A general enhancement of autonomic and cortisol responses during social evaluative threat

When virtual reality becomes psychoneuroendocrine reality: A stress(or) review

This review article was awarded the Dirk Hellhammer award from ISPNE in 2023. It explores the dynamic relationship between stressors and stress from a historical view as well as a vision towards the future of stress research via virtual reality (VR). We introduce the concept of a "syncytium," a permeable boundary that blurs the distinction between stress and stressor, in order to understand why the field of stress biology continues to inadequately measure stress alone as a proxy for the force of external stressors. Using Virtual Reality (VR) as an illustrative example to explicate the black box of stressors, we examine the distinction between 'immersion' and 'presence' as analogous terms for stressor and stress, respectively. We argue that the conventional psychological approaches to stress measurement and appraisal theory unfortunately fall short in quantifying the force of the stressor, leading to reverse causality fallacies. Further, the concept of affordances is introduced as an ecological or holistic tool to measure and design a stressor's force, bridging the gap between the external environment and an individual's physiological response to stress. Affordances also serve to ameliorate shortcomings in stress appraisal by integrating ecological interdependencies. By combining VR and psychobiological measures, this paper aims to unravel the complexity of the stressor-stress syncytium, highlighting the necessity of assessing both the internal and external facets to gain a holistic understanding of stress physiology and shift away from reverse causality reasoning. We find that the utility of VR extends beyond presence to include affordance-based measures of immersion, which can effectively model stressor force. Future research should prioritize the development of tools that can measure both immersion and presence, thereby providing a more comprehensive understanding of how external stressors interact with individual psychological states.

Relationship between heart rate variability and differential patterns of cortisol response to acute stressors in mid-life adults: A data-driven investigation

Cortisol and heart rate variability (HRV) are well-established biomarkers of the human stress response system. While a relationship between cortisol and HRV is assumed, few studies have found evidence of their correlation within single study designs. One complication for isolating such a relationship may lie in individual variability in the cortisol response to stress such that atypical cortisol responding (i.e., elevated or blunted) occurs. To-date, studies on the cortisol response have employed traditional mean-difference-based approaches to examine average magnitude change in cortisol over time. Alternatively, data-driven trajectory modelling, such as latent growth mixture modelling, may be advantageous for quantifying cortisol based on patterns of response over time. Latent growth mixture modelling was used in N = 386 adults to identify subgroups based on trajectories of cortisol responses to stress. The relationship between cortisol and HRV was tested within subgroups. Results revealed a 'prototypical' subgroup characterised by expected rise and fall in cortisol response to stress (n = 309), a 'decline' subgroup (n = 28) that declined in cortisol after stress, and a 'rise' subgroup (n = 49) that increased in cortisol after stress. Within the 'prototypical' subgroup, greater HRV during stress was associated with decline in cortisol after stress from its maximum (r (306) = 0.19, p < 0.001). This relationship failed to emerge in the 'decline' and 'rise' subgroups (p > 0.271). Results document different patterns of cortisol response to stress; among those who exhibit a 'prototypical' response, changes in HRV during stress are related to changes in cortisol after stress.

Acoustic and prosodic speech features reflect physiological stress but not isolated negative affect: a multi-paradigm study on psychosocial stressors

Heterogeneity in speech under stress has been a recurring issue in stress research, potentially due to varied stress induction paradigms. This study investigated speech features in semi-guided speech following two distinct psychosocial stress paradigms (Cyberball and MIST) and their respective control conditions. Only negative affect increased during Cyberball, while self-reported stress, skin conductance response rate, and negative affect increased during MIST. Fundamental frequency (F0), speech rate, and jitter significantly changed during MIST, but not Cyberball; HNR and shimmer showed no expected changes. The results indicate that observed speech features are robust in semi-guided speech and sensitive to stressors eliciting additional physiological stress responses, not solely decreases in negative affect. These differences between stressors may explain literature heterogeneity. Our findings support the potential of speech as a stress level biomarker, especially when stress elicits physiological reactions, similar to other biomarkers. This highlights its promise as a tool for measuring stress in everyday settings, considering its affordability, non-intrusiveness, and ease of collection. Future research should test these results' robustness and specificity in naturalistic settings, such as freely spoken speech and noisy environments while exploring and validating a broader range of informative speech features in the context of stress.

Loneliness during the post-confinement period: The significance of social living conditions for stress biomarkers and memory

In the aftermath of the COVID-19 lockdown, concerns about the impact of loneliness and reduced social interactions on mental health have arisen. This study explored the repercussions of post-lockdown social restrictions across psychological (loneliness, perceived stress, and depressive symptoms), biological (hair cortisol and cardiovascular activity), and cognitive dimensions (subjective memory complaints and working, declarative, and prospective memory), with a specific emphasis on perceived loneliness and the living situation. The study included 45 students: 23 (mean age = 25.69 years) in the Alone Group (AG), who experienced significant family changes and international relocation, and 22 (mean age = 25.50 years) in the Not Alone Group (NAG), who maintained their nuclear family and did not move from their home country. We assessed heart rate variability (HRV) before, during, and after immediate memory evaluations using time-domain (the square root of the mean, RMSSD) measures. The analysis revealed no significant group differences in telematic contact with family and friends, perceived stress, or depression. However, the AG participants reported fewer face-to-face interactions and greater perceived loneliness compared to the NAG. Additionally, the AG group exhibited slightly higher hair cortisol levels and worse working memory (WM) and prospective memory (PM) performance. Importantly, no significant associations were observed between memory outcomes and stress biomarkers. However, a significant interaction effect of loneliness in the relationship between hair cortisol levels and PM was found. That is, hair cortisol concentrations were negatively related to PM when participants perceived high and moderate loneliness. This interaction was absent in the working and declarative memory domains. In summary, these findings underscore the intricate interplay between loneliness, cortisol, and memory, emphasizing the need for comprehensive research on the complex mechanisms governing these multifaceted relationships.

Combining Cardiovascular and Pupil Features Using k-Nearest Neighbor Classifiers to Assess Task Demand, Social Context, and Sentence Accuracy During Listening

In daily life, both acoustic factors and social context can affect listening effort investment. In laboratory settings, information about listening effort has been deduced from pupil and cardiovascular responses independently. The extent to which these measures can jointly predict listening-related factors is unknown. Here we combined pupil and cardiovascular features to predict acoustic and contextual aspects of speech perception. Data were collected from 29 adults (mean  =  64.6 years, SD  =  9.2) with hearing loss. Participants performed a speech perception task at two individualized signal-to-noise ratios (corresponding to 50% and 80% of sentences correct) and in two social contexts (the presence and absence of two observers). Seven features were extracted per trial: baseline pupil size, peak pupil dilation, mean pupil dilation, interbeat interval, blood volume pulse amplitude, pre-ejection period and pulse arrival time. These features were used to train k-nearest neighbor classifiers to predict task demand, social context and sentence accuracy. The k-fold cross validation on the group-level data revealed above-chance classification accuracies: task demand, 64.4%; social context, 78.3%; and sentence accuracy, 55.1%. However, classification accuracies diminished when the classifiers were trained and tested on data from different participants. Individually trained classifiers (one per participant) performed better than group-level classifiers: 71.7% (SD  =  10.2) for task demand, 88.0% (SD  =  7.5) for social context, and 60.0% (SD  =  13.1) for sentence accuracy. We demonstrated that classifiers trained on group-level physiological data to predict aspects of speech perception generalized poorly to novel participants. Individually calibrated classifiers hold more promise for future applications.

Copresence Was Found to Be Related to Some Pupil Measures in Persons With Hearing Loss While They Performed a Speech-in-Noise Task

OBJECTIVES

To assess if a manipulation of copresence was related to speech-in-noise task performance, arousal, and effort of persons with hearing loss. Task-related arousal and effort were measured by means of pupillometry.

DESIGN

Twenty-nine participants (mean age: 64.6 years) with hearing loss (4-frequency pure-tone average [4F-PTA] of 50.2 dB HL [SD = 8.9 dB] in the right ear and 51.3 dB HL [SD = 8.7 dB] in the left ear; averaged across 0.5, 1, 2, and 4 kHz) listened to and repeated spoken Danish sentences that were masked by four streams of continuous speech. Participants were presented with blocks of 20 sentences, during which copresence was manipulated by having participants do the task either alone or accompanied by two observers who were recruited from a similar age group. The task was presented at two difficulty levels, which was accomplished by fixing the signal-to-noise ratio of the speech and masker to match the thresholds at which participants were estimated to correctly repeat 50% (difficult) or 80% (easy) of the sentences in a block. Performance was assessed based on whether or not sentences were repeated correctly. Measures of pupil size (baseline pupil size [BPS], peak pupil dilation [PPD], and mean pupil dilation [MPD]) were used to index arousal and effort. Participants also completed ratings of subjective effort and stress after each block of sentences and a self-efficacy for listening-questionnaire.

RESULTS

Task performance was not associated with copresence, but was found to be related to 4F-PTA. An increase in BPS was found for copresence conditions, compared to alone conditions. Furthermore, a post-hoc exploratory analysis revealed that the copresence conditions were associated with a significantly larger pupil size in the second half of the task-evoked pupil response (TEPR). No change in PPD or MPD did was detected between copresence and alone conditions. Self-efficacy, 4F-PTA, and age were not found to be related to the pupil data. Subjective ratings were sensitive to task difficulty but not copresence.

CONCLUSION

Copresence was not found to be related to speech-in-noise performance, PPD, or MPD in persons with HL but was associated with an increase in arousal (as indicated by a larger BPS). This could be related to premobilization of effort and/or discomfort in response to the observers' presence. Furthermore, an exploratory analysis of the pupil data showed that copresence was associated with greater pupil dilations in the second half of the TEPR. This may indicate that participants invested more effort during the speech-in-noise task while in the presence of the observers, but that this increase in effort may not necessarily have been related to listening itself. Instead, other speech-in-noise task-related processes, such as preparing to respond, could have been influenced by copresence.

Stress reappraisal improves the autonomic nervous system response of test anxious individuals: Evidence from heart rate variability

BACKGROUND

Stress belief plays an important role in stress response. This study investigated whether individuals with high test anxiety/low test anxiety (HTA/LTA) held different stress belief, and tested the effect of stress reappraisal on reducing test anxiety related autonomic nervous system (ANS) response.

METHODS

51 HTA students and 49 LTA students were recruited using the Test Anxiety Scale (TAS). They completed a 10-min intelligence test (including preparation, test, and recovery phases), then were randomly assigned to reappraisal group and control group to complete the test again. Heart rate variability (HRV) was recorded throughout the protocol. Beliefs about Stress Scale was obtained before and after the experiment. Stress belief were manipulated using a 2-min film clip that orienting participant to the enhancing nature of stress. Emotional changes were assessed.

RESULTS

HTA individuals held more negative stress beliefs and showed greater emotional arousal during the test than the LTA individuals. Their negative stress belief was associated with higher TAS score and worse HRV response. (2) When facing an exam, LTA individuals exhibited increased low-frequency HRV and stable high-frequency HRV, while HTA individuals showed stable low-frequency HRV and decreased high-frequency HRV. (3) HTA individuals who underwent reappraisal showed a reduction in test anxiety and in low-frequency/high-frequency HRV ratio.

CONCLUSIONS

The ANS activity of HTA individuals is imbalanced in the test situations. Stress belief is a meaningful variable in anxiety related ANS activity. Stress reappraisal can effectively reduce test anxiety and improve the balance of ANS activity of HTA individuals.

Life event stress is associated with blunted cardiovascular responding to both personally salient and personally non-salient laboratory tasks

Life event stress has been associated with blunted cardiovascular reactivity to acute psychological stress. However, recent studies have suggested that blunted reactivity to stress only arises when the laboratory tasks are not personally salient to the individual. We re-analyzed data from 136 healthy young adults where we had previously reported a negative association between life event stress and cardiovascular reactivity to two combined stressors. Participants completed a mental arithmetic task and a personally salient speech task, following a formal baseline period with Finometer-assessed cardiovascular parameters. The reanalyses examined reactivity to the verbal mental arithmetic (personally non-salient) and speech (personally salient) tasks separately and found that life event stress was negatively associated with diastolic blood pressure reactivity, to both the personally non-salient, β = -.20, p = .023, and personally salient stressors, β = -.24, p = .004. Life event stress was negatively associated with systolic blood pressure reactivity to the personally salient stressor only, β = -.20, p = .021, and was not associated with heart rate reactivity. This study provides evidence against the argument that blunted reactivity to stress emerges as a result of stressor context, with findings indicating that low reactors show lower reactivity to both personally salient and personally non-salient stress.

Adaptation to social-evaluative threat: Effects of repeated acceptance and status stressors on cardiovascular reactivity

Social-evaluative threat plays a key role in research on stress, health and related psychophysiological mechanisms such as cardiovascular reactivity (CVR). Social-evaluative threats can activate two broad social motives: striving for status, achievement and influence, and/or striving for acceptance, inclusion, and connection. Prior research emphasizes threats related to status (e.g., task performance) or combined threats to status and acceptance, obscuring their independent effects. Further, because prior research has mostly utilized single stressors, it is not clear if effects of social-evaluative threats involving status and acceptance on CVR persist or adapt quickly over repeated exposures. To address these issues, 139 undergraduates (93 females) were randomly assigned to undergo two repetitions of a stressful role-played interaction with a pre-recorded antagonistic partner under one of four conditions in a factorial design: low evaluative threat, high status threat only, high acceptance threat only, or a combined threat. In a single laboratory session, systolic and diastolic blood pressure (SBP, DBP) and heart rate (HR) were recorded during baseline and two stressor exposures. Task-induced CVR demonstrated significant adaptation across exposures. Both forms of social evaluative threat produced additional CVR, and these differences between high and low social-evaluative threat were generally maintained across exposures. Hence, threats to social status and acceptance have independent and sustained effects on CVR across multiple stressor exposures, even in the context of overall adaptation of cardiovascular responses.

Implicit theories shape responses to social-evaluative threat

It is important to understand factors that make one more or less vulnerable to the harmful effects of social threat. This study focuses on the role of implicit theories (also referred to as mindsets) in shaping responses to a potent form of social threat, namely social-evaluative threat (SET). 124 individuals participated in an experimental study in which they were induced to have an incremental theory or an entity theory about their social skills. Next, they were exposed to SET in the laboratory. Psychological and physiological responses were assessed including social self-esteem, rumination, spontaneous mentions of concerns about one's social skills, and heart-rate variability. Compared to those induced to have entity theories, those induced to have incremental theories were buffered from the typical harmful effects of SET on social self-esteem, rumination, and concerns about their social skills. The association between implicit theories and heart-rate variability fell just short of significance.

Acculturation in Context and Brain Health in Older Latino Adults: A Diffusion Tensor Imaging Study

BACKGROUND

Latinos are at higher risk of developing mild cognitive impairment (MCI) and Alzheimer's disease than non-Latino Whites. Acculturation factors may influence this risk, yet there are few studies that have examined associations of acculturation, particularly in the context of socioenvironmental and familial factors, and brain health in older Latinos.

OBJECTIVE

To examine potential associations between acculturation in context and brain health in older Latinos.

METHODS

Using three previously established composites of acculturation-in-context, (acculturation-related: nativity status, language preference, acculturation scores; contextually-related socioenvironmental: perceived discrimination, loneliness/social isolation, social network size; and familism), and diffusion-tensor imaging (DTI), associations with white matter structural integrity were examined in 92 Latino adults without dementia participating in one of three epidemiological studies of aging. Linear regression models were used to test associations with DTI-derived metrics (fractional anisotropy, FA; trace) as separate outcomes and acculturation composite scores as individual predictors, while adjusting for age, sex, education, scanner, and white matter hyperintensities (voxelwise and total volumes normalized by intracranial volume).

RESULTS

Higher scores on the socioenvironmental composite were associated with lower FA in two clusters of left-hemisphere connections. Cluster 1 was dominated by both short association pathways connecting frontal regions and projection pathways connecting frontal regions with the thalamus. Cluster 2 was dominated by long association pathways connecting parietal, frontal, and temporal regions.

CONCLUSIONS

This study of older Latino adults demonstrated an association between reduced brain white matter integrity and contextually related socioenvironmental experiences known to increase risk of MCI and Alzheimer's disease.

Evoking stress reactivity in virtual reality: A systematic review and meta-analysis

BACKGROUND

Virtual reality (VR) research probes stress environments that are infeasible to create in the real world. However, because research simulations are applied to narrow populations, it remains unclear if VR simulations can stimulate a broadly applicable stress-response. This systematic review and meta-analysis was conducted on studies using VR stress tasks and biomarkers.

METHODS

Included papers (N = 52) measured cortisol, heart rate (HR), galvanic skin response (GSR), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory sinus arrhythmia (RSA), parasympathetic activity (RMSSD), sympathovagal balance (LF/HF), and/or salivary alpha-amylase (sAA). Effect sizes (ES) and confidence intervals (CI) were calculated based on standardized mean change of baseline-to-peak biomarker levels.

RESULTS

From baseline-to-peak (ES, CI), analyses showed a statistically significant change in cortisol (0.56, 0.28-0.83), HR (0.68, 0.53-0.82), GSR (0.59, 0.36-0.82), SBP (.55, 0.19-0.90), DBP (.64, 0.23-1.05), RSA (-0.59, -0.88 to -0.30), and sAA (0.27, 0.092-0.45). There was no effect for RMSSD and LF/HF.

CONCLUSION

VR stress tasks elicited a varied magnitude of physiological stress reactivity. VR may be an effective tool in stress research.

The dysregulation of top-down control in individuals with high test anxiety: A resting state fMRI study

BACKGROUND

Individuals with high test anxiety (HTA) have deficits in attentional control and in stress responses when faced with tests. However, little is known about the underlying neural mechanism. Anterior cingulate cortex (ACC) is involved in both attention and emotion networks, therefore this study examined the neural functional dysregulation in test anxiety from the perspective of functional connectivity (FC) using bilateral ACC as the regions of interest.

METHODS

Fifty-one participants were divided into HTA (n = 23) and low test anxiety (LTA, n = 28) group according to their Test Anxiety Scale (TAS) scores. Brain imaging data in resting, preparing, and recovering phases of a modified social evaluative threat task were collected, and emotional changes were assessed.

RESULTS

Compared with the LTA group, the HTA group exhibited significantly lower FCs between the ACC and superior frontal gyrus (SFG) in all 3 phases, significantly lower FCs between the ACC and inferior parietal gyrus (IPG), and significantly higher FCs between the ACC superior temporal gyrus (STG) in the preparing phase. Moreover, in the HTA group, the resting state IPG-ACC FC was associated with their TAS score, the preparing state STG-ACC FC was associated with the increased anxiety.

CONCLUSIONS

Individuals with HTA have general prefrontal control deficits. When facing a test, they tend to recruit more resources to deal with high emotional interference. The dysregulated control of the ACC by the frontal-parietal network may underlie the pathophysiology of test anxiety.

Effects of Two Mindfulness Based Interventions on the Distinct Phases of the Stress Response Across Different Physiological Systems

When evaluating the effects of mindfulness-based interventions (MBIs) on the stress response, several aspects should be considered, such as 1) effects on various response systems, 2) temporal dynamics of the stress response, and 3) differences between programs. This study assesses the stress-attenuating effects of a standard mindfulness-based stress reduction (MBSR) and a second-generation MBI: MBSR with elements of other Buddhist practices (MBSR-B). Ninety-nine healthy volunteers were randomly assigned to the MBSR, MBSR-B, or waitlist control groups and their stress response was evaluated with the Trier Social Stress Test. Changes in the activity of the hypothalamic-pituitary-adrenal (HPA) axis, sympathoadrenomedullary system, the autonomic nervous system (ANS), and affect were measured during distinct phases of the task. Compared to waitlist control, the stress-attenuated effects of MBIs were detected across almost all systems and both negative and positive affect. In the parasympathetic branch of the ANS, the effect of MBIs was present in all stress phases (however, in the recovery phase, only MBSR-B has shown a statistically significant effect in comparison with the waitlist control). The stress-attenuating effects of MBIs were observed already in the anticipatory phase for cortisol, ANS, and negative affect (for negative affect, only the modified MBSR-B program has shown statistically significant effect in comparison with the waitlist control).

Loneliness and cardiovascular reactivity to acute stress in older adults

Loneliness has been linked to cardiovascular health outcomes in older adulthood. One proposed mechanism by which loneliness influences cardiovascular health is through atypical cardiovascular reactivity (CVR) to stress. This study is an examination of loneliness and CVR in older adults, comparing associations across two stressors and two commonly used measures of loneliness, with a particular focus on underlying hemodynamic variables including cardiac output, total peripheral resistance, and ejection time (EJT). Eighty older adults, ranging in age from 55 to 88 years (M = 68.93, SD = 8.28), completed two versions of the UCLA loneliness scale (a 20‐item and a briefer, three‐item) and took part in a laboratory stress‐testing procedure which included a mental arithmetic challenge and a public speaking task. Cardiovascular activity was monitored continuously throughout. For the 20‐item version of the UCLA loneliness scale, loneliness was not significantly related to CVR, and was only significantly associated with lower levels of overall EJT. For the three‐item version of the UCLA, no associations withstood adjustment for multiple testing. Loneliness was not reliably associated with CVR. Further, although greater loneliness was related to lower levels of overall EJT, this was only observed for the 20‐item scale. The findings do not strongly provide support for reactivity to acute stress as a pathway linking loneliness to disease outcomes, and highlight key methodological issues related to the assessment of loneliness‐reactivity associations for future.

This article provides an examination of associations between loneliness and cardiovascular reactivity (CVR) to acute stress in a sample of older adults. The findings do not provide support for a reliable association between loneliness and CVR in older adults. This article highlights methodological issues that are important to consider for future in this research area.

Attenuated beta-adrenergic response to stress and increased anticipation and perception of social threat in women high on perceived criticism

A large amount of literature has demonstrated that Perceived Criticism (PC)-that is, how critical a person believes a given relative is of him or her-is associated with negative clinical outcomes in a broad range of psychiatric disorders (e.g., relapse or recurrence of symptoms). A possible mechanism behind the predictive value of PC might be its association with the stress regulation process. This is the first study to investigate differences in the psychophysiological response to a social stress task in young women (mean age = 21.66, SD = 4.33) with high (n = 40) and low (n = 39) PC. The physiological response was investigated by measuring two markers of sympathetic activity mediated by acetylcholine (skin conductance levels; SCL) and adrenaline (pre-ejection period; PEP) levels, respectively, and one marker of the vagally-mediated parasympathetic system (heart rate variability; HRV). Moreover, we investigated the anticipation and perception of social threat, in the form of criticism, during the stressor. No differences in HRV and SCL were observed. However, individuals high in PC mobilized fewer cardiovascular resources to deal with the stressor, reflected in an attenuated beta-adrenergic response (i.e., lower PEP response). Women high in PC also expected and perceived more criticism during the stress task. Together, our results indicate that women high in PC make heightened social threat anticipation and interpretations, and they tend to engage in less active coping when exposed to socially evaluated stressful events. Our findings indicate that PC is associated with underlying stress-related psychobiological vulnerabilities that may contribute to its association with negative clinical outcomes.

Validity of the 15-item social inhibition questionnaire in outpatients receiving psychological or psychiatric treatment: The association between social inhibition and affective symptoms

OBJECTIVE

Social inhibition may promote symptoms of depression and anxiety in adults from an outpatient hospital population. The current work builds on a previously corroborated construct of social inhibition and examines the psychometric properties of this assessment tool and its predictive validity in the adult outpatient hospital population.

METHODS

A total of 350 adult outpatients receiving treatment at the department of Medical Psychology or Psychiatry completed measures of social inhibition and symptoms of anxiety (7-item Generalized Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire). Factor analyses, reliability estimates, and regression analyses were used to replicate the robustness of the model of social inhibition, and the 15-item Social Inhibition Questionnaire (SIQ15).

RESULTS

In the current sample (N = 350; M_age = 45 years; 67.4% women), factor analyses confirmed the previously suggested three-factor model of social inhibition as measured by the SIQ15. The subscales of behavioral inhibition, interpersonal sensitivity and social withdrawal proved to be internally consistent (Cronbach's α between 0.87/0.95) and stable over time (test-retest reliability between r = 0.76/0.83). At baseline, interpersonal sensitivity and social withdrawal were associated with anxiety and depressive symptoms. At three months follow-up, only interpersonal sensitivity was related to depressive symptoms.

CONCLUSIONS

Social inhibition is associated with anxiety and depression at baseline and can be reliably assessed with the SIQ15 in an outpatient hospital population. The association of interpersonal sensitivity with depressive symptoms at three-month follow-up suggests an important aim for future research on the development of preventive methods for affective symptoms in socially inhibited outpatients.

Lower Cardiovascular Reactivity is Associated with More Childhood Adversity and Poorer Midlife Health: Replicated Findings from the Dunedin and MIDUS Cohorts

Cardiovascular reactivity has been proposed as a biomarker linking childhood adversity and poorer health. The current study examined the association of childhood adversity, cardiovascular reactivity, and health in the Dunedin (n=922) and MIDUS studies (n=1,015). In both studies, participants who experienced more childhood adversity had lower cardiovascular reactivity. In addition, people with lower cardiovascular reactivity had poorer self-reported health and greater inflammation. Dunedin participants with lower cardiovascular reactivity were aging biologically faster, and MIDUS participants with lower heart rate reactivity had increased risk of early mortality. Cardiovascular reactivity was not associated with hypertension in either study. Results were partially accounted for by greater reactivity among more conscientious, less depressed, and higher-functioning participants. These results suggest that people who experienced childhood adversity have a blunted physiological response, which is associated with poorer health. The findings highlight the importance of accounting for individual differences when assessing cardiovascular reactivity using cognitive stressor tasks.

Cardiovascular Stress Reactivity and Health: Recent Questions and Future Directions

OBJECTIVE

High cardiovascular reactions to psychological stress are associated with the development of hypertension, systemic atherosclerosis, and cardiovascular disease. However, it has become apparent that low biological stress reactivity also may have serious consequences for health, although less is known about the mechanisms of this. The objectives of this narrative review and opinion article are to summarize and consider where we are now in terms of the usefulness of the reactivity hypothesis and reactivity research, given that both ends of the reactivity spectrum seem to be associated with poor health, and to address some of the key criticisms and future challenges for the research area.

METHODS

This review is authored by the members of a panel discussion held at the American Psychosomatic Society meeting in 2019, which included questions such as the following: How do we measure high and low reactivity? Can high reactivity ever indicate better health? Does low or blunted reactivity simply reflect less effort on task challenges? Where does low reactivity originate from, and what is a low reactor?

RESULTS

Cardiovascular (and cortisol) stress reactivity are used as a model to demonstrate an increased understanding of the different individual pathways from stress responses to health/disease and show the challenges of how to understand and best use the reconstruction of the long-standing reactivity hypothesis given recent data.

CONCLUSIONS

This discussion elucidates the gaps in knowledge and key research issues that still remain to be addressed in this field, and that systematic reviews and meta-analyses continue to be required.

Sympathetic involvement in time-constrained sequential foraging

Appraising sequential offers relative to an unknown future opportunity and a time cost requires an optimization policy that draws on a learned estimate of an environment’s richness. Converging evidence points to a learning asymmetry, whereby estimates of this richness update with a bias toward integrating positive information. We replicate this bias in a sequential foraging (prey selection) task and probe associated activation within the sympathetic branch of the autonomic system, using trial-by-trial measures of simultaneously recorded cardiac autonomic physiology. We reveal a unique adaptive role for the sympathetic branch in learning. It was specifically associated with adaptation to a deteriorating environment: it correlated with both the rate of negative information integration in belief estimates and downward changes in moment-to-moment environmental richness, and was predictive of optimal performance on the task. The findings are consistent with a framework whereby autonomic function supports the learning demands of prey selection.

Social observation increases the cardiovascular response of hearing-impaired listeners during a speech reception task

Certain cardiovascular measures allow for distinction between sympathetic and parasympathetic nervous system activity. Applied during listening, these measures may provide a novel and complementary insight into listening effort. To date, few studies have implemented cardiovascular measures of listening effort and seldom have these included hearing-impaired participants. These studies have generally measured changes in cardiovascular parameters while manipulating environmental factors, such as listening difficulty. Yet, listening effort is also known to be moderated by individual factors, including the importance of performing successfully. In this study, we aimed to manipulate success importance by adding observers to the traditional laboratory set-up. Twenty-nine hearing-impaired participants performed a speech reception task both alone and in the presence of two observers. Auditory stimuli consisted of Danish Hearing in Noise Test (HINT) sentences masked by four-talker babble. Sentences were delivered at two individually adapted signal-to-noise ratios, corresponding to 50 and 80% of sentences correct. We measured change scores, relative to baseline, of pre-ejection period, two indices of heart rate variability, heart rate and blood pressure (systolic, diastolic, and mean arterial pressure). After each condition, participants rated their effort investment, stress, tendency to give up and preference to change the situation to improve audibility. A multivariate analysis revealed that cardiovascular reactivity increased in the presence of the observers, compared to when the task was performed alone. More specifically, systolic, diastolic, and mean arterial blood pressure increased while observed. Interestingly, participants' subjective ratings were sensitive only to intelligibility level, not the observation state. This study was the first to report results from a range of different cardiovascular variables measured from hearing-impaired participants during a speech reception task. Due to the timing of the observers' presence, we were not able to conclusively attribute these physiological changes to being task related. Therefore, instead of representing listening effort, we suggest that the increased cardiovascular response detected during observation reveals increased physiological stress associated with potential evaluation.

Mental Resilience and Coping With Stress: A Comprehensive, Multi-level Model of Cognitive Processing, Decision Making, and Behavior

Aversive events can evoke strong emotions that trigger cerebral neuroactivity to facilitate behavioral and cognitive shifts to secure physiological stability. However, upon intense and/or chronic exposure to such events, the neural coping processes can be maladaptive and disrupt mental well-being. This maladaptation denotes a pivotal point when psychological stress occurs, which can trigger subconscious, "automatic" neuroreactivity as a defence mechanism to protect the individual from potential danger including overwhelming unpleasant feelings and disturbing or threatening thoughts.The outcomes of maladaptive neural activity are cognitive dysfunctions such as altered memory, decision making, and behavior that impose a risk for mental disorders. Although the neurocognitive phenomena associated with psychological stress are well documented, the complex neural activity and pathways related to stressor detection and stress coping have not been outlined in detail. Accordingly, we define acute and chronic stress-induced pathways, phases, and stages in relation to novel/unpredicted, uncontrollable, and ambiguous stressors. We offer a comprehensive model of the stress-induced alterations associated with multifaceted pathophysiology related to cognitive appraisal and executive functioning in stress.

Stress-Induced Eating Among Racial/Ethnic Groups in the United States: a Systematic Review

OBJECTIVE

Racial/ethnic disparities in obesity may be due, in part, to minority groups consuming more energy-rich diets in response to greater stress exposure. The present study systematically reviewed the literature describing the effects of stress on food consumption among various racial/ethnic groups in the US.

METHODS

PubMed and PsycINFO databases were searched for studies reporting associations between stress and food consumption by different racial/ethnic groups, conducted between January 1, 1999 to November 25, 2019. The search included terms related to food consumption, stress, and race/ethnicity. After screening 3660 records, 30 studies were included for review.

RESULTS

The selected studies assessed diverse stressors and eating constructs; African-American and Hispanic/Latinx were the most commonly studied minority groups. Studies generally supported that diverse forms of stress exposure are associated with reduced healthy eating patterns and increased obesogenic eating patterns across racial/ethnic groups. However, studies that directly compared stress-eating associations among multiple racial/ethnic groups showed mixed results.

CONCLUSION

Members of diverse racial/ethnic groups are susceptible to stress-induced unhealthy eating patterns, though evidence is insufficient to conclude whether the degree of susceptibility differs among groups. Additional studies utilizing observational measures of food intake and culturally sensitive measures of stress are needed to identify the most influential stressors on dietary behaviors, to assess whether some stressors are more salient for given racial/ethnic groups, and to examine the extent to which stress-induced eating contributes to racial/ethnic disparities in obesity and obesity-related diseases.

Gratitude, social support and cardiovascular reactivity to acute psychological stress

The pathways linking gratitude to cardiovascular reactivity (CVR) to acute stress are not fully understood. We examine whether this association is mediated by social support. Healthy adults (N = 178) completed measures of trait gratitude and perceived social support and participated in a standardised mental arithmetic and speech stress testing protocol. Their CVR (i.e., systolic and diastolic blood pressure [SBP, DBP], heart rate [HR], cardiac output [CO] and total peripheral resistance [TPR]) were monitored throughout. Gratitude was positively associated with SBP, DBP and TPR reactivity, with those reporting higher gratitude showing higher CVR. Social support was positively associated with TPR to the maths task. The association between gratitude and TPR was mediated by social support but this was only evident in response to the maths task and not the speech task. These novel findings suggest that CVR may be a potential mechanism underlying the gratitude-physical health link.

Stress Reactivity to the Trier Social Stress Test in Traditional and Virtual Environments: A Meta-Analytic Comparison

OBJECTIVE

The traditional Trier Social Stress Test (TSST) is a widely used standardized stress induction protocol and has recently been adapted in a variety of virtual reality environments (V-TSST). Research has demonstrated the ability of the V-TSST to induce a stress reactivity response measured via cortisol, heart rate, and self-report. However, research comparing stress reactivity induced via the V-TSST to the traditional TSST across neuroendocrine, cardiovascular, and self-report variables has not yet been systematically and quantitatively reviewed.

METHODS

In this meta-analytic review, the existing studies that used V-TSST were gathered, and each was age and sex matched with samples using the traditional TSST. These studies were then meta-analytically synthesized to determine if there was a moderating effect of TSST type (traditional TSST or V-TSST) on multiple measures of stress reactivity (i.e., cortisol, heart rate, and self-report).

RESULTS

Examining the pre-post stress induction, the V-TSST studies demonstrated comparable effect sizes (ESs) for stress reactivity (cortisol ES = 0.61, heart rate ES = 0.98, self-reported stress ES = 0.94) to traditional TSST study ESs (cortisol ES = 0.79, heart rate ES = 0.85, self-reported stress ES = 0.85).

CONCLUSIONS

The TSST type differences between ESs were not statistically significant, indicating that the V-TSST is as effective as the traditional TSST at eliciting a physiological and self-reported stress reactivity response. Implications and limitations of this meta-analysis are discussed, and recommendations for future research are provided.

The cardiovascular response to acute psychological stress is related to subjectively giving and receiving social support

The pathways linking giving and receiving emotional and instrumental social support, and cardiovascular reactivity (CVR) are not yet fully understood. Eight-two healthy young adults completed psychometric measures of giving and receiving emotional and instrumental social support and participated in a standardised laboratory stress task. Cardiovascular and hemodynamic parameters were monitored throughout. Both giving and receiving emotional support were positively associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), such that those reporting giving and receiving more emotional support had higher reactivity. Only receiving instrumental was associated with DBP, with those receiving more instrumental support having higher reactivity. Moreover, while the significant association between giving social support and CVR withstood adjustment for several confounding factors (e.g., BMI, sex) it was abolished when receiving support was controlled for. These findings are novel and extend the literature on social support and CVR. Taken together, these findings suggest that receipt of support, rather than giving, may be more influential in this context.

Hyper- and hypo-cortisol functioning in post-institutionalized adolescents: The role of severity of neglect and context

Understanding the developmental timing of stress exposure may help inform mechanisms underlying how stress "gets under the skin" and influences the stress response system, including the HPA axis and its end-product cortisol. Early adversity may be particularly detrimental; however, it is difficult to disentangle the timing of adversity from its cumulative burden because there is typically high continuity between early and later adversity. Moreover, context and the different stressors inherent in various contexts may interact with stress exposure to influence psychophysiological functioning. To address this issue, we examined adolescents who had been reared in institutions and suffered neglect or social deprivation ranging from approximately six months to several years of life prior to adoption into U.S. homes. We focused on the stress hormone cortisol because it can reflect continued regulatory problems in youth, even years after youth transition to typical homes. We examined cortisol morning levels and diurnal rhythms across multiple contexts (home, school, lab) on 5 separate days in 41 post-institutionalized youth and 78 comparison youth. Employing hierarchical linear modeling, we found that when assessed in the lab, post-institutionalized (PI) youth displayed lower morning cortisol levels and flatter diurnal slopes than the control youth. Yet at home, PI youth displayed higher morning cortisol levels than the control youth. In addition to group effects, we also examined severity of early adversity and found that PI kids who had endured the most severe early adversity displayed lower home cortisol levels than controls. No significant predictors of diurnal cortisol on school days were identified. These data fit with the notion that the HPA axis is impacted by early adversity, even years after adoption, and with emerging theories that postulate that stress physiology calibrates within youth to help them adapt to their context. In the case of severe early adversity, the cost of such adaptation may not be desirable. It also highlights the important role of context when assessing HPA axis activity, particularly in post-institutionalized youth.

Multi-modal responses to the Virtual Reality Trier Social Stress Test: A comparison with standard interpersonal and control conditions

The Trier Social Stress Test (TSST) is a reliable social-evaluative stressor. To overcome limitations of the in vivo TSST, a standardized virtual reality TSST (VR-TSST) was developed. The present study compares the emotional (anxiety) and physiological (heart period and variability) response to a VR-TSST with an in vivo TSST and a control condition. Participants took part in either an in vivo TSST (N = 106, 64% female), VR-TSST (N = 52, 100% female), or a control TSST (N = 20, 40% female). Mixed linear modeling examined response profile differences related to TSST type. While there was an equivalent anxiety response to the in vivo TSST as the VR-TSST, we found a smaller heart period and heart rate variability response in VR-TSST compared to the in vivo TSST, especially in response to the math part of the test. The present findings demonstrate that social evaluative stress can be successfully induced in a VR setting, producing similar emotional and slightly attenuated cardiovascular responses.

Associations between multisystem stress reactivity and peer nominated aggression in early childhood vary by sex

There is emerging evidence that the development of problematic aggression in childhood may be associated with specific physiological stress response patterns, with both biological overactivation and underactivation implicated. This study tested associations between sex-specific patterns of stress responses across the sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis and peer nominations of aggression among 271 kindergarten children (Mean age = 5.32 years; 52% Female; 44% White). Upon entry to kindergarten, children participated in a multidomain standardized stress paradigm. Changes in pre-ejection period (PEP) and salivary cortisol were assessed. On a separate day, children provided peer ratings of physical and relational aggression in a standardized interview. As expected, there was a significant three-way interaction between PEP, cortisol reactivity, and sex, but only for physical aggression. Among boys, cortisol reactivity was positively associated with physical aggression only for those with higher SNS reactivity. Findings suggest that for boys, asymmetrical and symmetrical HPA/SNS reactivity may be associated with lower and higher risk for peer-directed physical aggression, respectively. Understanding the complex associations between multisystem physiology, child sex and peer-directed aggression in early childhood may offer insight into individual differences underlying the emergence of behavioral dysregulation in early peer contexts.

Music performance anxiety from the challenge and threat perspective: psychophysiological and performance outcomes

Background

Although many musicians perceive music performance anxiety (MPA) as a significant problem, studies about the psychobiological and performance-related concomitants of MPA are limited. Using the biopsychosocial model of challenge and threat as theoretical framework, we aim to investigate whether musicians’ changes in their psychobiological responses and performance quality from a private to a public performance are moderated by their general MPA level. According to the challenge and threat framework, individuals are in a threat state when the perceived demands of a performance situation outweigh the perceived resources, whereas they are in a challenge state when the perceived resources outweigh the perceived demands. The resources-demands differential (resources minus demands) and the cardiovascular challenge-threat index (sum of cardiac output and reverse scored total peripheral resistance) are the main indices of these states. We postulate that the relationship between general MPA level and performance quality is mediated by these challenge and threat measures.

Methods

We will test 100 university music students reporting general MPA levels ranging from low to high. They will perform privately (i.e., without audience) and publicly (i.e., with an audience) on two separate days in counterbalanced order. During each performance session, we will record their cardiovascular and respiratory activity and collect saliva samples and self-reported measures. Measures of primary interest are self-reported anxiety, the resources-demands differential, the cardiovascular challenge-threat index, sigh rate, total respiratory variability, partial pressure of end-tidal carbon dioxide and the salivary biomarkers cortisol, dehydroepiandrosterone, and alpha-amylase. Both, the participants and anonymous experts will evaluate the performance quality from audio recordings.

Discussion

The results of the planned project are expected to contribute to a more comprehensive understanding of the psychobiology of MPA and of the processes that influence musicians’ individual reactions to performance situations. We also anticipate the findings of this project to have important implications for the development and implementation of theory-based interventions aimed at managing musicians’ anxiety and improving performance quality. Thanks to the use of multimethod approaches incorporating psychobiology, it might be possible to better assess the progress and success of interventions and ultimately improve musicians’ chance to have a successful professional career.

Trial registration

Not applicable.

Type D personality and cardiovascular reactivity to acute stress: The mediating effects of social support and negative social relationships

Type D personality has been consistently associated with adverse cardiovascular health with atypical cardiovascular reactions to psychological stress one potential underlying mechanism. As Type D individuals have been noted to report lower social support and greater perceptions of negativity in social interactions, this study examined if the association between Type D personality and cardiovascular reactivity was mediated by these social relationships. A sample of 195 undergraduate students (138 female) participated in this observational study, where they completed measures assessing Type D personality (DS14), social support, and perceptions of negative social relationships (National Institute of Health social relationship scales), before undergoing a traditional cardiovascular reactivity protocol. Systolic and diastolic blood pressure (SBP; DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) were monitored throughout. ANCOVAs and regressions indicated that Type D personality was associated with lower cardiovascular reactivity to a mental arithmetic stressor. Furthermore, mediation analyses (process macro) indicated that the relationship between Type D personality and cardiovascular reactivity was mediated via increased perceptions of negative social relationships, as well as lower levels of social support. Apart from a significant association between Type D personality and increased HR reactivity, all results failed to withstand adjustment for the individual effects of negative affect (NA) and social inhibition (SI) in controlled analyses. Overall, these findings suggest that the predictive utility of Type D personality on cardiovascular reactivity above and beyond the individual effects of NA and SI is limited, and may vary depending on the cardiovascular parameter of focus.

The Interaction Between Physical and Psychosocial Stressors

Do physical and psychosocial stressors interact to increase stress in ways not explainable by the stressors alone? A preliminary study compared participants' stress response while subjected to a physical stressor (reduced or full physical load) and a predetermined social stressor (confronted by calm or aggressive behavior). Salivary cortisol samples measured endocrine stress. Heart rate variability (HRV) and electrodermal activity (EDA) measured autonomic stress. Perceived stress was measured via discomfort and stress state surveys. Participants with a heavier load reported increased distress and discomfort. Encountering an aggressive individual increased endocrine stress, distress levels, and perceived discomfort. Higher autonomic stress and discomfort were found in participants with heavier physical load and aggressive individuals. The results suggest a relationship where physical load increases the stressfulness of aggressive behavior in ways not explainable by the effects of the stressors alone. Future research is needed to confirm this investigation's findings.

Focusing attention on biological markers of acute stressor intensity: Empirical evidence and limitations

ARMARIO, A, J. Labad and R. Nadal. Focusing attention on biological markers of acute stressor intensity: empirical evidence and limitations. NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS. The availability of biological markers that objectively quantify stress is a highly relevant issue. However, experimental evidence suggests that most physiological changes elicited by emotional stressors do not reflect their intensity and are not useful for this purpose. Thus, we review experimental evidence in animals and humans about the putative validity of neuroendocrine and sympathetic/parasympathetic variables to measure stress. Plasma levels of some hormones (e.g. ACTH, glucocorticoids, prolactin and catecholamines) have been found to reflect, at least under certain conditions, the intensity of emotional stressors in animals and probably in humans. However, the temporal resolution of hormone changes is insufficient to reflect the very dynamic psychological processes taking place while experiencing stressors. Cardiovascular parameters (e.g. heart rate and blood pressure) have much better temporal resolution but their validity as markers of stressor intensity either in animals or humans is problematic. Skin conductance and pupil dilation appear to be promising. Additional and more systematic studies are needed to demonstrate the actual validity of stress-induced physiological changes to quantify stress.

The short Sing-a-Song Stress Test: A practical and valid test of autonomic responses induced by social-evaluative stress

The Sing-a-Song Stress Test (SSST) was recently developed as an alternative to the Trier Social Stress Test (TSST) to investigate autonomic nervous system responses to social-evaluative stress. In the SSST, participants are suddenly cued to sing a song in the presence of confederates. However, the SSST is still quite long (~15 min) and the requirement for confederates makes it labor-intensive. The current study tested whether a shorter (~6.5 min), single-experimenter, version of the SSST can still reliably elicit subjective and physiological stress reactivity. Our sample consisted of 87 healthy young adult participants (age range: 18-35 years). During the short SSST and a speeded reaction time task, in which aversive loud tones were to be avoided (TA), we measured heart period (HP), sympathetic nervous system (SNS) activity using pre-ejection-period (PEP), skin conductance level (SCL), and non-specific skin conductance responses (ns.SCR), and parasympathetic nervous system (PNS) activity using respiratory-sinus-arrhythmia (RSA) and the root-mean-square of successive differences (RMSSD). The short SSST induced significant decreases in positive affect and increases in negative affect. MANOVAs on the clusters of SNS and PNS variables showed that the short SSST elicited significant HP (-118.46 ms), PEP (-7.76 ms), SCL (+4.85 μS), ns.SCR (+8.42 peaks/min) and RMSSD (-14.67) reactivity. Affective, SNS, and PNS reactivity to the new SSST social-evaluative stress task were of comparable magnitude to that evoked by the TA mental stressor. We conclude that the short SSST is a valid and cost-effective task for large scaled studies to induce social-evaluative stress to a sufficient degree to evoke measurable changes in PNS and SNS activity and affective state.

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

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

Ventromedial prefrontal cortex connectivity during and after psychological stress in women

The ventromedial prefrontal cortex (vmPFC) integrates sensory, affective, memory-related, and social information from diverse brain systems to coordinate behavioral and peripheral physiological responses according to contextual demands that are appraised as stressful. However, the functionality of the vmPFC during stressful experiences is not fully understood. Among 40 female participants, the present study evaluated (a) functional connectivity of the vmPFC during exposure to and recovery following an acute psychological stressor, (b) associations among vmPFC functional connectivity, heart rate, and subjective reports of stress across individuals, and (c) whether patterns of vmPFC functional connectivity were associated with distributed brain networks. Results showed that psychological stress increased vmPFC functional connectivity with individual brain areas implicated in stressor processing (e.g., insula, amygdala, anterior cingulate cortex) and decreased connectivity with the posterior cingulate cortex and thalamus. There were no statistical differences in vmPFC connectivity to individual brain areas during recovery, as compared with baseline. Spatial similarity analyses revealed stressor-evoked increased connectivity of the vmPFC with the so-called dorsal attention, ventral attention, and frontoparietal networks, as well as decreased connectivity with the default mode network. During recovery, vmPFC connectivity increased with the frontoparietal network. Finally, individual differences in heart rate and perceived stress were associated with vmPFC connectivity to the ventral attention, frontoparietal, and default mode networks. Psychological stress appears to alter network-level functional connectivity of the vmPFC in a manner that further relates to individual differences in stressor-evoked cardiovascular and affective reactivity.

Neuroendocrine and cardiovascular responses to shifting status

We review recent work on human neuroendocrine and cardiovascular responses to stable and unstable status. We describe experiments examining inter-personal and inter-group contexts, involving both experimentally created as well as naturalistic (gender, SES) status differences. Across studies the pattern of results is clear: Stable status differences are stressful for those low in status, which is evident from increased cortisol and a cardiovascular response-pattern indicative of threat (low cardiac output, high vascular resistance); however, when status differences are unstable the same effects are found among those high in status, while those low in status show challenge (low vascular resistance, high cardiac output). Potential status-loss also leads to increased testosterone. We discuss implications and suggestions for further research.

Adrenocortical and autonomic attunement between romantic partners in emerging adulthood

Parent-child physiological attunement, particularly during stressful situations, appears adaptive as shared stress reactivity may promote dyadic engagement. Romantic partners eventually replace parents as the primary support figure, yet it remains unclear whether romantic partners buffer physiological stress or display physiological attunement as most studies on adults examine attunement during conflict paradigms. The present study examined physiological attunement in 63 emerging adult romantic partner dyads (one partner was the active participant, the other the observer) during the Trier Social Stress Task (TSST). Heart rate (HR) and respiratory sinus arrhythmia (RSA) were continuously monitored across the visit. Repeated saliva samples were assayed for cortisol. Physiological attunement was operationalized as a correlation in biomarkers between the TSST participant and their partner; sex, social support, and physical proximity were examined as moderators. We then compared the biomarker profiles of partnered-TSST participants to individuals who participated in the TSST solo (n = 63) to determine if partner presence buffered stress biomarker reactivity during the TSST. RSA attunement between partners was found but was not further moderated by social support or sex. Adrenocortical attunement was moderated, such that lower social support and increased proximity resulted in higher attunement. HR attunement was higher when the participant was male and when partners were in close physical proximity. Compared to TSST solo, romantic partner presence increased participant cortisol levels and altered HR reactivity, suggesting that emerging adult romantic partners do not buffer physiological stress reactivity. Future research should examine whether physiological attunement and partner presence is protective in more established relationships.

Social inhibition in population-based and cardiac patient samples: Robustness of inhibition, sensitivity and withdrawal as distinct facets

OBJECTIVE

Behavioral inhibition plays a key role in animal stress research and developmental research in children. Therefore, we examined the robustness of our multifaceted model of adult social inhibition that comprises behavioral inhibition, interpersonal sensitivity, and social withdrawal components.

METHOD

A total of 899 adults completed the 15-item Social Inhibition Questionnaire (SIQ15) and measures of emotional distress. Confirmatory Factor Analysis (CFA), reliability estimates, and correlational and second-order factor analyses were used to examine the robustness of our model.

RESULTS

CFA (RMSEA = 0.052; NFI = 0.938; CFI = 0.957) and Cronbach's α estimates ≥0.87 confirmed the robustness of our multi-facet social inhibition model based on three correlated inhibition, sensitivity, and withdrawal factors in 560 adults from the general population and in 194 undergraduate students. Inhibition, sensitivity, and withdrawal were stable over time (3-month test-retest correlations ≥ 0.78), and were closely related to the Gest Behavioral Inhibition and PID-5 Withdrawal measures in a clinical sample of 145 cardiac patients. Of note, male cardiac patients reported more inhibition and withdrawal than female patients. Across samples, social inhibition was distinctly different from negative affectivity.

CONCLUSIONS

Our 3-facet model of inhibition, sensitivity and withdrawal was robust across samples, and may promote research on adult social inhibition in population-based and clinical studies.

The multidimensional nature of adult social inhibition: Inhibition, sensitivity and withdrawal facets of the SIQ15

BACKGROUND

Social inhibition may promote emotional problems in children, but little is known about this disposition in adults. Our research builds on a theory-based model to suggest that adult social inhibition involves distinct behavioral (inhibition), cognitive (sensitivity), and affective (withdrawal) characteristics.

METHODS

A total of 1385 adults completed measures of social inhibition, emotional distress, and social stress. Factor analyses, reliability estimates and regression analyses were used to examine the robustness of our model, and the validity of the 15-item Social Inhibition Questionnaire (SIQ15).

RESULTS

In Study 1 (N = 1180; M_age 46.9 years; 52% women), factor analysis confirmed that behavioral inhibition, interpersonal sensitivity, and social withdrawal reflected distinct facets of social inhibition. Next, we developed the SIQ15 that covers these facets with 5 items each; e.g. has difficulty making contact; expects negative reactions from others; keeps others at a distance. Study 2 (N = 209; M_age 20.3 years; 77% women) showed that the SIQ15 and its 5-item Inhibition, Sensitivity and Withdrawal facet scales were internally consistent (Cronbach's α between 0.86/0.94) and stable over time (test-retest between r = 0.73/0.78). The SIQ15 facets differentially predicted related inhibition (Behavioral Inhibition Scale), rumination (Penn State Worry Questionnaire) and withdrawal (Personality Inventory for DSM-5) scores at 6 months follow-up. Younger age and having no partner were associated with more social inhibition.

LIMITATIONS

Findings are based on self-report; experimental and prospective studies are needed to further validate our inhibition model.

CONCLUSIONS

Inhibition, sensitivity, and withdrawal are distinct manifestations of adult social inhibition that can be reliably assessed with the SIQ15. Research needs to examine how this multidimensional nature of social inhibition has an effect on stress, health, and wellbeing.

The neuromodulatory and hormonal effects of transcutaneous vagus nerve stimulation as evidenced by salivary alpha amylase, salivary cortisol, pupil diameter, and the P3 event-related potential

BACKGROUND

Transcutaneous vagus nerve stimulation (tVNS) is a new, non-invasive technique being investigated as an intervention for a variety of clinical disorders, including epilepsy and depression. It is thought to exert its therapeutic effect by increasing central norepinephrine (NE) activity, but the evidence supporting this notion is limited.

OBJECTIVE

In order to test for an impact of tVNS on psychophysiological and hormonal indices of noradrenergic function, we applied tVNS in concert with assessment of salivary alpha amylase (SAA) and cortisol, pupil size, and electroencephalograph (EEG) recordings.

METHODS

Across three experiments, we applied real and sham tVNS to 61 healthy participants while they performed a set of simple stimulus-discrimination tasks. Before and after the task, as well as during one break, participants provided saliva samples and had their pupil size recorded. EEG was recorded throughout the task. The target for tVNS was the cymba conchae, which is heavily innervated by the auricular branch of the vagus nerve. Sham stimulation was applied to the ear lobe.

RESULTS

P3 amplitude was not affected by tVNS (Experiment 1A: N = 24; Experiment 1B: N = 20; Bayes factor supporting null model = 4.53), nor was pupil size (Experiment 2: N = 16; interaction of treatment and time: p = .79). However, tVNS increased SAA (Experiments 1A and 2: N = 25) and attenuated the decline of salivary cortisol compared to sham (Experiment 2: N = 17), as indicated by significant interactions involving treatment and time (p = .023 and p = .040, respectively).

CONCLUSION

These findings suggest that tVNS modulates hormonal indices but not psychophysiological indices of noradrenergic function.

Physiological and behavioral reactivity to social exclusion: a functional infrared thermal imaging study in patients with psoriasis

Recent studies have shown that sympathetic nervous system (SNS) activity can be heavily impacted not only by basic threats to survival but also by threats to social bonds. In this study we explored the behavioral and physiological consequences of social exclusion/inclusion in patients with psoriasis, a disease frequently associated with the experience of being ostracized and with deficient emotion regulation skills. We employed a virtual ball-tossing game (Cyberball) to induce the experience of social exclusion/inclusion. We then used a Trust Game to measure the effects of this social modulation on trust. During Cyberball, infrared thermal imaging was used to record participants' facial temperature and thus obtain an online measure of SNS activation. Behavioral data showed that social exclusion shifted participants' trust toward unfamiliar players who had not previously excluded them. Physiological data indicated that in control participants, social exclusion triggered higher SNS activation than inclusion. No such effect was found in patients with psoriasis, whose SNS activity was the same during inclusion as it was during exclusion, suggesting that they benefit less from inclusive experiences than control participants. In addition, in patients but not in controls, higher SNS activation during social exclusion was linked to higher monetary investment toward unfamiliar players, a result in keeping with the social reconnection hypothesis, according to which emotions triggered by social rejection can be regulated by investing in new social interactions. We also found that an increase in periorbital temperature is accompanied by a decrease in happiness ratings after social exclusion was experienced during the Cyberball game. NEW & NOTEWORTHY Previous research on emotional processes in psoriasis has mainly employed self-report measures. In this study we used thermal imaging to obtain an online measure of the sympathetic nervous system (SNS) activity during social exclusion and tested how this experience influenced subsequent trust. We found that being included was a less positive experience for patients compared with controls and that SNS activity during exclusion had a stronger influence on subsequent trust in patients than in controls.

The role of bicultural adaptation, familism, and family conflict in Mexican American adolescents' cortisol reactivity

Scarce research has examined stress responsivity among Latino youths, and no studies have focused on the role of acculturation in shaping cortisol stress response in this population. This study assessed Mexican American adolescents' Mexican and Anglo cultural orientations and examined prospective associations between their patterns of bicultural orientation and hypothalamic-pituitary-adrenal cortisol reactivity to an adapted Trier Social Stress Test. The sample included 264 youths from a longitudinal birth cohort study who completed the Trier Social Stress Test and provided saliva samples at age 14. The youths completed assessments of cultural orientation at age 12, and family conflict and familism at age 14. Analyses testing the interactive effects of Anglo and Mexican orientation showed significant associations with cortisol responsivity, including the reactivity slope, peak levels, and recovery, but these associations were not mediated by family conflict nor familism values. Findings revealed that bicultural youth (high on both Anglo and Mexican orientations) showed an expected pattern of high cortisol responsivity, which may be adaptive in the context of a strong acute stressor, whereas individuals endorsing only high levels of Anglo orientation had a blunted cortisol response. Findings are discussed in relation to research on biculturalism and the trade-offs and potential recalibration of a contextually responsive hypothalamic-pituitary-adrenal axis for acculturating adolescents.

Association between changes in heart rate variability during the anticipation of a stressful situation and the stress-induced cortisol response

Vagal activity - reflecting the activation of stress regulatory mechanisms and prefrontal cortex activation - is thought to play an inhibitory role in the regulation of the hypothalamus-pituitary-adrenal axis. However, most studies investigating the association between stress-induced changes in heart rate variability (HRV, an index of cardiac vagal tone) and cortisol have shown a non-significant relationship. It has been proposed that physiological changes observed during anticipation of a stressor allow individuals to make behavioral, cognitive, and physiological adjustments that are necessary to deal with the upcoming actual stressor. In this study, in a large sample of 171 healthy adults (96 men and 75 women; mean age = 29.98, SD = 11.07), we investigated whether the cortisol response to a laboratory-based stress task was related to anticipation-induced or stress task-induced changes in HRV. As expected, regression analyses showed that a larger decrease in HRV during the anticipation of a stress task was related to higher stress task-induced cortisol increase, but not cortisol recovery. In line with prior research, the stress task-induced change in HRV was not significantly related to cortisol increase or recovery. Our results show for the first time that anticipatory HRV (reflecting differences in stress regulation and prefrontal activity before the encounter with the stressor) is important to understand the stress-induced cortisol increase.