Life Stress and Health: A Review of Conceptual Issues and Recent Findings

Chronic Physiological Dysregulation and Changes in Depressive Symptoms: Testing Sex and Race as Vulnerability Factors

Depression is a growing public health concern that affects approximately 5% of adults in their lifetime (WHO in Depression, 2021). Understanding the biological correlates of depression is imperative for advancing treatment. Of particular interest is allostatic load, a multisystem indicator of chronic physiological dysregulation (McEwen and Seeman in, Ann N Y Acad Sci, 1999). The current longitudinal study examined the association between allostatic load, depressive symptoms, and the moderating roles of sex and race. Participants consisted of 150 young adults (Mage = 18.81) who reported their demographics and depressive symptoms at T1 and T2, a year and a half later. Allostatic load was computed using indicators of metabolic, cardiovascular, and neuroendocrine functioning. Allostatic load was found to predict changes in depressive symptoms. Moreover, interaction effects models revealed that the associations between allostatic load and depressive symptoms at follow-up were further influenced by sex, such that the relationship was significant for males, with pronounced effects for Black males in particular. Black males may be particularly vulnerable to the mental health consequences of biological dysregulation.

Multi-discrimination exposure and biological aging: Results from the midlife in the United States study

Discrimination is a social determinant of health and health disparities for which the biological mechanisms remain poorly understood. This study investigated the hypothesis that discrimination contributes to poor health outcomes by accelerating biological processes of aging. We analyzed survey and blood DNA methylation data from the Midlife in the United States (MIDUS) study (N = 1967). We used linear regression analysis to test associations of everyday, major, and workplace discrimination with biological aging measured by the DunedinPACE, PhenoAge, and GrimAge2 epigenetic clocks. MIDUS participants who reported more discrimination tended to exhibit a faster pace of aging and older biological age as compared to peers who reported less discrimination. Effect-sizes for associations tended to be larger for the DunedinPACE pace-of-aging clock (effect-size range r = 0.1-0.2) as compared with the PhenoAge and GrimAge2 biological-age clocks (effect-sizes r < 0.1) and for experiences of everyday and major discrimination as compared with workplace discrimination. Smoking status and body-mass index accounted for roughly half of observed association between discrimination and biological aging. Reports of discrimination were more strongly associated with accelerated biological aging among White as compared with Black participants, although Black participants reported more discrimination overall and tended to exhibit older biological age and faster biological aging. Findings support the hypothesis that experiences of interpersonal discrimination contribute to accelerated biological aging and suggest that structural and individual-level interventions to reduce discrimination and promote adaptive coping have potential to support healthy aging and build health equity.

An examination of the relationship between sport performers' organizational stressor dimensions, physical health, and well-being

Whilst research has assessed the multidimensionality of organizational stressors, severity has been overlooked. This study aimed to develop and validate a severity response scale, before examining the relationship between organizational stressor severity, physical health, and well-being, and if severity mediated the relationship between stressor occurrence and outcomes. 403 sport performers (186 male; Mage = 21.43) completed a questionnaire assessing study variables and data were analysed using structural equation modelling. Organizational stressor severity had a significant, negative relationship with physical health (r = -.374, p < .001), but notwith hedonic or eudaimonic well-being (p = .624 and .203). Direct effects were found for neuroticism (β = -0.632, p < .001) and stressor frequency (β = -0.226, p = .016) on physical health; however, when adding severity as a mediator, stressor frequency positively predicted stressor severity (β = 1.025, p < .001); however, the indirect effect of stressor frequency on physical health via stressor severity (β = -0.018, p = .885) and the direct effect between stressor frequency and physical health (β = -0.191, p = .204) were non-significant. These novel findings highlight that higher stressor severity is associated with higher physical health complaints, and that repeated exposure to stressors may heighten an vulnerability to future stressors.

How is momentary well-being and stress associated in persons with spinal cord injury and their romantic partners? A study protocol for a dyadic everyday life study

INTRODUCTION

Very little is known about daily life dynamics and mutual influences that tie together well-being and psychobiological stress responses in persons with spinal cord injury (SCI) and their romantic partners in particular. The role of social support and physical activity in the associations between emotional well-being and stress has not been investigated in the context of SCI yet and studies applying a dyadic approach, exploring the role of a romantic partner, are currently unavailable. The overall objective is thus to better understand the interplay between emotional well-being and the psychobiological stress marker cortisol, and to investigate the potentially moderating role of social support and physical activity in the well-being-stress association among persons with SCI and their romantic partners using a dyadic perspective.

METHODS AND ANALYSIS

The stRess and Health Among romantic couPles with Spinal cOrD injurY study, funded by the Swiss National Science Foundation (10001C_204739), aims to recruit N=150 community-dwelling persons with SCI and their romantic partners including three phases of data collection. The first phase includes a baseline questionnaire. The second phase, the time sampling phase, comprises an ecological momentary assessment design in the everyday life of couples where both partners provide concurrent salivary cortisol samples five times a day and complete assessments four times a day over seven consecutive days. Wrist-worn accelerometers record physical activity during this period. The third phase is an observational study in the laboratory, where a couples' discussion on the SCI management in their everyday life is recorded and coded to identify a couple-specific coping with SCI to enrich data. The dyadic data will be analysed using multilevel modelling, based on the actor-partner interdependence model framework.

ETHICS AND DISSEMINATION

The study was approved by the ethics committee of Northwest and Central Switzerland (2022-01072) and findings will be disseminated through peer-reviewed publications and conference presentations.

Stress exposure, perceived stress, protective psychosocial factors, and health status in Ukraine after the full-scale invasion

The concept of stress as a cause of ill health has received much attention in social sciences. The distinction between stress exposure and perceived stress emphasizes the importance of cognitive dimension of stress. This quantitative study (N = 213) conducted in Ukraine in November 2022 collected self-reported cognitive data on stress exposure, perceived stress, and self-rated heath. The goals of the study included (1) testing if stress exposure and perceived stress differ in terms of breadth and depth of their impact; (2) isolating psychosocial factors that reduce stress; and (3) testing if individuals who have relocated within Ukraine or abroad to escape the war had worse health outcomes than those who remained at their domiciles. The results suggest that while perceived stress was a stronger predictor of negative health outcomes, optimism and social support served as protective psychosocial factors. Having moved abroad predicted higher stress levels and more adverse health symptoms.

The effects of childhood adversity on twenty-five disease biomarkers and twenty health conditions in adulthood: Differences by sex and stressor type

BACKGROUND

Although early adversity is now recognized as a major public health concern, it remains unclear if the effects of early-life stressors on disease biology and health differ by sex or stressor type. Because childhood stressors often covary, examining whether such stressors typically occur together (e.g., cumulative adversity) or in distinct multivariate patterns is needed to determine if and how different life stressors uniquely affect disease biology and health.

METHOD

To investigate, we conducted latent class analyses (LCA) to identify clusters of adults experiencing multiple childhood stressors (N = 2,111, Mage = 53.04, 54.8% female) in the Midlife in the United States (MIDUS) Study. We then tested how latent stressor exposure groups, and individual stressors, related to 25 biomarkers of inflammation, metabolism, and stress, and 20 major health conditions. Multivariate effect sizes were estimated using Mahalanobis's D.

RESULTS

Optimal LCA models yielded three female (Low-, Moderate-, and High-Stress) and two male (Low- and High-Stress) stressor exposure classes. The High-Stress classes had greater inflammation (male: D = 0.43; female: D = 0.59) and poorer metabolic health (male: D = 0.32-0.33; female: D = 0.32-0.47). They also had more cardiovascular (male: HR = 1.56 [1.17, 2.07]; female: HR = 1.97 [1.50, 2.58]), cancer (male: HR = 2.41 [1.52, 3.84]; female: HR = 2.51 [1.45, 4.35]), metabolic (male: HR = 1.54 [1.16, 2.03]; female: HR = 2.01 [1.43, 2.83]), thyroid (male: HR = 3.65 [1.87, 7.12]; female: HR = 2.25 [1.36, 3.74]), arthritis (male: HR = 1.81 [1.30, 2.54]; female: HR = 1.97 [1.41, 2.74]), and mental/behavioral health problems (male: HR = 2.62 [1.90, 3.62]; female; HR = 3.67 [2.72, 4.94]). Moreover, stressors were related to these outcomes in a sex- and stressor-specific manner.

CONCLUSIONS

Childhood adversity portends worse biological health and elevated risk for many major health problems in a sex- and stressor-specific manner. These findings advance stress theory, and may help inform precision interventions for managing stress and enhancing resilience.

Effects of acute stress on reward processing: A comprehensive meta-analysis of rodent and human studies

Stressors can initiate a cascade of central and peripheral changes that modulate mesocorticolimbic dopaminergic circuits and, ultimately, behavioral response to rewards. Driven by the absence of conclusive evidence on this topic and the Research Domain Criteria framework, random-effects meta-analyses were adopted to quantify the effects of acute stressors on reward responsiveness, valuation, and learning in rodent and human subjects. In rodents, acute stress reduced reward responsiveness (g = -1.43) and valuation (g = -0.32), while amplifying reward learning (g = 1.17). In humans, acute stress had marginal effects on valuation (g = 0.25), without affecting responsiveness and learning. Moderation analyses suggest that acute stress neither has unitary effects on reward processing in rodents nor in humans and that the duration of the stressor and specificity of reward experience (i.e., food vs drugs) may produce qualitatively and quantitatively different behavioral endpoints. Subgroup analyses failed to reduce heterogeneity, which, together with the presence of publication bias, pose caution on the conclusions that can be drawn and point to the need of guidelines for the conduction of future studies in the field.

Human immune and metabolic biomarker levels, and stress-biomarker associations, differ by season: Implications for biomedical health research

Although seasonal changes in physiology are well documented, little is known about how human immune and metabolic markers vary across seasons, and no studies have examined how stress → health biomarker associations differ across the year. To investigate these issues, we analyzed data from 2118 participants of the Midlife in the United States (MIDUS) study to determine whether there were differences in (a) levels of 19 immune and metabolic markers, and (b) the association between perceived stress and each biomarker across the year. Results of component-wide boosted generalized additive models revealed seasonal patterning for most biomarkers, with immune proteins generally peaking when days were shorter. Moreover, whereas levels of hemoglobin A1C rose from late fall to spring, triglycerides were elevated in the summer and fall, and high-density lipoprotein decreased steadily from January to December. Urinary cortisol and cortisone exhibited opposite patterns, peaking at the beginning and end of the year, respectively. Most critically, we found that the effects of perceived stress on 18 of the 19 health biomarkers assessed varied by month of measurement. In some cases, these differences involved the magnitude of the stress → biomarker association but, in other cases, it was the direction of the effect that changed. Studies that do not account for month of biomarker assessment may thus yield misleading or unreproducible results.

Impact of lifetime stressor exposure on neuroenergetics in schizophrenia spectrum disorders

N-acetylasparate and lactate are two prominent brain metabolites closely related to mitochondrial functioning. Prior research revealing lower levels of NAA and higher levels of lactate in the cerebral cortex of patients with schizophrenia suggest possible abnormalities in the energy supply pathway necessary for brain function. Given that stress and adversity are a strong risk factor for a variety of mental health problems, including psychotic disorders, we investigated the hypothesis that stress contributes to abnormal neuroenergetics in patients with schizophrenia. To test this hypothesis, we used the Stress and Adversity Inventory (STRAIN) to comprehensively assess the lifetime stressor exposure profiles of 35 patients with schizophrenia spectrum disorders and 33 healthy controls who were also assessed with proton magnetic resonance spectroscopy at the anterior cingulate cortex using 3 Tesla scanner. Consistent with the hypothesis, greater lifetime stressor exposure was significantly associated with lower levels of N-acetylasparate (β = -0.36, p = .005) and higher levels of lactate (β = 0.43, p = .001). Moreover, these results were driven by patients, as these associations were significant for the patient but not control group. Though preliminary, these findings suggest a possible role for stress processes in the pathophysiology of abnormal neuroenergetics in schizophrenia.

Factors associated with self-management behaviors among Chinese adults with ischemic stroke: A cross-sectional study

Background

In China, adults with ischemic stroke are getting younger. Additionally, following a stroke, they often neglect self-management (SM), which significantly impacts the rehabilitation process and treatment outcomes.

Objective

This study aimed to describe SM behavior and examine the relationship between stroke prevention knowledge, life stress, family relationships, and SM behavior among adults with ischemic stroke.

Methods

A total of 125 participants were recruited between October 2022 and March 2023 based on defined inclusion criteria. Research instruments included a demographic questionnaire, the Stroke Self-management Behavior Scale for Young Adults, the Stroke Prevention Knowledge Questionnaire, the Perceived Stress Scale, and the Brief Family Relationship Scale. Data were analyzed using descriptive statistics and Pearson's product-moment correlation.

Results

The mean score of SM behavior was 88.1 out of 130 (SD = 16.5). Stroke prevention knowledge and family relationships showed a moderate positive significant relationship with SM behavior (r = 0.39, r = 0.34, p <0.001, respectively). Life stress had a significant negative relationship with SM behavior (r = -0.33, p <0.001).

Conclusion

The findings offer insights for nurses to develop nursing interventions to promote SM behavior among adults with stroke. Furthermore, they can assist hospitals in transitioning care to the community by emphasizing holistic nursing practices that educate about stroke prevention knowledge, encourage family support, and provide stress management strategies to enhance the SM abilities of adults with stroke.

The positive side of stress: Investigating the impact of challenge stressors on innovative behavior in higher education

Stress can be a double-edged sword. Given the intricacy of the innovation process, the link between job stress and individual innovation behavior remains uncertain. To clarify the relationship between challenge stressors and the innovative behavior of higher education teachers, this study was based on the conservation of resources (COR) theory and adopted the structural equation modeling method to explore the impact of challenge stressors on the innovative behavior of higher education teachers and reveal its influencing mechanism and boundary conditions. By analyzing the data from 208 questionnaires of higher education teachers, the findings reveal that challenge stressors positively influence innovative behavior, with task crafting serving as a critical bridge. Additionally, a favorable employment relationship climate enhances the positive impact of challenge stressors. Gender dynamics are also explored, adding nuance to the understanding of this relationship. These results shed light on the inherent mechanisms governing the relationship between challenge stressors and innovative behavior among higher education teachers, and underscore the significance of task crafting. In addition, the discoveries provided fresh insights and ideas for investigating how organizational climate affects individual innovative behavior.

How much stressful life events really matter? Conceptual and methodological difficulties in assessing the impact of self-reported events on adolescents' subjective stress

Numerous studies have pointed to the strong impact of stressful life events on subjective stress and indirectly on the adolescents' mental health. However, the results of many such studies contain bias caused by the choice of measurement method or an incomplete theoretical framework. To estimate the extent of possible bias when using self-reports, we conducted research on a representative sample of 2201 Croatian adolescents aged 14-18 years. Using manipulation we examined the influence of measurement method and the number of constructs included in the model on the variance of subjective stress explained by stressful events. Structural equation modelling indicated that different measurement methods, occurrence-based and severity-based, provide a marked discrepancy in the impact size estimation. The occurrence-based method provided estimates of a much smaller proportion of the explained variance (6%-25%) compared to the severity-based approach, which estimated the explained variance in the range of 25%-55% depending on the model. The complexity of the tested models additionally contributed to the variation in the estimates. It is recommended that when using self-reports to measure stressful life events, occurrence-based and severity-based methods are used simultaneously and that impact estimates are expressed within intervals.

Procrastination, depression and anxiety symptoms in university students: a three-wave longitudinal study on the mediating role of perceived stress

BACKGROUND

It is generally assumed that procrastination leads to negative consequences. However, evidence for negative consequences of procrastination is still limited and it is also unclear by which mechanisms they are mediated. Therefore, the aim of our study was to examine the harmful consequences of procrastination on students' stress and mental health. We selected the procrastination-health model as our theoretical foundation and tried to evaluate the model's assumption that trait procrastination leads to (chronic) disease via (chronic) stress in a temporal perspective. We chose depression and anxiety symptoms as indicators for (chronic) disease and hypothesized that procrastination leads to perceived stress over time, that perceived stress leads to depression and anxiety symptoms over time, and that procrastination leads to depression and anxiety symptoms over time, mediated by perceived stress.

METHODS

To examine these relationships properly, we collected longitudinal data from 392 university students at three occasions over a one-year period and analyzed the data using autoregressive time-lagged panel models.

RESULTS

Procrastination did lead to depression and anxiety symptoms over time. However, perceived stress was not a mediator of this effect. Procrastination did not lead to perceived stress over time, nor did perceived stress lead to depression and anxiety symptoms over time.

CONCLUSIONS

We could not confirm that trait procrastination leads to (chronic) disease via (chronic) stress, as assumed in the procrastination-health model. Nonetheless, our study demonstrated that procrastination can have a detrimental effect on mental health. Further health outcomes and possible mediators should be explored in future studies.

Recovery of synaptic loss and depressive-like behavior induced by GATA1 through blocking of the neuroinflammatory response

GATA1, a member of the GATA transcription factor family, is a critical factor in hematopoietic system development. In a previous study, we demonstrated the increased expression of GATA1 in the dorsolateral prefrontal cortex (dlPFC) of patients suffering from depression and described its role as a transcriptional repressor of synapse-related genes. In this study, we investigated how GATA1 globally altered gene expression using multi-omics approaches. Through the combined analyses of ChIPseq, mRNAseq, and small RNAseq, we profiled genes that are potentially affected by GATA1 in cultured cortical neurons, and Gene Ontology (GO) analysis revealed that GATA1 might be associated with immune-related functions. We hypothesized that GATA1 induces immune activation, which has detrimental effects including synapse loss and depressive-like behavior. To test this hypothesis, we first performed a microglial morphometric analysis of a brain having overexpression of GATA1 because microglia are the resident immune cells of the central nervous system. Fractal analysis showed that the ramification and process length of microglia decreased in brains having GATA1 overexpression compared to the control, suggesting that GATA1 overexpression increases the activation of microglia. Through flow cytometry and immunohistochemical analysis, we found that activated microglia showed pro-inflammatory phenotypes characterized by the expression of CD86 and CD68. Finally, we demonstrated that the effects of GATA1 overexpression including synapse loss and depressive-like behavior could be blocked by inhibiting microglial activation using minocycline. These results will elucidate the regulatory mechanisms of GATA1 that affect pathophysiological conditions such as depression and provide a potential target for the treatment of depression.

Lifetime adversity predicts depression, anxiety, and cognitive impairment in a nationally representative sample of older adults in the United States

OBJECTIVE

Although life stress and adversity are well-known risk factors for mental health problems and cognitive impairment among older adults, limited research has comprehensively examined the impact of both childhood and adulthood adversity on psychiatric and cognitive impairment symptoms over a prolonged period. To address this issue, we investigated how lifetime adversity exposure is related to symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the United States.

METHOD

We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3496 individuals (59.9% female), aged ≥64 years old (Mage = 76.0 ± 7.6 years in 2016). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities, and later-life depression, anxiety, and cognitive impairment.

RESULTS

Many participants experienced a significant early life (38%) or adulthood (79%) stressor. Moreover, experiencing one childhood adversity (vs. none) was associated with a 17.4% increased risk of adulthood adversity. Finally, as hypothesized, childhood adversity exposure was related to experiencing more depression and anxiety symptoms in later life, whereas adulthood stressor exposure predicted more cognitive impairment as well as more depression and anxiety symptoms.

DISCUSSION

These findings demonstrate significant associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help healthcare professionals and policymakers identify individuals who could potentially benefit from interventions designed to reduce stress and enhance resilience.

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.

Negative feedback-seeking in depression: The moderating roles of rumination and interpersonal life stress

OBJECTIVES

Swann's self-verification theory proposes that negative feedback seeking (NFS)-the solicitation of negative feedback from others that confirms one's self-views-works in a negative cycle to maintain and exacerbate depression in the face of interpersonal stress. We propose a cognitive-interpersonal integration account of NFS such that this maladaptive behavior prospectively predicts depression only among those with a trait tendency to ruminate on the causes and consequences of depressed mood and stress.

METHOD

Participants included 91 young adults who were over-sampled for a lifetime history of a unipolar depressive disorder (age 17-33; 69% women; 67% lifetime depressive disorder). At baseline, participants completed a structured diagnostic interview and self-report measures of NFS, rumination, and depression symptoms. In addition, participants engaged in an interpersonal rejection task (the Yale Interpersonal Stressor) followed by a behavioral measure of NFS. At a 3-month follow-up, depression symptoms were again assessed by self-report and exposure to stressful interpersonal life events in the intervening period were assessed with a rigorous contextual interview and independent rating system.

RESULTS

Controlling for baseline depression severity, greater self-reported, and behaviorally assessed NFS predicted greater follow-up depression severity, but only among those with higher trait tendency to ruminate. For self-reported NFS, this association was further moderated by level of interpersonal, but not noninterpersonal, life events experienced over follow-up.

CONCLUSION

These findings suggest that rumination may represent a modifiable intervention target that could break the vicious interpersonal cycle of depression and, thus, mitigate the depressogenic effects of NFS.

Self-Reported Chronic Stress Is Unique Across Lifetime Periods: A Test of Competing Structural Equation Models

BACKGROUND AND OBJECTIVES

Chronic stress can have deleterious effects on physical and mental health. However, self-report measures of chronic stress typically only assess stress recently, ignoring ongoing or repeated stress throughout the life span. The present study tested whether retrospective judgments of stress across different lifetime periods offer unique information that cannot be ascertained by measures of recent chronic stress.

RESEARCH DESIGN AND METHODS

A survey was given to 271 adults aged 46-81 using Amazon's Mechanical Turk. The questions assessed self-reported stress across multiple domains (e.g., general stress, financial stress, interpersonal stress) from well-known and validated surveys. Also, items were added to assess different lifetime periods of self-reported stress, including one's childhood, 20s/30s, and 50s/60s. Using structural equation modeling, we tested competing models for how lifetime periods and stress domains might relate to one another.

RESULTS

The best fitting model revealed that different domains of stress (discrimination, loneliness, personal, and general stress) were highly correlated with one another within a given lifetime period but that the different lifetime periods (childhood, 20s/30s, 50s/60s, and current) were relatively independent.

DISCUSSION AND IMPLICATIONS

Current measures assessing the frequency or strength of "chronic stress" are misleading because they do not capture ongoing or repeated stress throughout the life span. Past experiences convey unique information about one's chronic stress, offering a new perspective on the meaning of "chronic stress" from a life-course perspective, consistent with previous stress accumulation models.

The Psychoneuroimmunological Model of Moral Distress and Health in Healthcare Workers: Toward Individual and System-Level Solutions

Healthcare is presently experiencing a global workforce crisis, marked by the inability of hospitals to retain qualified healthcare workers. Indeed, poor working conditions and staff shortages have contributed to structural collapse and placed a heavy toll on healthcare workers' (HCWs) well-being, with many suffering from stress, exhaustion, demoralization, and burnout. An additional factor driving qualified HCWs away is the repeated experience of moral distress, or the inability to act according to internally held moral values and perceived ethical obligations due to internal and external constraints. Despite general awareness of this crisis, we currently lack an organized understanding of how stress leads to poor health, wellbeing, and performance in healthcare workers. To address this critical issue, we first review the literature on moral distress, stress, and health in HCWs. Second, we summarize the biobehavioral pathways linking occupational and interpersonal stressors to health in this population, focusing on neuroendocrine, immune, genetic, and epigenetic processes. Third, we propose a novel Psychoneuroimmunological Model of Moral Distress and Health in HCWs based on this literature. Finally, we discuss evidence-based individual- and system-level interventions for preventing stress and promoting resilience at work. Throughout this review, we underscore that stress levels in HCWs are a major public health concern, and that a combination of system-level and individual-level interventions are necessary to address preventable health care harm and foster resilience in this population, including new health policies, mental health initiatives, and additional translational research.

Relationship Between Athletes' History of Stressors and Sport Injury: A Systematic Review and Meta-Analysis

A history of stressors in athletes represents psychosocial factors that may lead to sport injury. However, empirical studies have provided varying results for the relationship between stress history and sport injury. We examined prior literature on the stress history - sport injury relationship within a systematic review and, by meta-analysis, we offered a pooled estimate of the strength of this relationship. We searched seven major academic databases (Sportdiscus, Psyinfo, Academic Search Premier, Ovid, Scopus, Web of Science, and PubMed) from January 2000 to September 2023 and identified 19 empirical studies that examined injuries in sports contexts for meta-analysis. In 19 empirical studies of moderate to high publication quality, we found moderate heterogeneity (Q(17) = 98.61; p < .001), low sensitivity (I2 77.82-83.77), and low publication bias (Z-value = 7.74; p < .001). Further, using a random effect estimate-r, we found a low but significant correlation between stress history and sport injury, yielding a small overall effect size (ES) of r = .12. Furthermore, moderation analyses found adolescents (r = .14), contact-sport athletes (r = .09), non-elite athletes (r = .13), and non-European athletes (America r = .16; Asia r = .14; Oceania r = .14) to have a relatively higher ES than their counterparts in this stress history/sport injury relationship. We concluded that inevitable life stressors may lead to many negative consequences for athletes, such that sports professionals should provide stress management educational programs to enhance athletes' health and well-being.

Cellular Stress Responses against Coronavirus Infection: A Means of the Innate Antiviral Defense

Cellular stress responses are crucial for maintaining cellular homeostasis. Stress granules (SGs), activated by eIF2α kinases in response to various stimuli, play a pivotal role in dealing with diverse stress conditions. Viral infection, as one kind of cellular stress, triggers specific cellular programs aimed at overcoming virus-induced stresses. Recent studies have revealed that virus-derived stress responses are tightly linked to the host's antiviral innate immunity. Virus infection-induced SGs act as platforms for antiviral sensors, facilitating the initiation of protective antiviral responses called "antiviral stress granules" (avSGs). However, many viruses, including coronaviruses, have evolved strategies to suppress avSG formation, thereby counteracting the host's immune responses. This review discusses the intricate relationship between cellular stress responses and antiviral innate immunity, with a specific focus on coronaviruses. Furthermore, the diverse mechanisms employed by viruses to counteract avSGs are described.

Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy

BACKGROUND

Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms.

OBJECTIVES

The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping.

METHODS

Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles.

RESULTS

Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment.

CONCLUSIONS

More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles.

IMPLICATIONS FOR PRACTICE

Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Multi-omics in stress and health research: study designs that will drive the field forward

Despite decades of stress research, there still exist substantial gaps in our understanding of how social, environmental, and biological factors interact and combine with developmental stressor exposures, cognitive appraisals of stressors, and psychosocial coping processes to shape individuals' stress reactivity, health, and disease risk. Relatively new biological profiling approaches, called multi-omics, are helping address these issues by enabling researchers to quantify thousands of molecules from a single blood or tissue sample, thus providing a panoramic snapshot of the molecular processes occurring in an organism from a systems perspective. In this review, we summarize two types of research designs for which multi-omics approaches are best suited, and describe how these approaches can help advance our understanding of stress processes and the development, prevention, and treatment of stress-related pathologies. We first discuss incorporating multi-omics approaches into theory-rich, intensive longitudinal study designs to characterize, in high-resolution, the transition to stress-related multisystem dysfunction and disease throughout development. Next, we discuss how multi-omics approaches should be incorporated into intervention research to better understand the transition from stress-related dysfunction back to health, which can help inform novel precision medicine approaches to managing stress and fostering biopsychosocial resilience. Throughout, we provide concrete recommendations for types of studies that will help advance stress research, and translate multi-omics data into better health and health care.

Using Ecological Momentary Assessments to Study How Daily Fluctuations in Psychological States Impact Stress, Well-Being, and Health

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments with relatively long time-lags. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports to help reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to deliver ecological momentary interventions, or just-in-time interventions, to help prevent such events from occurring. To enable this work, we provide examples of scales and single-item questions used in EMA studies, recommend study designs and statistical approaches that capitalize on EMA data, and discuss limitations of EMA methods. In doing so, we aim to demonstrate how, when used carefully, EMA methods are well poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.

Stressors and Pain across the Late-Life Span: Findings from Two Parent Longitudinal Studies of Aging and Health

OBJECTIVE

The objective is to determine associations between stressors and pain across the late-life span.

METHOD

Multilevel linear modeling was applied separately to harmonized repeated measures data from the Longitudinal Late-Life Health study (LLLH; n = 342; 13-year interval) and the Health and Retirement Study (HRS; n = 2959; 8-year interval).

RESULTS

In both the LLLH and HRS samples, independent of age, gender, and race, participants with higher average stressor levels experienced more numerous painful conditions and higher pain severity over the study intervals. In the HRS sample, they also experienced higher levels of pain interference. In general, participants' stressor levels did not influence rates of increase in their pain. Gender and race had few moderating effects on associations between stressors and pain.

DISCUSSION

Stressors and pain are associated across the late-life span. Future research should focus on the mediating mechanisms that account for this association and the moderating factors that affect its strength.

The allostatic load model: a framework to understand the cumulative multi-system impact of work-related psychosocial stress exposure among firefighters

Firefighting is recognised as a profession where health and well-being can be affected by a variety of occupational factors, such as physical, thermal, and chemical stressors. Along with the risks intuitively associated with the fire service, however, psychosocial stress has begun to attract attention as another variable deserving of consideration. Indeed, long-term exposure to work-related psychosocial stress has been linked with poor health outcomes in many workers; however, despite this association, very little has been done to examine how such stressors become biologically embedded in firefighters. To help facilitate research into how psychosocial stress can affect health-related outcomes in the fire service, we propose a framework centered on the notion of allostatic load. First, we reviewed the occupational characteristics that may generate psychosocial stress within firefighters before introducing allostatic load (that is, dysregulation across various physiological systems caused by the need to manage ongoing stressors). Next, we provided a summary of how allostatic load can be measured and touched on the framework's utility for studying the cumulative effects of work-related stress on firefighter health. After this, factors that may influence the steps leading from stress exposure to health outcomes were discussed; in particular, we commented upon how research in this area should consider specific non-modifiable (age, sex, and ethnicity) and modifiable (psychosocial resources and behavioural habits) factors. Finally, we presented methodological barriers and opportunities that may arise when using the allostatic load framework with this professional group. By introducing the framework, we hope to provide a tool that may be used by those interested in stress-health research in firefighters to build the evidence needed to inform primary prevention measures.

What is the impact of stress on the onset and anti-thyroid drug therapy in patients with graves' disease: a systematic review and meta-analysis

BACKGROUND

The effect of stress on Graves' disease (GD) is controversial. Our purpose was to quantify the impacts of stress on patients with Graves' disease.

METHODS

Systematic searches of PubMed, MEDLINE, Embase, Web of Science, Scopus, Cochrane Library and PsycInfo were conducted from inception to 1 January 2023. Studies comparing the incidence of stressful life events (SLEs) that occurred before diagnosis and during drug therapy in cases diagnosed with GD and controls were included in the final analysis.

RESULTS

Nine case-control studies and four cohort studies enrolling 2892 participants (1685 [58%] patients) were included. Meta-analysis revealed a high and significant effect-size index in a random effect model (d = 1.81, P = 0.01), indicating that stress is an important factor in the onset of GD. The relationship between SLEs and GD was stronger in studies with higher proportions of female patients (β = 0.22, P < 0.01) and weaker in studies with older patients with GD (β =-0.62, P < 0.01). However, stress did not significantly affect the outcome of antithyroid drug therapy for GD (d = 0.32, P = 0.09).

CONCLUSIONS

The results of this meta-analysis suggest that stress is one of the environmental triggers for the onset of GD. Therefore, we recommend stress management assistance for individuals genetically susceptible to GD, especially for young females.

Affective Science Research: Perspectives and Priorities from the National Institutes of Health

Affective science is a broad and burgeoning field, and the National Institutes of Health (NIH) support research on a similarly broad range of topics. Across NIH, funding is available for basic, translational, and intervention research, including research in non-human animals, healthy populations, and those with or at risk for disease. Multiple NIH Institutes and Centers have specific programs devoted to topics within the affective science umbrella. Here, we introduce the funding priorities of these six: the National Cancer Institute (NCI), National Center for Complementary and Integrative Health (NCCIH), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), National Institute on Drug Abuse (NIDA), and National Institute on Minority Health and Health Disparities (NIMHD). We then discuss overlapping themes and offer a perspective on promising research directions.

Cumulative lifetime acute stressor exposure interacts with reward responsiveness to predict longitudinal increases in depression severity in adolescence

BACKGROUND

Life stress and blunted reward processing each have been associated with the onset and maintenance of major depressive disorder. However, much of this work has been cross-sectional, conducted in separate lines of inquiry, and focused on recent life stressor exposure, despite the fact that theories of depression posit that stressors can have cumulative effects over the lifespan. To address these limitations, we investigated whether acute and chronic stressors occurring over the lifespan interacted with blunted reward processing to predict increases in depression over time in healthy youth.

METHOD

Participants were 245 adolescent girls aged 8-14 years old (Mage = 12.4, s.d. = 1.8) who were evaluated at baseline and two years later. The reward positivity (RewP), an event-related potential measure of reward responsiveness, was assessed at baseline using the doors task. Cumulative lifetime exposure to acute and chronic stressors was assessed two years later using the Stress and Adversity Inventory for Adolescents (Adolescent STRAIN). Finally, depressive symptoms were assessed at both baseline and follow-up using the Children's Depression Inventory.

RESULTS

As hypothesized, greater lifetime acute stressor exposure predicted increases in depressive symptoms over two years, but only for youth exhibiting a blunted RewP. This interaction, however, was not found for chronic stressors.

CONCLUSIONS

Lifetime acute stressor exposure may be particularly depressogenic for youth exhibiting a blunted RewP. Conversely, a robust RewP may be protective in the presence of greater acute lifetime stressor exposure.

Early and recent exposure to adversity, TLR-4 stimulated inflammation, and diurnal cortisol in women with interstitial cystitis/bladder pain syndrome: A MAPP research network study

Both early (ELA) and recent life adversity (RLA) have been linked with chronic pain conditions and persistent alterations of neuroendocrine and inflammatory responses. Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic urologic disorder characterized by bladder and/or pelvic pain, and excessive urinary frequency and/or urgency. IC/BPS has been associated with high levels of ELA as well as a distinct inflammatory signature. However, associations between ELA and RLA with inflammatory mechanisms in IC/BPS that might underlie the link between adversity and symptoms have not been examined. Here we investigated ELA and RLA in women with IC/BPS as potential risk factors for inflammatory processes and hypothalamic-pituitaryadrenal (HPA) abnormalities using data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. Women with IC/BPS and healthy controls (n = 154 and 32, respectively) completed surveys, collected salivary cortisol at awakening and bedtime for 3 days, and gave a blood sample which was analyzed for 7 LPS-stimulated cytokines and chemokines (IL-6, TNFα, IL-1β, MIP1α, MCP1, IL-8, and IL-10). Two cytokine/chemokine composites were identified using principal components analysis. Patients with greater exposure to RLA or cumulative ELA and RLA of at least moderate severity showed elevated levels of a composite of all cytokines, adjusting for age, body mass index, and study site. Furthermore, there was a trending relationship between ELA and the pro-inflammatory composite score. Nocturnal cortisol and cortisol slope were not associated with ELA, RLA, or inflammation. The present findings support the importance of adverse events in IC/BPS via a biological mechanism and suggest that ELA and RLA should be assessed as risk factors for inflammation as part of a clinical workup for IC/BPS.

Differential associations of leisure music engagement with resilience: A network analysis

Background/Objective

Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement.

Method

511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation).

Results

Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies.

Conclusions

Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.

Combined effects of cumulative stress and daily stressors on daily health

OBJECTIVE

It has been proposed that cumulative stress, one's experience of chronic stressors across multiple domains, worsens health by altering the extent to which daily stressors impact daily affect and physical symptoms. Recent work confirms that high cumulative stress exacerbates the association between daily stressor exposure and increased daily negative affect, though it remains untested the extent to which cumulative stress and daily stressor exposure interact to predict daily symptoms.

METHOD

We employed data from the second wave of the midlife in the U.S. Survey (N = 2,022; Mage = 56.2; 57.2% female) to examine whether levels of cumulative stress compound daily symptoms on days with (vs. without) stressful events. Experiences of life stressors across eight domains, occurrence of daily stressors, and occurrence, number, and severity of daily physical symptoms were analyzed using multilevel modeling.

RESULTS

Greater cumulative stress and experiencing (vs. not experiencing) a daily stressor independently increased the odds of occurrence, number, and severity of daily symptoms (ps ≤ .016). Moreover, after adjusting for covariates (e.g., sociodemographic characteristics, chronic health conditions, percent of days with reported stressors, and health behaviors), the associations between daily stressor exposure and odds of occurrence, number, and severity of daily symptoms were potentiated as levels of cumulative stress increased (ps ≤ .009).

CONCLUSIONS

The negative implications of daily stressor exposure for daily health may be most pronounced in those who report higher levels of cumulative stress across multiple life domains and across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Speech as a promising biosignal in precision psychiatry

Health research and health care alike are presently based on infrequent assessments that provide an incomplete picture of clinical functioning. Consequently, opportunities to identify and prevent health events before they occur are missed. New health technologies are addressing these critical issues by enabling the continual monitoring of health-related processes using speech. These technologies are a great match for the healthcare environment because they make high-frequency assessments non-invasive and highly scalable. Indeed, existing tools can now extract a wide variety of health-relevant biosignals from smartphones by analyzing a person's voice and speech. These biosignals are linked to health-relevant biological pathways and have shown promise in detecting several disorders, including depression and schizophrenia. However, more research is needed to identify the speech signals that matter most, validate these signals against ground-truth outcomes, and translate these data into biomarkers and just-in-time adaptive interventions. We discuss these issues herein by describing how assessing everyday psychological stress through speech can help both researchers and health care providers monitor the impact that stress has on a wide variety of mental and physical health outcomes, such as self-harm, suicide, substance abuse, depression, and disease recurrence. If done appropriately and securely, speech is a novel digital biosignal that could play a key role in predicting high-priority clinical outcomes and delivering tailored interventions that help people when they need it most.

Understanding the relationships between physiological and psychosocial stress, cortisol and cognition

Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.

Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions

Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.

Developing a stress induction tool relevant to relationships in a health context

Concerns pertaining to health and to problems in close relationships are both known to be major stressors, yet existing tools are inadequate to assess individual reactions to such stressors. Thus, we sought to develop and preliminarily validate a stress-inducing task for use in a laboratory setting that pertains to the sorts of health-related concerns people face in close relationships. Heterosexual dating couples (44 individuals: mean age 22) were randomized to be paired with their own partner or a stranger and to play a role of speaker or listener. Participants were asked to imagine a scenario in which one person is hit by a car (listener role) and the partner has no means to provide or seek out help for the victim (speaker role). The session consisted of baseline, speech preparation, stress task, and recovery phases. General linear modeling results revealed that the task induced stress, evidenced in cardiovascular activities and self-reported negative affect. Giving a brief speech about the stressful situation creates physiological and psychological strains, regardless of pairing with one's own partner or stranger. Furthermore, cardiovascular and negative affect reactivity to the STress Induction Tool for Close relationships and Health (STITCH) task tended to vary by individual characteristics that reflect one's sensitivity to close relationship-and health-related stress. This tool is intended to be used for testing relationship theory-driven phenomenon and longer-term implications of physiological and affective reactivities in the quality of life and health outcomes of those who experienced a medically stressful circumstance personally or in the family.

Associations between Stressful Life Events and Increased Physical and Psychological Health Risks in Adolescents: A Longitudinal Study

Stressful life events (SLEs) are understood as risk factors for mental and physical health problems, particularly in the vulnerable period of adolescence. Using a longitudinal approach, this study investigated associations between SLE and several negative health outcomes in adolescents. Moderating effects of sociodemographic factors were considered. We analyzed the data of a healthy adolescent sample from the LIFE Child study in Leipzig, Germany (n = 2024, aged 10-18 years). SLEs were measured by a questionnaire, addressing SLEs in the family and the social environment domain. Health-related quality of life (HrQoL), behavioral difficulties and BMI were compared before and after an SLE had occurred. Moderator effects of socioeconomic status (SES), age, and sex were investigated using linear regression models. All considered health parameters had, on average, deteriorated after the occurrence of an SLE in the social environment. Differences in HrQoL before and after an SLE were significantly stronger in girls. Higher SES functioned as a slight protective factor against decreased well-being after an SLE. The findings suggest that SLEs function as risk factors for mental and physical health disadvantages in adolescents. Prevention programs should seek to support adolescents in all age and SES groups affected by SLEs, with a specific focus on girls.

Investigating the Link Between IADL and Depressive Symptoms in Older Adults: A Cross-Sectional Serial Mediation Model

OBJECTIVES

There is a dearth of research on the psychological processes that underlie the negative relation between impaired instrumental activities of daily living (IADL) and depressive symptoms in older adults. Drawing on the stress process model and the resilience framework, we investigated whether purpose in life and resilience serially mediate the relationship between impaired IADL and depressive symptoms.

METHODS

We recruited 111 cognitively healthy community-dwelling older adults (ages 54-85; M = 66.5) who scored a minimum of 25 points on the Mini-Mental State Examination.

RESULTS

We found that purpose in life and resilience serially mediated the relationship between IADL and depressive symptomatology in older adults. This association held true when we controlled for covariates. Additional sensitivity analyses also supported these findings.

CONCLUSIONS

This study extends our understanding of how IADL limitations contribute to depressive symptoms. Using a community-dwelling, cognitively healthy sample, we demonstrate that functional limitations indirectly influence older adults' depressive symptoms through a decreased sense of purpose in life and decreased resilience.

CLINICAL IMPLICATIONS

Our findings have implications for intervention programs that aim to alleviate IADL limitations and mental health issues in an aging population and promote healthy aging by improving psychosocial resources (i.e., purpose in life and resilience).

[Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts (June 8, 2023)]

Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts.

More Problems, More Pain: The Role of Chronic Life Stressors and Racial/Ethnic Identity on Chronic Pain Among Middle-Aged and Older Adults in the United States

There is a high prevalence of chronic pain among middle-aged and older adults in the United States. Chronic life stressors have been shown to have detrimental consequences for myriad health conditions, including chronic pain. However, there is limited evidence on the types of chronic life stressors that affect middle-aged and older adults and how these stressors influence the chronic pain burden in this population. Moreover, the interaction between chronic life stressors and racial/ethnic identity remains poorly understood as it relates to chronic pain. The current analysis used the 2018 Health and Retirement Study to investigate relationships between chronic life stressors and odds to experience any chronic pain and high-impact chronic pain. Chronic life stressors were characterized, overall and by racial/ethnic identity, and the main and interaction effects were calculated to evaluate relationships between chronic life stressors, racial/ethnic identity, and odds of experiencing any chronic pain and high-impact chronic pain. Results indicate that in 2018, the most common chronic life stressor among middle-aged and older adults was dealing with their own health problems (68%), followed by dealing with the physical or emotional issues affecting a spouse or child (46%). Adjusted analyses showed that a higher total of chronic life stressors increased the odds of middle-aged and older adults experiencing any chronic pain and high-impact chronic pain. There were no significant interactions between the overall chronic life stress burden and racial/ethnic identity as a predictor of odds to experience any chronic pain or high-impact chronic pain, but significant interaction effects were found related to specific chronic life stressors. Findings underscore the significant impact of chronic life stressors on the chronic pain burden among middle-aged and older adults in the United States, which cut across racial/ethnic identity.

Negative emodiversity is associated with emotional eating in adolescents: An examination of emotion dynamics in daily life

INTRODUCTION

Emotional eating is a mental health concern, common in adolescents, that develops as a result of their tendency to use high-energy food to regulate their fluctuating emotions. Due to their highly fluctuating emotional life, adolescents tend to have unique within-person profiles of emotional experiences that change across moments and days, often lost in global assessments of emotions. Hence, it is imperative to examine individual differences in dynamics of emotions, as experienced in daily life, in relation to emotional eating in adolescents.

METHODS

In an Ecological Momentary Assessment study, we examined individual differences in three within-person dynamic characteristics (baseline levels, intraindividual variability, and emodiversity) of emotions in 158 dominantly Hispanic adolescents in the United States, aged 14-17 years old, predicting trait-level emotional eating.

RESULTS

Results indicated that higher negative emodiversity, baselines, and variability in stress were predictive of emotional eating in adolescents. When all considered together, negative emodiversity (i.e., variety of the types of negative emotions experienced in one's daily life) remained the only significant predictor of emotional eating.

CONCLUSIONS

This study affirms the importance of diversity in emotional experiences in relation to emotional eating, particularly in daily contexts of adolescents' lives. Additionally, the study emphasizes the importance of distinguishing between diversity (i.e., variety in types) in positive versus negative emotional experiences with regard to emotional eating. By taking into account the ecological validity of adolescents' daily lives and individual differences in dynamical changes in emotions, we are taking a step forward by shedding light on how the dynamics of negative emotions-in terms of within-person baselines, variability, and diversity-might be related to general levels of emotional eating in adolescents.

Cumulative lifetime stressor exposure and health in elite athletes: the moderating role of perfectionism

Although greater lifetime stressor exposure has been associated with physical and mental health issues in the general population, relatively little is known about how lifetime stressors impact the physical and mental health of elite athletes or the factors moderating this association. Given that many elite athletes show signs of perfectionism, and that this trait has been linked with ill-health, it is possible that perfectionism may moderate the lifetime stressor-health relationship. To test this possibility, we examined how cumulative lifetime stressor exposure was associated with general mental and physical health complaints in elite athletes, and the extent to which these associations were moderated by perfectionism. Participants were 110 elite athletes (64 female; M age = 29.98 years, SD = 10.54) who completed assessments of lifetime stressor exposure, physical health, psychological distress, and perfectionism. As hypothesised, hierarchical regression analyses revealed that experiencing more severe lifetime stressors was related to poorer physical and mental health. Furthermore, self-oriented perfectionism moderated the association between lifetime stressor count and severity and physical health, but not mental health. Overall, these data demonstrate stressor-specific effects among elite athletes and highlight the potential importance of assessing lifetime stressor exposure and perfectionistic tendencies in order to improve athlete health and well-being.

Acoustic speech features in social comparison: how stress impacts the way you sound

The use of speech as a digital biomarker to detect stress levels is increasingly gaining attention. Yet, heterogeneous effects of stress on specific acoustic speech features have been observed, possibly due to previous studies' use of different stress labels/categories and the lack of solid stress induction paradigms or validation of experienced stress. Here, we deployed a controlled, within-subject psychosocial stress induction experiment in which participants received both neutral (control condition) and negative (negative condition) comparative feedback after solving a challenging cognitive task. This study is the first to use a (non-actor) within-participant design that verifies a successful stress induction using both self-report (i.e., decreased reported valence) and physiological measures (i.e., increased heart rate acceleration using event-related cardiac responses during feedback exposure). Analyses of acoustic speech features showed a significant increase in Fundamental Frequency (F0) and Harmonics-to-Noise Ratio (HNR), and a significant decrease in shimmer during the negative feedback condition. Our results using read-out-loud speech comply with earlier research, yet we are the first to validate these results in a well-controlled but ecologically-valid setting to guarantee the generalization of our findings to real-life settings. Further research should aim to replicate these results in a free speech setting to test the robustness of our findings for real-world settings and should include semantics to also take into account what you say and not only how you say it.

Resentment Is Like Drinking Poison? The Heterogeneous Health Effects of Affective Polarization

Affective polarization-the tendency for individuals to exhibit animosity toward those on the opposite side of the partisan divide-has increased in the United States in recent years. This article presents evidence that this trend may have consequences for Americans' health. Structural equation model analyses of nationally representative survey data from Pew Research Center's American Trends Panel (n = 4,685) showed heterogeneous relationships between affectively polarized attitudes and self-rated health. On one hand, such attitudes were directly negatively associated with health such that the polarized political environment was proposed to operate as a sociopolitical stressor. Simultaneously, affective polarization was positively associated with political participation, which in turn was positively associated with health, although the direct negative effect was substantially larger than the indirect positive one. These results suggest that today's increasingly hostile and pervasive form of partisanship may undermine Americans' health even as it induces greater political engagement.

The Hormesis Model for Building Resilience Through Adversity: Attention to Mechanism in Developmental Context

In developmental science, resilience refers to children and youths’ ability to recover and pursue positive development in the face of stress related to adversity. Extant research has documented protective factors and ecological contexts that mitigate the impact of adversity and thereby promote resilience. One intriguing aspect of resilience is that individuals also develop strength in response to early adversity. However, very little theoretical guidance exists on the developmental mechanisms and contexts through which early adversity may lead to strengthening effects that confer the process of resilience. The strengthening mechanism in the context of specific circumscribed environmental stress is a process known in the field of toxicology as hormesis. It is proposed here that the study of resilience in developmental and psychological sciences can benefit from shifting more attention to the hormesis model. The hormesis model is reviewed and discussed as a promising perspective on mechanisms, developmental timing, and context through which adversity strengthens or impedes resilience.

Adolescent microglia stimulation produces long-lasting protection against chronic stress-induced behavioral abnormalities in adult male mice

Our previous studies had reported that microglia activation one day before stress exposure prevented the behavioral abnormalities induced by chronic stress in adult mice, and a 10-day interval between microglia stimulation and stress exposure can abolish the prophylactic effect of LPS preinjection on the behavioral abnormalities induced by chronic stress, which, however, could be rescued by repeated LPS injection. This suggests that increased stimulation of microglia results in animals developing a strong ability to prevent deleterious stress stimuli. Because microglia in the adolescent brain exhibit flexible immunological plasticity, we hypothesize that a single low-dose LPS injection during adolescence may provide long-lasting protection against behavioral abnormalities induced by chronic stress in adult mice. As expected, our results showed that a single injection of LPS (100 μg/kg) at post-natal day 28 (PND 28) prevented the development of abnormal behaviors and shifted neuroinflammatory responses toward an anti-inflammatory phenotype in adult mice treated with CSDS at their different stages of the age (PND 56, 140, and 252). Moreover, pretreatment with minocycline or PLX3397 to inhibit microglial activation abolished the prophylactic effect of LPS preinjection after PND 28 on behavioral abnormalities and neuroinflammatory responses induced by CSDS in adult mice at their different stages of the age, PND 56, 140, and 252. These results indicate that stimulation of microglia in adolescence may confer long-lasting protection against neuroinflammatory responses and behavioral abnormalities induced by chronic stress in adult mice. This may offer the potential for the development of a "vaccine-like strategy" to prevent mental disorders.

Stressful Events During Last Year, Violence and Anxiety and Depression: A Moderated Mediation Model by Sex

The literature suggests that being subject to a stressful life and victimization may negatively affect mental health, and that women and men seem to differ in these variables. Nevertheless, neither the mediating role of victimization experiences in the relationship between stress and mental health, nor the moderated role of sex have been explored. A sample of 826 adults, aged from 18 to 77 years old, completed a set of self-reported questionnaires (69.4% women). Results revealed significant mediation effects of psychological violence on the relationship between stress, depression and anxiety. Participants who reported more stressful life events in the previous year, also reported higher psychological abuse, which in turn predicted higher depression and anxiety. Furthermore, the moderating effects of sex were found to be statistically significant. Results suggest that interventions should be tailored to individual needs in order to prevent secondary victimization derived from biased beliefs related to stress, violence and gender in professional practice.

Review of electroencephalography signals approaches for mental stress assessment

The innovation of electroencephalography (EEG) more than a century ago supports the technique to assess brain structure and function in clinical health and research applications. The EEG signals were identified on their frequency ranges as delta (from 0.5 to 4 Hz), theta (from 4 to 7 Hz), alpha (from 8 to 12 Hz), beta (from 16 to 31 Hz), and gamma (from 36 to 90 Hz). Stress is a sense of emotional tension caused by several life events. For example, worrying about something, being under pressure, and facing significant challenges are causes of stress. The human body is affected by stress in various ways. It promotes inflammation, which affects cardiac health. The autonomic nervous system is activated during mental stress. Posttraumatic stress disorder and Alzheimer's disease are common brain stress disorders. Several methods have been used previously to identify stress, for instance, magnetic resonance imaging, single-photon emission computed tomography and EEG. The EEG identifies the electrical activity in the human brain by applying small electrodes positioned on the scalp of the brain. It is a useful non-invasive method and collects feedback from stress hormones. In addition, it can serve as a reliable tool for measuring stress. Furthermore, evaluating human stress in real-time is complicated and challenging. This review demonstrates the power of frequency bands for mental stress and the behaviors of frequency bands based on medical and research experiencebands based on medical and research experience.