and facts about themselves-during the conversation. As expected, dyads who were assigned to ask and answer high self-disclosure questions disclosed more than those assigned to ask and answer low self-disclosure questions. In addition, greater self-disclosure during the conversation was associated with greater similarity in cortisol change-that is, dyad members who revealed more about themselves experienced more similar cortisol changes in response to their conversation. This work reveals one social process through which adrenocortical attunement occurs during early relationship formation, and, in doing so, describes how our physiological functioning is linked to those around us-even people we have just met.

Social Contagion of Vasovagal Symptoms in Blood Donors: Interactions With Empathy

BACKGROUND

Vasovagal reactions (VVRs) are commonly experienced in medical situations such as blood donation. Many believe that psychosocial contagion can contribute to the development of VVRs, but this is largely clinical lore.

PURPOSE

The goal of the present investigation was to examine the physiological effects of observing another experience a reaction, focusing on the potential moderating effects of empathy.

METHODS

This study was part of a randomized controlled trial of behavioral techniques on the prevention of VVRs in blood donors. The sample was composed of 530 healthy university students. Measures of symptoms were obtained with the Blood Donation Reactions Inventory (BDRI) and through observation. Physiological variables were measured using respiratory capnometry and a digital blood pressure monitor. The Affective and Cognitive Measure of Empathy was administered to 230 participants.

RESULTS

Donors who witnessed another experiencing a reaction were more likely to spontaneously report symptoms during the blood draw, to be treated for a reaction, to score higher on the BDRI, and to exhibit smaller compensatory heart rate increases. Donors with higher affective empathy reported more symptoms, exhibited hyperventilation, and were more likely to be treated. Donors with higher cognitive empathy were less likely to require treatment if they witnessed a reaction.

CONCLUSION

These results suggest that psychosocial contagion of physical symptoms can occur. The moderating effects of empathy differed depending on the subtype of empathy. Perhaps a better cognitive understanding of how other people are feeling functions as a coping response, whereas feeling sympathetic about others' distress increases one's own.

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.

Synchrony with distress in affective empathy and compassion

Sensitivity to suffering of others is a core factor in social cohesion and evolutionary success. The emergence of such sensitivity may occur via two neuro-functional mechanisms. One is sharing the pain and distress of others, which relies on affective empathy. The other involves a caring concern for others' wellbeing, termed compassion. Both affective empathy and compassion are triggered by cues of pain and distress, exhibited by suffering targets. Yet, the mechanisms underlying distress processing in empathy and compassion are not clear. In the current research, we investigated synchrony with a target's distress, as a putative mechanism for continuous processing of distress cues. Participants viewed a video of a target in distress when given two different instructions: they were asked to continuously rate their distress in the affective empathy condition, or their feelings of care in the compassion condition. We used these dynamic ratings as well as participants' autonomic and facial responses to assess multi-channel synchrony with the target's self-rated distress fluctuations. Dynamic ratings and facial corrugator responses were significantly positively synchronized with the target's distress. For the corrugator responses, synchrony with the target was more pronounced than synchrony with participants' own ratings. Autonomic responses exhibited negative synchrony with the target's distress. Synchrony was higher in the affective empathy than in the compassion condition, across channels. These results point to the key role of subjective and physiological synchrony with the target's distress in empathic sharing of negative experiences. They also highlight the attenuation of embodied resonance with distress in compassionate experiences.

Convergent neuroendocrine mechanisms of social buffering and stress contagion

Social interactions play a key role in modulating the impact of stressful experiences. In some cases, social interactions can result in social buffering, the process in which the presence of one individual reduces the physiological and behavioral impact of stress in another individual. On the other hand, there is growing evidence that a key initiating factor of social buffering behaviors is the initiation of an anxiogenic state in the individual that was not directly exposed to the stress. This is referred to as stress contagion (a form of emotion contagion). Both processes involve the transmission of social information, suggesting that contagion and buffering could share similar neural mechanisms. In general, mechanistic studies of contagion and buffering are considered separately, even though behavioral studies show that a degree of contagion is usually necessary for social buffering behaviors to occur. Here we consider the extent to which the neuropeptides corticotropin releasing hormone and oxytocin are involved in contagion and stress buffering. We also assess the importance that frontal cortical areas such as the anterior cingulate cortex and infralimbic cortex play in these behavioral processes. We suggest that further work that directly compares neural mechanisms during stress contagion and stress buffering will be important for identifying what appear to be distinct but overlapping circuits mediating these processes.

Physiological Resonance in Empathic Stress: Insights from Nonlinear Dynamics of Heart Rate Variability

Because most humans live and work in populated environments, researchers recently took into account that people may not only experience first-hand stress, but also second-hand stress related to the ability to empathically share another person’s stress response. Recently, researchers have begun to more closely examine the existence of such empathic stress and highlighted the human propensity to physiologically resonate with the stress responses of others. As in case of first-hand stress, empathic stress could be deleterious for health if people experience exacerbated activation of hypothalamic–pituitary–adrenal and autonomic nervous systems. Thus, exploring empathic stress in an observer watching someone else experiencing stress is critical to gain a better understanding of physiological resonance and conduct strategies for health prevention. In the current study, we investigated the influence of empathic stress responses on heart rate variability (HRV) with a specific focus on nonlinear dynamics. Classic and nonlinear markers of HRV time series were computed in both targets and observers during a modified Trier social stress test (TSST). We capitalized on multiscale entropy, a reliable marker of complexity for depicting neurovisceral interactions (brain-to-heart and heart-to-brain) and their role in physiological resonance. State anxiety and affect were evaluated as well. While classic markers of HRV were not impacted by empathic stress, we showed that the complexity marker reflected the existence of empathic stress in observers. More specifically, a linear model highlighted a physiological resonance phenomenon. We conclude on the relevance of entropy in HRV dynamics, as a marker of complexity in neurovisceral interactions reflecting physiological resonance in empathic stress.

A systematic review and realist synthesis on toilet paper hoarding: COVID or not COVID, that is the question

OBJECTIVE

To explore whether the coronavirus disease 2019 (COVID-19) pandemic is associated with toilet paper hoarding and to assess which risk factors are associated with the risk of toilet paper hoarding.

DESIGN

A systematic review and realist review were conducted.

DATA SOURCES

PubMed, Web of Science, Scopus and PsycINFO were searched (systematic review). PubMed, pre-prints and grey literature were also searched (realist review). The databases were searched from inception until October 2020.

STUDY SELECTION

There were no restrictions on the study design.

OUTCOMES AND MEASURES

For the systematic review, toilet paper hoarding was the main outcome, and pathological use of toilet paper was the secondary outcome. For the realist review, the context-mechanisms-outcome (CMO) scheme included the COVID-19 pandemic (context), four proposed mechanisms, and one outcome (toilet paper hoarding). The four potential mechanisms were (1) gastrointestinal mechanisms of COVID-19 (e.g. diarrhoea), (2) social cognitive biases, (3) stress-related factors (mental illnesses, personality traits) and (4) cultural aspects (e.g. differences between countries).

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

All studies of human populations were considered (including general population studies and clinical studies of patients suffering from mental health problems).

RESULTS

The systematic review identified 14 studies (eight studies for the main outcome, six studies for the secondary outcome). Three surveys identified the role of the COVID-19 threat in toilet paper hoarding in the general population. One study pointed to an association between a personality trait (conscientiousness) and toilet paper buying and stockpiling as well as an additional significant indirect effect of emotionality through the perceived threat of COVID-19 on toilet paper buying and stockpiling. Six case reports of pathological use of toilet paper were also identified, although none of them were associated with the COVID-19 pandemic. The realist review suggested that of all the mechanisms, social cognitive biases and a bandwagon effect were potential contributors to toilet paper hoarding in the general population. The stressful situation (COVID-19 pandemic) and some personality traits (conscientiousness) were found to be associated with toilet paper hoarding. Cultural differences were also identified, with relatively substantial effects of toilet paper hoarding in several Asian regions (Australia, Japan, Taiwan and Singapore).

CONCLUSIONS

The COVID-19 pandemic has been associated with a worldwide increase in toilet paper hoarding. Social media and social cognitive biases are major contributors and might explain some differences in toilet paper hoarding between countries. Other mental health-related factors, such as the stressful situation of the COVID-19 pandemic, fear of contagion, or particular personality traits (conscientiousness), are likely to be involved.

REGISTRATION

PROSPERO CRD42020182308.

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

In the wake of the massive Canadian wildfire of May 2016 in the area of Fort McMurray Alberta, we observed increased rates of mental health problems, particularly post-traumatic stress disorder (PTSD), in school-aged adolescents (ages 11-19). Surprisingly, we did not see these rates decline over the 3.5-year follow-up period. Additionally, our research suggested that the impact of this mass incident resulted in other unanticipated effects, including the finding that children who were not present for and relatively unaffected by the wildfire showed a similar PTSD symptom profile to children more directly involved, suggesting some degree of spillover or stress contagion. A potential explanation for these high rates in individuals who were not present could be undiagnosed retraumatization in some of the students. To investigate this possibility, we compared two groups of students: those who reported the wildfire as their most significant trauma (n = 740) and those who had their most significant trauma prior to the wildfire (n = 295). Those with significant pre-existing trauma had significantly higher rates of both depression and PTSD symptoms, although, unexpectedly the groups exhibited no differences in anxiety level. Taken together, this evidence suggests retraumatization is both longer-lasting and more widespread than might be predicted on a case-by-case basis, suggesting the need to reconceptualize the role of past trauma history in present symptomatology. These findings point to the need to recognize that crises instigated by natural disasters are mass phenomena which expose those involved to numerous unanticipated risks. New trauma-informed treatment approaches are required that incorporate sensitivity to the collective impact of mass crises, and recognize the risk of poorer long-term mental health outcomes for those who experienced trauma in the past.

The social curse: Evidence for a moderating effect of shared social identity on contagious stress reactions

Contagious stress describes the transmission of a stress response from a distressed individual (target) to an uninvolved observer. Building on social identity theory, we hypothesize that a shared social identity between the observer and the target as compared to a personal identity increases the likelihood of contagious endocrine and psychological stress responses. Participants underwent the experiment in groups of four or five individuals. After experimentally inducing either a shared social identity or a personal identity, one participant in each group (N_target = 27) was randomly chosen to undergo the Trier Social Stress Test (TSST), while being observed by the rest of the group (N_observer = 89). Salivary cortisol and psychological stress responses were assessed repeatedly during the experiment. As predicted, the likelihood of cortisol stress reactions was significantly higher in the social identity condition (25 %) as compared to the personal identity condition (7 %). No effect of our manipulation on psychological stress responses was found. We also tested whether observers' trait empathy moderates contagious stress and found no support for this moderation.

Physiological and Behavioral Synchrony Predict Group Cohesion and Performance

Interpersonal synchrony contributes to social functioning in dyads, but it remains unknown how synchrony shapes group experiences and performance. To this end, we designed a novel group drumming task in which participants matched their drumming to either predictable or unpredictable tempos. Fifty-one three-person groups were randomly assigned to one of two conditions: synchronized or asynchronized drumming. Outcome measures included electrocardiograms and self-reports of group cohesion and synchrony. The drumming task elicited an increase in physiological synchrony between group members (specifically their hearts' interbeat intervals). We also found that physiological synchronization and behavioral synchronization predicted individuals' experience of group cohesion. Physiological synchrony also predicted performance in a subsequent group task that involved freely drumming together. The findings suggest that the behavioral and physiological consequences of synchronization contribute to the formation of group bonds and coordination. They also confirm that insights from translational social neuroscience can inform our knowledge of the development of cohesive and efficacious groups.

The "Managed" or Damaged Heart? Emotional Labor, Gender, and Posttraumatic Stressors Predict Workplace Event-Related Acute Changes in Cortisol, Oxytocin, and Heart Rate Variability

Vital to the everyday operation of police services, police communicators (911 call-takers and dispatchers) are persistently subject to imminent challenges in the workplace; they must always be prepared to engage and deal with a wide variety of circumstances that provoke various intense emotions and physiological stress responses. Acute changes in cortisol, oxytocin, and heart rate variability are central to adaptive responses in stressful complex social interactions, but they might also be indicative of physiological dysregulation due to long-term psychosocial stress exposures. Thus, we examine acute stress-induced release of peripheral oxytocin and cortisol along with changes in heart rate variability, and how each relates to persistent workplace stressors and symptoms of posttraumatic stress. Findings indicate chronic forms of gendered workplace stress such as emotional labor, gender role stress and, posttraumatic stress each have differential associations with, and predict physiological responses to, acutely stressful events in the workplace. These associations suggest potential mechanisms through which communicators become more vulnerable to developing stress-related disorders such as posttraumatic stress injuries, especially after cumulative traumatic exposures in this context. The results also suggest potential pathways for the biological embedding of stressful gendered workplace experiences.

Hedione Reduces Subjective Vicarious Stress

Observing another person in a stressful situation can cause a full-blown physiological stress response in the observer, which is referred to as empathic stress. One way through which stress-related information might be transmitted between individuals under conditions of empathic stress is chemosensory communication. In the present study, we investigated whether the odorant Hedione, as a potential chemosignal, affects the empathic stress response at a physiological and psychological level. For this purpose, two experiments were designed, each testing one group of participants in an odor-free room and a second group in a room scented with Hedione. In Experiment 1, 60 participants (25 males) watched a video of an unknown female participant in the Trier Social Stress Test (TSST). In Experiment 2, 37 free-cycling females watched a live video of a male participant in the TSST. Observers’ psychological and physiological stress response was captured via repeated measurements of salivary cortisol, alpha-amylase, and self-report ratings. Empathy with the stressed participants was assessed on the dimensions of personal distress and empathic concern of the Emotional Response Scale (ERS). Our results show no substantial physiological stress response in the observers and no effect of Hedione on physiological stress measures. Further, in Experiment 1, there was no subjective stress elicited by the video and no effect of Hedione. In Experiment 2, the observation was perceived as stressful and Hedione reduced subjective vicarious stress. The subjective stress response was associated with the Observers’ direct personal distress, but not with their empathic concern for the target in both experiments. Based on the findings presented above, we conclude that under conditions of empathic stress, Hedione alleviates subjectively perceived stress felt when observing another person being stressed, while leaving empathic concern for the target unaffected. In this regard, future research is warranted to clarify the underlying mechanisms of this effect.

An inverted U-shaped relationship between heart rate deceleration and empathic emotions

Previous studies have shown that the high frequency component of heart rate variability is associated with empathic emotions (empathic concern and personal distress) negatively and quadratically-there is an inverted U-shaped relationship between tonic parasympathetic nervous system (PNS) activity and empathy. However, it is unclear whether the inverted U-shape also applies to the relationship between phasic PNS activity and empathic emotions. Therefore, the present study addressed this issue. Participants were asked to empathize with others' negative states (and neutral states as the control condition), followed by evaluating their own emotions. We measured the participants' cardiac activity during this task by electrocardiogram. Results revealed an inverted U-shaped relationship between heart rate deceleration, which reflects phasic PNS activity, and subjective personal distress and empathic concern. These results suggest that moderate levels of phasic PNS activity are more strongly associated with personal distress and empathic concern than low or high levels of PNS activity.

Does stress affect nonverbal engagement in teams? A case study in professional team sport

Purpose

Team effectiveness is often predicated by a group’s ability to communicate. However, the effect of stress response on communication success, particularly nonverbal engagement, and how this might affect team performance, is not clear; a “phenomenon” this study sought to explore.

Design/methodology/approach

This was an observational study in a cohort of professional rugby players. Participants gave presentations to their peers on two separate occasions during a “live-in” camp designed to have psychologically stressful elements. Presentations were video recorded and audience engagement was measured. Testosterone and cortisol were used as biomarkers of stress response, with a high testosterone–cortisol ratio considered positive. A team training session followed the presentations and participants were rated for training quality.

Findings

A small decline in testosterone was observed each day after waking. Conversely, cortisol rose after waking, with the rise being the highest on the first day. A decline in testosterone–cortisol ratio was also seen each day after waking; the decline was greatest on the first day. Presentation duration and audience engagement was greatest for the second presentation; when the testosterone-cortisol ratio decline and the cortisol increase after waking was smaller. Training quality was also better that day. Pooled data revealed a moderate inverse relationship and weak positive relationships for audience engagement with post-meeting cortisol and post-meeting testosterone–cortisol ratio, respectively. Training quality was related to testosterone and testosterone–cortisol ratio, but inversely related to cortisol.

Originality/value

This study suggests that in stressful conditions, as suggested by an awakening hormone response, communication and team performance could become compromised with reduced ability to engage with others.

Embodied stress: The physiological resonance of psychosocial stress

Psychosocial stress is a ubiquitous phenomenon in our society. While acute stress responses are necessary and adaptive, excessive activation of neurobiological stress systems can predispose an individual to far-reaching adverse health outcomes. Living in a complex social environment, experiencing stress is not limited to challenges humans face individually. Possibly linked with our capacity for empathy, we also display the tendency to physiologically resonate with others' stress responses. This recently identified source of stress raises many interesting questions. In comparison to the wealth of studies that have advanced our understanding of sharing others' affective states, the physiological resonance of stress has only recently begun to be more closely investigated. The aim of the current paper is to review the existing literature surrounding the emerging area of "stress contagion", "empathic stress" or "stress resonance", as it has been variably called. After a brief introduction of the concepts of stress and empathy, we discuss several key studies that paved the way for the merging of empathy with the concept of physiological resonance. We then delineate recent empirical studies specifically focusing on the physiological resonance of stress. In the final section of this review, we highlight differences between these studies and discuss the variability in terminology used for what seems to be the same phenomenon. Lastly, potential health implications of chronic empathic stress are presented and possible mechanisms of physiological stress transmission are discussed.

Social identification and contagious stress reactions

Contagious stress describes the transmission of stress from a stressed person to an observer, which we examined at the neuroendocrine and the affective level. We tested whether a shared social identity moderates contagious stress. Ninety-four participants participated in groups of four. After inducing either a shared social or a personal identity, participants observed a confederate undergoing the Trier Social Stress Test (TSST), a standardized social-evaluative stressor. Salivary cortisol and affective stress were assessed multiple times before and after the observation of the TSST. We found a physiologically significant contagious stress reaction on a neuroendocrine level for 17% of all participants. Additionally, we found an increase in observers' self-reported stress. Contrary to our expectations, the manipulation of social identity had no effect on contagious stress. Our variation of the TSST is a viable methodological strategy to increase standardization as well as experimental economy in studies examining contagious stress.

Oxytocin reduces a chemosensory-induced stress bias in social perception

Social transmission of fear is not restricted to visual or auditory cues, but extends to the phylogenetically more ancient olfactory domain. Anxious individuals exhibit heightened sensitivity towards chemosensory stress signals in sweat; however, it is still unknown whether endogenous neuromodulators such as the peptide hormone oxytocin (OXT) influence the chemosensory communication of stress. Here, we investigated whether OXT selectively diminishes behavioral and neural responses to social chemosensory stress cues utilizing a randomized, double-blind, placebo (PLC)-controlled, within-subject functional MRI study design. Axillary sweat was obtained from 30 healthy male donors undergoing the Trier Social Stress Test (stress) and bicycle ergometer training (sport). Subsequently, 58 healthy participants (30 females) completed a forced-choice emotional face recognition task with stimuli of varying intensities (neutral to fearful) while they were exposed to both sweat stimuli and a non-social control odor following intranasal OXT or PLC administration, respectively. OXT diminished stress-induced recognition accuracy and response time biases towards fear. On the neural level, OXT reduced stress-evoked responses in the amygdala in both sexes, the anterior cingulate cortex (ACC) in females, and the hippocampus in males. Furthermore, OXT reinstated the functional connectivity between the ACC and the fusiform face area that was disrupted by stress odors under PLC. Our findings reveal a new role for OXT signaling in the modulation of chemosensory communication of stress in humans. Mechanistically, this effect appears to be rooted in a downregulation of stress-induced limbic activations and concomitant strengthening of top-down control descending from the ACC to the fusiform face area.