Depressive and Anxious Symptoms, Experimentally Manipulated Acute Social-Evaluative Threat, and Cortisol Reactivity.

OBJECTIVE: Exposure to social-evaluative threat (SET) can elicit greater physiological responses, including cortisol, compared to non-SET stressors. An individual's level of depressive and anxious symptoms predicts variability in cortisol responses to stressors, and other research suggests these individual differences may predict vulnerability to social evaluation. The current study integrates both lines of research, testing if there are different relationships between depressive and/or anxious symptoms and cortisol reactivity in the presence or absence of SET. METHODS: Healthy undergraduate students (N = 158, 65% female) were randomly assigned to deliver a speech in the presence (SET) or absence (non-SET) of two evaluators. Salivary cortisol was collected throughout, and self-reported depressive and anxious symptoms were assessed. We hypothesized that in the SET condition, higher levels of depressive and/or anxious symptoms would predict dysregulated cortisol responses compared to lower levels of symptoms and/or assignment to the non-SET group. RESULTS: In spite of inconclusive p-values (which might be attributed to low statistical power), individuals with high depressive or high anxious symptoms appeared to have exaggerated cortisol responses in the SET condition, as indicated by more concave trajectories. CONCLUSIONS: This study suggests that both depression and anxiety could be associated with increased cortisol reactivity to SET.

Conflicting patterns of cardiovascular reactivity, self-report, and behavior associated with social anxiety during a conversation with a close friend.

Social anxiety (SA) is characterized by anxious symptomology and fear during social situations, but recent work suggests that SA may not necessarily be associated with negative interpersonal and intrapersonal outcomes in support contexts. The current research investigates the discrepancies between self-perceptions, behavior, and physiological responses associated with SA in social support conversations with close friends. Specifically, we examined the associations between SA and positive and negative affect, perceptions of demands and resources, and responsiveness. Additionally, we used the biopsychosocial model of challenge and threat to understand the physiological responses associated with SA. Participants (79.9% White, 9.8% Black or African American, 10.3% Multiple races or other; 78.7% Female), totaling 172 undergraduate friend dyads, completed self-report measures and had physiological responses recorded while they discussed a problem unrelated to the friendship. Trained coders rated responsive behaviors exhibited during the conversation. Results revealed that greater SA was associated with greater negative perceptions of social interactions (greater negative affect, fewer perceived resources, and greater perceived demands). However, cardiovascular reactivity and behavioral responses within the conversation, as well as perceptions of partners' behavior after the conversation, contrasted with these negative perceptions. Indeed, greater SA was associated with greater sympathetic arousal (indicative of greater task engagement), but not with greater challenge or threat, and SA was not associated with perceived partner responsiveness or responsive behaviors. These results add to the growing body of research that suggests people with greater SA show inconsistencies between their conscious appraisals of social situations and their physiological responses.

Gender roles are related to cortisol habituation to repeated social evaluative stressors in adults: secondary analyses from a randomized controlled trial.

Masculine and feminine gender roles influence stressor appraisals and coping in everyday life, but their effect on stress response systems like the hypothalamic-pituitary-adrenocortical axis is unclear. Accordingly, the present study tested the association between gender roles and cortisol responses to repeated stress as part of secondary analyses of data from a randomized controlled trial examining the effects of stress management interventions on cortisol habituation. Participants (Nfinal = 86; 72% female) completed a baseline survey assessing gender role endorsement using the Bem Sex Role Inventory, from which 4 groups were derived: masculine (n = 20), feminine (n = 20), androgynous (high masculinity, high femininity; n = 22), and undifferentiated (low masculinity, low femininity; n = 24). Following the stress management intervention (mindfulness-based stress reduction or cognitive-behavioral skills training) or waitlist period control, participants completed the Trier Social Stress Test on two laboratory visits (48 h apart). Salivary cortisol was assessed 0, 25, 35, and 60 min post-stressor during both laboratory visits. Androgynous and undifferentiated individuals both exhibited a significant decrease in total cortisol from visit 1 to visit 2 (i.e. habituation) whereas feminine and masculine individuals did not. Undifferentiated individuals exhibited greater habituation than feminine and masculine individuals, whereas androgynous individuals only exhibited greater habituation than the feminine group. Controlling for study condition assignment did not alter these results. Results imply that gender roles may be implicated in stress-related disease because of their association with HPA axis functioning during episodes of acute stress.

When Family Matters Most: A Test of the Association Between Sexual Minority Identity Disclosure Context and Diurnal Cortisol in Sexual Minority Young Adults.

OBJECTIVE: Revealing one's sexual identity to others is a complex process marked by a shift in the types of stressors faced by sexual minority young adults. Such stressors influence the secretion of health-relevant hormones, including cortisol, yet how dimensions of disclosure (i.e., the degree and context) influence neuroendocrine functioning remains poorly understood. The current study examined the association between disclosure context (disclosure to family members, friends/co-workers/acquaintances, and members of religious groups) and diurnal cortisol while allowing disclosure to vary in degree (i.e., how much is disclosed). METHODS: One hundred twenty-one sexual minority young adults (aged 18-35 years, 54.5% female, free of major psychiatric/endocrine disorders) completed an initial survey that assessed the degree and context of sexual minority identity disclosure. A randomly selected subset (n = 58) also provided salivary cortisol samples at wake, 45 minutes after wake, 12 hours after wake, and at bedtime for 1 week. RESULTS: Greater total disclosure and greater disclosure to family members were associated with reduced cortisol output, defined as Area Under the Curve relative to ground (AUCg; F(1,230) = 5.95, p = .015, and F(1,231) = 10.90, p = .001, respectively). Disclosure to co-workers, friends, acquaintances, or religious groups was unrelated to cortisol AUCg. All disclosure contexts tested were unrelated to the shape of diurnal cortisol slopes (including the cortisol awakening response). CONCLUSIONS: Disclosure to family members uniquely predicted cortisol AUCg. Therefore, these results suggest that effects of disclosure on diurnal cortisol and its associated health outcomes may occur in the context of familial relationships.

Recovery from stress: an experimental examination of focused attention meditation in novices.

Identifying strategies that aid in recovery from stress may benefit cardiovascular health. Ninety-nine undergraduate meditation novices were randomly assigned to meditate, listen to an audio book, or sit quietly after a standardized stressor. During recovery, meditators' heart rate variability and skin conductance levels returned to baseline, whereas only heart rate variability returned to baseline for the audio book and control groups. Positive and negative affect were no different than baseline following meditation, whereas, both audio book and control groups had lower positive affect and higher negative affect following the intervention. Findings suggest that the sympathetic nervous system is uniquely affected by meditation, and novices may benefit emotionally from meditating after a stressor. Further research is needed to determine meditation's utility in recovering from stress.

Education Is Associated with the Magnitude of Cortisol Responses to Psychosocial Stress in College Students.

PURPOSE: Researchers benefit from controlling for individual differences that systematically account for variance in acute cortisol responses (e.g., sex). Similarly, some suggest that education could be used as a cortisol covariate because prior work found a negative relationship between education and the magnitude of acute cortisol responses in middle-aged adults. Nevertheless, education is seldom controlled for in tests of cortisol responses to acute stress, in part because the effect of education on acute cortisol responses has yet to be tested in a college sample. The present study therefore tested the relationship between education and cortisol responses to acute stress in college students. METHOD: Participants (124 healthy undergraduate students) self-reported education level and were subjected to a stressful speech task. Salivary cortisol was collected 0, + 15, + 25, + 40, and + 55 min post-stressor onset. Participant also completed a battery of questionnaires assessing individual differences, day-to-day demands, and stress-related appraisals. RESULTS: Students in their fourth year of college education or above had significantly less curvilinear responses to the stress task relative to first-, second-, and third-year students. CONCLUSION: The effect of education on cortisol responses previously found in middle-aged adults was replicated in college students. Future research may therefore benefit from controlling for education when analyzing acute cortisol responses in college samples.

Stress-Induced Parasympathetic Control and Its Association With Inflammatory Reactivity.

OBJECTIVE: It has been proposed that the inflammatory cytokine system is regulated through the vagus nerve, where vagal activation inhibits release of inflammatory cytokines and, therefore, inflammation. Thus, loss of vagal activation (i.e., reduced high-frequency heart rate variability [HF-HRV]) should result in greater inflammation. Evidence to date for this relationship has relied on animal models and resting states in humans. The present study used a psychosocial stressor to test whether stress-induced decreases in HF-HRV predict increases in circulating inflammatory markers. METHODS: Thirty healthy young women completed a speech stressor. HF-HRV was assessed before and during the stressor while circulating plasma interleukin 6, tumor necrosis factor α, and C-reactive protein were assessed before and 1 hour after the stressor. RESULTS: Consistent with the neural reflex for immunity, greater reductions in HF-HRV during the stressor were associated with greater increases in tumor necrosis factor α (ß = -0.29 to -0.47) and interleukin 6 (ß = -0.40 to -0.68) but not C-reactive protein (ß = 0.10 to 0.29) 1 hour after the stressor. CONCLUSIONS: These findings expand on the current literature by showing that changes in HF-HRV predict and precede changes in circulating inflammatory cytokines in humans and may have implications for treatment of inflammatory diseases.

Buccal telomere length and its associations with cortisol, heart rate variability, heart rate, and blood pressure responses to an acute social evaluative stressor in college students.

OBJECTIVE: Understanding the relationship between stress and telomere length (a marker of cellular aging) is of great interest for reducing aging-related disease and death. One important aspect of acute stress exposure that may underlie detrimental effects on health is physiological reactivity to the stressor. METHODS: This study tested the relationship between buccal telomere length and physiological reactivity (salivary cortisol reactivity and total output, heart rate (HR) variability, blood pressure, and HR) to an acute psychosocial stressor in a sample of 77 (53% male) healthy young adults. RESULTS: Consistent with predictions, greater reductions in HR variability (HRV) in response to a stressor and greater cortisol output during the study session were associated with shorter relative buccal telomere length (i.e. greater cellular aging). However, the relationship between cortisol output and buccal telomere length became non-significant when adjusting for medication use. Contrary to past findings and study hypotheses, associations between cortisol, blood pressure, and HR reactivity and relative buccal telomere length were not significant. Overall, these findings may indicate there are limited and mixed associations between stress reactivity and telomere length across physiological systems.

Trait reflection predicts interleukin-6 response to a social-evaluative stressor.

Past work has linked negative repetitive thought (worry, rumination) about stressors to sustained stress responses. Less is known about the effects of neutral types of repetitive thought (e.g., reflection) on physiological stress responses. The present study examined whether greater trait reflection was associated with a lower inflammatory response to an acute psychosocial stressor. Thirty-four healthy undergraduate women completed a speech stressor, and plasma interleukin-6 (IL-6), C-reactive protein, and tumor necrosis factor-α levels were assessed before and after the stressor. Higher levels of reflection predicted lower IL-6 responses 1h after the stressor. Stressor appraisal was not a significant mediator. These preliminary findings stand in contrast to existing evidence that other forms of repetitive thought like worry and rumination may exacerbate or prolong the inflammatory stress response and indicate that reflection is a notable factor worth considering when examining the relationship between stress, inflammation, and health.

Communication and Stress: Effects of Hope Evocation and Rumination Messages on Heart Rate, Anxiety, and Emotions After a Stressor.

How we cope with the many stressors that we encounter throughout our lives has implications for our well-being. By affecting how individuals appraise stressful events, communication can prolong or ameliorate physiological and emotional responses to stress. This study investigated the short-term effects of hope-inducing and rumination-inducing messages on heart rate, state anxiety, and emotions after a standardized, social-evaluative stressor. Continuous heart rate was monitored for 127 college students (64 female, 63 male) throughout an experiment that included a performance stressor and messages designed to (a) cause feelings of hope, (b) evoke rumination, or (c) be a distraction (control). Heart rate varied by message, such that heart rate was lowest in the hope evocation condition. State anxiety was lower in the hope evocation and distraction control conditions than in the rumination condition. The rumination condition led to greater anger, greater guilt, and less happiness than did the other conditions. This study advances our knowledge about potential ways that communication messages can counter the psychological and biological effects of stressful life events. Overall, the study provides preliminary evidence that hope evocation messages may be a form of supportive communication and can ameliorate stress.

Trait rumination moderates the effect of mentation type on heart rate responses to stressor recall.

Ruminative thought about stressors has been linked to extended post-stressor cardiovascular activation, which in turn predicts negative long-term health outcomes. Past work indicates that the nature of thought (mental imagery or verbal thought) may shape cardiovascular responses. Some evidence suggests that individuals with rumination tendencies may be especially vulnerable to stress-related cardiovascular activation, although it is unclear to what extent type of thought (imagery or verbal thought) influences this relationship. This study included a laboratory stressor followed by a stressor recall task in which mentation type was manipulated. Healthy undergraduate students (N = 138; 47% female) underwent a speech stressor and then were randomly assigned to complete a stressor recall task using either mental imagery or verbal-linguistic mentation. Heart rate (HR) and blood pressure (BP) were measured throughout. Self-report trait rumination was measured at baseline. Results indicated that trait rumination and mentation type interacted to predict HR. Individuals with high trait rumination scores had significantly greater increases in HR during the verbal-linguistic conditions compared to the mental imagery conditions. There were no mentation type differences in the low trait ruminators, no differences in BP and no main effects of trait rumination. Results suggest that mentation type may be a key in understanding the relationship between rumination and cardiovascular activation, especially for trait ruminators.

The role of social-evaluative threat for cortisol profiles in response to psychosocial stress: A person-centered approach.

Heterogeneity in individuals' physiological stress responses is central to theories linking stress with vulnerability to disease. Although multiple cortisol profiles have been reported in response to acute psychological stress, most prior work focuses on a single, average pattern and relative deviations from it, such as greater or lesser response peaks or reactivity. The present aims were to identify cortisol stress response trajectory classes using a data-driven approach and test whether social-evaluative threat (SET), a reliable elicitor of cortisol, predicted a greater likelihood of membership in the more reactive profiles. Data were pooled from 13 acute laboratory stressor studies from two geographically distinct U.S. university communities. Participants included 1,258 adults ranging from 18 to 52 years (Mage = 20.5; 62% women; 38% men) with diverse racial/ethnic identities and socioeconomic statuses. Studies included a version of the Trier Social Stress Test and at least three salivary cortisol assessments. SET was tested in three ways: study conditions with evaluators present, perceptions of evaluation, and ratings of shame-related emotions. Latent group-based trajectory modeling was applied to identify cortisol response patterns that best fit the data. Results revealed five unique cortisol response profiles. Consistent with hypotheses, SET conditions, greater perceived evaluation, and greater shame-related emotions predicted membership in the most reactive response trajectories. The findings highlight the high degree of heterogeneity that characterizes cortisol stress response profiles, which has important implications for theories of stress and health and methodological approaches in future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Re-assessing the assessment of fears of positive and negative evaluation: Scale development and psychometric evaluation of the Bivalent Fear of Evaluation Scale (BFOES).

The bivalent fear of evaluation (BFOE) model of social anxiety divides fear of evaluation into two distinct valences: fear of positive evaluation (FPE) and fear of negative evaluation (FNE). However, there is evidence that the two most widely utilized and psychometrically supported measures of FNE and FPE contain items which are ambiguous with regard to valence of evaluative fear. To formally address this, the BFOE Scale (BFOES) was developed, by merging items from measures of FNE and FPE into a single scale with an integrated response format. The present studies examined the psychometric profile of the BFOES across a large pooled archival dataset (N = 2216), which included approximately 10 % (n = 224) patients with social anxiety disorder (SAD). The factorial validity, internal consistency, and construct validity of the BFOES were examined. Additionally, item response theory analyses were employed for the purpose of merging items from self-report scales which utilized different Likert-type response formats. Results from both studies provided support for the psychometric profile of the BFOES. The implications of the BFOES for the assessment of social anxiety, and theoretical models of fear of evaluation and SAD, are discussed.

When enhanced awareness threatens: Interactive effects of domain-specific awareness and acceptance manipulations on cardiovascular indices of challenge and threat.

Mindfulness includes acceptance and awareness subcomponents, and emerging theories imply that cultivating both acceptance and awareness may benefit health by diminishing stress reactivity. Yet, no prior work has examined the effects of mindful acceptance and awareness on cardiovascular markers of threat and challenge-cardiac output and total peripheral resistance-despite the unique insights these indices yield into stress-related evaluations and motivation. The current research integrates Monitor and Acceptance Theory with the Biopsychosocial Model of Challenge and Threat to elucidate how an awareness manipulation and a brief acceptance training are associated with cardiovascular stress responses underlying states of challenge and threat. Healthy young adults (N = 202) were enrolled in a 2 × 2 between-subjects experimental design manipulating both awareness (enhanced awareness vs. no enhanced awareness) and acceptance (acceptance training vs. no acceptance training) of physiological responses to a social-evaluative cold pressor test. Cardiovascular indices were recorded throughout. The combination of enhanced awareness and acceptance training led to higher cardiac output and lower total peripheral resistance (indexing greater challenge, less threat) to the cold pressor test than the combination of enhanced awareness and no acceptance training. However, the combination of no enhanced awareness and no acceptance training also led to higher cardiac output and lower total peripheral resistance than the combination of enhanced awareness and no acceptance training. These results add to a growing body of work suggesting that mindful awareness and acceptance subcomponents interact to influence stress reactivity and imply that enhanced stressor awareness without acceptance may lead to increased threat.

Childhood adversity and cortisol habituation to repeated stress in adulthood.

BACKGROUND: Childhood adversity is a robust predictor of poor health outcomes in adulthood and hypothalamic-pituitary-adrenocortical (HPA) axis dysfunction may be a key mechanism explaining this association. However, little is known about the influence childhood adversity may exhibit on adult HPA axis habituation (i.e., decreased cortisol output in response to a repeated stressor), where HPA axis dysfunction can be inferred if habituation deviates from normal patterns. METHODS: The current study used data from a larger study that examined the effects of stress management interventions on cortisol habituation to repeated stress. Eighty-three adults reported childhood adversity with the Adverse Childhood Experience scale and completed the Trier Social Stress Test (TSST) twice (48 h apart) scheduled after a 6-wk intervention period. Salivary cortisol was assessed pre-stressor and +25, +35, and +60 mins post-stressor onset during both visits. RESULTS: Results indicated that childhood adversity was associated with a marginally larger decrease in total cortisol from visit 1 to visit 2 among men (i.e., habituation), but not women (i.e. non-habituation). CONCLUSIONS: These findings suggest that childhood adversity may alter HPA axis habituation to repeated stress later in life, with possible sex differences. Future research should investigate whether HPA axis habituation to repeated stress may be a pathway through which childhood adversity affects adult health, and how it may affect men and women differently.

Daily stressors and diurnal cortisol among sexual and gender minority young adults.

OBJECTIVE: Minority stress may contribute to poor health by dysregulating stress response systems, including diurnal cortisol rhythms. However, few studies have examined the association between sexual and gender minority stress and diurnal cortisol in lesbian, gay, bisexual, and transgender (LGBT) individuals. The current investigation tested whether the daily experience of minority stressors is uniquely related to diurnal cortisol above and beyond general stressors. METHOD: One hundred and 21 sexual and gender minority young adults (aged 18-35, 54.5% female) completed initial and daily evening questionnaires for 7 consecutive days to document daily general stressors and LGBT stressors. A randomly selected subset (n = 58) also provided salivary cortisol samples at wake, 45-min postwake, 12-hr postwake, and bedtime. RESULTS: Controlling for covariates (sex assigned at birth, wake time, bedtime, and day of the week) and general stressors, individuals who reported more LGBT stressors across the week displayed elevated cortisol levels at wake, t(491) = 9.68, p = .002 and 45-min postwake, t(492) = 6.41, p = .011, relative to individuals who reported fewer LGBT stressors. In contrast, after controlling for covariates, the frequency of general stressors only predicted cortisol 12 hr postwake, t(785) = 2.02, p = .043. Diurnal cortisol was unrelated to within-person fluctuations in LGBT and general stressors. CONCLUSIONS: Results imply that the experience of everyday minority stressors is uniquely related to diurnal cortisol and may have implications for the mental and physical health of LGBT adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Standardized stress reduction interventions and blood pressure habituation: Secondary results from a randomized controlled trial.

Meta-analyses suggest a small association between cardiovascular responses to acute stressors and cardiovascular disease, but a recent review suggests that this effect may be underestimated due to insufficient consideration of individual differences in habituation to repeated stressors. OBJECTIVE: The present article reports new analyses of a published randomized controlled trial comparing the effects of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and a passive control condition on blood pressure habituation-a secondary outcome. Psychological mediators of intervention effects were examined. METHOD: Participants (138 healthy adults reporting moderate/high stress) were randomly assigned to 6-week MBSR, CBT, or a waitlist control. Analyses were conducted on 86 participants who subsequently completed stressful speech and mental arithmetic tasks during two posttreatment visits scheduled 48 hr apart. Blood pressure was measured -15, +0, +5, +10, +25, +35, and +60 min poststressor onset. RESULTS: There were no between-condition differences in blood pressure habituation (all ps > .05). However, both MBSR and CBT led to increased perceived control over thoughts, F(2, 72) = 5.20, p = .008, and individuals who displayed a greater change in perceived control over thoughts also displayed greater habituation to the speech portion of the stressor, F(6, 799) = 2.32, p = .020. Results implied an indirect effect of stress reduction interventions on blood pressure habituation via change in perceived control over thoughts (b = -3.93, SE = 1.98, 95% CI: [-8.392, -0.701]). CONCLUSION: Stress reduction interventions that increase perceived control over thoughts may benefit cardiovascular health by promoting blood pressure habituation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Salivary cortisol responses to a psychosocial laboratory stressor and later verbal recall of the stressor: The role of trait and state rumination.

This study investigated whether trait rumination predicts greater increases in salivary cortisol concentration and delayed recovery in response to a standardized, acute laboratory psychosocial stressor (modified Trier Social Stress Test). It also tested whether trait and state rumination predict reactivation of the cortisol response during later verbal recall of the stressor. Fifty-nine undergraduates (31 females; 28 males) completed the stress protocol and returned 2 weeks later for a surprise interview about the first session, conducted in either a supportive or unsupportive context. Participants completed a measure of trait rumination and reported negative thoughts about the stressor in the 2 weeks between sessions (state rumination). Trait rumination was associated with greater reactivity of salivary cortisol level and delayed recovery from the stressor, F(1,310) = 6.77, p < 0.001. It also predicted greater cortisol reactivity when recalling the stressor, but only for males in the unsupportive interview context, F(2,119) = 7.53, p < 0.001. This effect was heightened for males who also scored high on state rumination, F(2,119) = 7.53, p < 0.001. Rumination was not associated with cortisol responses to the interviews in females. The findings indicate that rumination may play a role in prolonging cortisol stress responses through delayed recovery and reactivation and that rumination disposition and the context of stressor recall are important in understanding the rumination-cortisol response association.