The Psychological, Physiological, and Behavioral Responses of Patients to Magnetic Resonance Imaging (MRI): A Systematic Review and Meta-Analysis.

BACKGROUND: MRI is generally well-tolerated although it may induce physiological stress responses and anxiety in patients. PURPOSE: Investigate the psychological, physiological, and behavioral responses of patients to MRI, their evolution over time, and influencing factors. STUDY TYPE: Systematic review with meta-analysis. POPULATION: 181,371 adult patients from 44 studies undergoing clinical MRI. ASSESSMENT: Pubmed, PsycInfo, Web of Science, and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quality appraisal was conducted with the Joanna Briggs Institute critical appraisal tools. Meta-analysis was conducted via Meta-Essentials workbooks when five studies were available for an outcome. Psychological and behavioral outcomes could be analyzed. Psychological outcomes were anxiety (State-Trait-Anxiety Inventory, STAI-S; 37) and willingness to undergo MRI again. Behavioral outcomes included unexpected behaviors: No shows, sedation, failed scans, and motion artifacts. Year of publication, sex, age, and positioning were examined as moderators. STATISTICAL TESTS: Meta-analysis, Hedge's g. A P value <0.05 was considered to indicate statistical significance. RESULTS: Of 12,755 initial studies, 104 studies were included in methodological review and 44 (181,371 patients) in meta-analysis. Anxiety did not significantly reduce from pre- to post-MRI (Hedge's g = -0.20, P = 0.051). Pooled values of STAI-S (37) were 44.93 (pre-MRI) and 40.36 (post-MRI). Of all patients, 3.9% reported unwillingness to undergo MRI again. Pooled prevalence of unexpected patient behavior was 11.4%; rates for singular behaviors were: Failed scans, 2.1%; no-shows, 11.5%; sedation, 3.3%; motion artifacts, 12.2%. Year of publication was not a significant moderator (all P > 0.169); that is, the patients' response was not improved in recent vs. older studies. Meta-analysis of physiological responses was not feasible since preconditions were not met for any outcome. DATA CONCLUSION: Advancements of MRI technology alone may not be sufficient to eliminate anxiety in patients undergoing MRI and related unexpected behaviors. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 5.

Prospective associations of technostress at work, burnout symptoms, hair cortisol, and chronic low-grade inflammation.

BACKGROUND: Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation. METHODS: Hospital employees (N = 238, 182 females, Mage = 28.5 years) participated in a prospective cohort study with two follow-ups six months apart (T2, T3). Participants answered standardized questionnaires on general job strain (job demand-control ratio), technostressors (work interruptions, multitasking, information overload), burnout symptoms (exhaustion, mental distance), and relevant confounders. Moreover, they provided capillary blood samples for C-reactive protein (CRP) and hair strands for hair cortisol concentration (HCC) analysis. Structural equation modelling was performed. RESULTS: The factorial structure of survey measures was confirmed. Burnout symptoms (MT2 = 2.17, MT3 = 2.33) and HCC (MT2 = 4.79, MT3 = 9.56; pg/mg) increased over time, CRP did not (MT2 = 1.15, MT3 = 1.21; mg/L). Adjusted path models showed that technostress was negatively associated with HCC (ß = -0.16, p =.003), but not with burnout and CRP. General work stress in contrast, was not significantly associated with burnout, HCC or CRP. Furthermore, there were reciprocal effects of CRP on HCC (ß = 0.28, p =.001) and of HCC on CRP (ß = -0.10, p ≤.001). Associations were robust in additional analyses including further confounders. CONCLUSION: This is the first study on prospective effects of technostress on employees' endocrine and inflammatory systems. Results suggest differential effects of technostress on the hypothalamic-pituitary-adrenocortical axis activity. Given its key role for long-term health, the findings have important implications for occupational health and safety in digitalized work environments.

Study protocol for a randomized controlled trial investigating the effect of online interpretation bias intervention on stress reactivity in the children of parents with depression: the CoCo study.

BACKGROUND: Current preventive interventions for the children of parents with depression demonstrate modest effects on depression incidence. This may be because existing interventions tend to comprise general psychotherapeutic tools, rather than targeting the specific mechanisms underlying familial transmission. Improved theoretical models of familial transmission could enhance the development of targeted interventions. Although existing models assume that cognitive and biological vulnerability factors influence one another, the precise mechanisms are unknown. This project is the first to experimentally test whether negative interpretation bias has an impact on cortisol response in children of parents with depression. This study protocol reports a randomised controlled trial of an interpretation bias intervention which aims to shift participants' interpretation bias in a more positive direction and thereby alter their stress response. METHODS: Children aged 10-14 years who have i) one parent with a current or previous depression diagnosis, with at least one episode occurring during the child's lifetime and ii) do not have a current or previous psychiatric diagnosis themselves, will be assigned to one of two conditions: an interpretation bias intervention (n = 50) or a structurally similar placebo intervention (n = 50). The interpretation bias intervention consists of a short lab-based cognitive reappraisal of interpretations training, a four-week app-based Cognitive Bias Modification of Interpretations intervention and interpretation bias specific if-then plans. Interpretation bias will be assessed before and after the intervention using the Scrambled Sentences Task. The effect of the intervention on participants' stress response will be assessed by salivary cortisol collected at five different time points: from immediately before until 45 min after administering the Trier Social Stressor Test for Children. Stress reactivity will be measured via baseline to peak cortisol and stress recovery will be measured via the 45 min cortisol marker. We hypothesise that children who participate in the interpretation bias intervention will display a positive shift in interpretation bias and this, in turn, will alter their stress response. Children who receive the placebo intervention are expected to show a smaller positive shift in interpretation bias and stress reactivity. DISCUSSION: The findings of the present study will contribute to models of familial depression transmission as well as informing preventive interventions. If training a more positive interpretation bias subsequently alters participants' stress response, then incorporating such tools may increase the efficacy of existing preventive interventions. TRIAL REGISTRATION: Deutsches Register Klinischer Studien DRKS00028842. Registered August 19, 2022.

Validation of the Benefits of Being a Caregiver Scale (BBCS) - further development of an independent characteristic of informal caregiving.

BACKGROUND: Although larger amounts of scientific attention have been directed toward the concept of positive aspects of caregiving (PAC) in recent years, a globally uniform definition and a suitable, scientifically valid questionnaire for all informal caregivers have yet to be developed. On the basis of the questionnaires that already exist for measuring PAC, the authors aimed to (a) concretize the concept and (b) develop a new scale by focusing only on items that show that family caregivers experience a benefit for themselves and that the benefit they experience is the result of their caregiving activities. METHODS: The Benefits of Being a Caregiver Scale (BBCS) was validated on data from 961 informal caregivers. Cronbach's alpha was calculated to assess the internal consistency of the items, and a factor analysis was conducted to determine the structure of the BBCS. The discriminatory power and item difficulties were examined. Construct validity was established by testing four hypotheses. RESULTS: The factor analysis confirmed the single-factor structure of the BBCS. Cronbach's alpha for the total scale was 0.922. One of the 15 items did not show good to very good discriminatory power and was excluded from the final version of the scale. A higher BBCS score was observed if the caregiver experienced more positive aspects of caregiving and tended to have better general coping skills and a positive relationship with the care-receiver. The BBCS score was not associated with the subjective burden of the caregiver. Results confirmed the validity of the BBCS. CONCLUSION: The BBCS is a valid assessment instrument for measuring the benefits that caregivers experience from their caregiving work and can easily be used in research and practice. The BBCS is available free of charge in English and German ( http://www.caregiver-benefits.de ).

Associations of technostressors at work with burnout symptoms and chronic low-grade inflammation: a cross-sectional analysis in hospital employees.

OBJECTIVE: Despite the increasing scholarly interest in the phenomenon technostress, associated biological effects on employee health are under-researched. Chronic low-grade inflammation is suggested as a central pathway linking stress experience to disease development. The aim of this study was to assess associations of technology-related work stressors (technostressors) with low-grade inflammation and burnout symptoms. METHODS: N = 173 (74.6% women, Mage = 31.0 years) university hospital employees participated in a cross-sectional study. Self-report questionnaires were used for the assessment of general psychosocial working conditions (work overload, job control, social climate), a range of different technostressors, burnout symptoms, and relevant confounders. Participants provided capillary blood samples, and high-sensitivity C-reactive protein (hs-CRP) as an inflammatory biomarker was analyzed from dried blood spots. RESULTS: Based on a factor analysis, we identified four underlying dimensions of technostressors: techno- and information overload, techno-complexity, interruptions and multitasking as well as usability and technical support. In multivariate linear regressions, techno-/information overload and techno-complexity were associated with core (exhaustion, mental distance) and secondary (psychosomatic complaints) symptoms of burnout. Techno-/information overload was a significant predictor of burnout core symptoms, even when general work overload was controlled for. The technostressors were not associated with hs-CRP. CONCLUSION: This is the first study on technology-related stress at work and chronic low-grade inflammation. The results suggest that (information) overload caused by digital technology use is a distinct work stressor with genuine consequences for psychological health. To what extent these effects also manifest on a physiological level needs to be subjected to future studies, ideally with prospective designs.

Effects of psychosocial stress on prosociality: the moderating role of current life stress and thought control.

To date, only a few studies have examined whether and when stressed individuals are still prosocially motivated and willing to help others, which is in contrast to the relevance and importance that helping others has for our society. The present study investigates the impact of affective and biopsychological acute stress responses on prosociality (prosocial motivation, helping behavior) under controlled laboratory conditions. In addition, it was examined whether this relationship is affected by individuals' current life stress and the cognitive ability to keep stress-related thoughts at bay. To induce acute stress responses (heart rate, negative affect, salivary alpha-amylase, cortisol), 55 individuals (28 women, M = 24 years old, SD = 4.53) were exposed to the Trier Social Stress Test (TSST). Current life stress (cortisol) was assessed over two days of participants' everyday lives. Thought control ability was assessed with the think/no-think paradigm and was additionally manipulated after the acute stress intervention (TSST) via instructions. The results showed that acute stress was positively associated with prosociality. Specifically, negative affect was positively related to prosocial motivation and salivary alpha-amylase was positively associated with helping behavior. Current life stress moderated the relationship between salivary cortisol and helping behavior: the association was positive at low levels of current life stress. The instruction to control one's thoughts but not participants' general ability to do so reduced stress responses (negative affect). In sum, the findings suggest that prosociality increases following acute stress and that this effect depends on the level of current life stress. Additionally, adopting the strategy of controlling stress-related thoughts was found to be promising for attenuating individuals' stress responses.

A laboratory medical anamnesis interview elicits psychological and physiological arousal.

Since medical communication can be perceived as stressful, the assessment of patients' physiological arousal and behavior during anamnesis interviews may lead to a better understanding of doctor-patient interactions. Therefore, the aim of this study was to test physiological arousal and word use in a laboratory anamnesis interview. In total, sixty-five participants with a mean age of 25.0 years were randomly assigned either to an experimental group (n = 35, 65.7% women) in which they underwent an anamnesis interview or to a control group (n = 30, 73.3% women). Physiological arousal was assessed by salivary cortisol, salivary alpha-amylase (sAA), heart rate (HR) and heart rate variability (HRV). Psychological arousal was assessed using the Positive and Negative Affect Schedule (PANAS). Anamnesis interviews were analyzed using the Linguistic Inquiry and Word Count text analysis tool (LIWC). Participants of the experimental group showed an increase of sAA, HR and negative affect (p's ≤.0.05). Moreover, higher cortisol area under the curve with respect to ground (AUCg) was associated with lesser use of positive emotion words during the interview and subsequent higher negative affect (p's <.05). These results indicate that talking about one's own and family's medical history in anamnesis interview induces physiological arousal. Our findings suggest that anamnesis interviews could not only induce higher negative affect, but also induce physiological arousal, underscoring the importance of good doctor-patient communication.

Differences in acute stress responses depending on first or second language in a Hispanic-American sample.

Using a second language is a daily experience for many people today, among them many migrants. To determine whether speaking a second language induces a stronger cortisol or alpha-amylase (sAA) response than first language, we tested a Hispanic-American sample in two Trier Social Stress Test (TSST) conditions: First (Spanish) and second (German) language. Thirty-two participants (64.5% female) between the age of 19 and 53 years (mean = 30.68) from Latin America were tested (15 in Spanish, 17 in German). Participants were randomized to a German or Spanish version of the TSST, gave six saliva samples and completed questionnaires on perceived threat and stress, positive and negative affect as well as state-anxiety. A significantly higher stress response was found in the German condition for salivary cortisol, but not for sAA. Self-report showed significantly higher perceived threat and negative affect after the TSST for the German compared to the first language condition. Speaking a second compared to first language in a challenging situation appeared to be more stressful and threatening for participants. Further, reported increases in state-anxiety appeared to be higher in the German condition, even though group differences did not reach significance. A more detailed investigation of underlying, stress inducing mechanisms should be considered in future studies as well as associations with language proficiency and improvements over time.

Preparing patients according to their individual coping style improves patient experience of magnetic resonance imaging.

MRI-related anxiety is present in 30% of patients and may evoke motion artifacts/failed scans, which impair clinical efficiency. It is unclear how patient anxiety can be countered most effectively. Habitual preferences for coping with stressful situations by focusing or distracting one's attention thereof (coping style) may play a key role in this context. This study aimed to compare the effectiveness of two patient-preparation videos with informational vs. relaxational content and to determine whether the fit between content and coping style affects effectivity. The sample consisted of 142 patients (M = 48.31 ± 15.81 years). Key outcomes were anxiety, and cortisol as a physiological stress marker. When not considering coping style, neither intervention improved the patients' reaction; only patient preparation that matched the patients' coping style was associated with an earlier reduction of anxiety. This suggests that considering individual preferences for patient preparation may be more effective than a one-size-fits-all approach.

Resistance training as an acute stressor in healthy young men: associations with heart rate variability, alpha-amylase, and cortisol levels.

Regular resistance training has been shown to have many physiological and psychological health benefits. However, the underlying physiological processes are not yet fully understood. One explanation is that resistance training acts like an acute stressor and modulates physiological pathways that are associated with the stress response such as the sympathetic nervous system (SNS), the parasympathetic nervous system (PNS), and the hypothalamic-pituitary-adrenal (HPA) axis. This was systematically investigated in our study. Participants were 45 healthy men who had been doing resistance training regularly for at least nine months. Salivary α-amylase and heart rate that were used as markers for SNS activity increased during the training and decreased afterwards. PNS activity that was assessed by means of heart rate variability parameters decreased during the training and increased after it. Salivary cortisol that was used as marker for HPA axis activity decreased throughout the session. Furthermore, an improvement of positive affect was found after the training. However, additional analyses indicated that the physiological response patterns were found for participants who chose upper-body exercises (in contrast to lower-body exercises) only. Therefore, we were able to show that an upper-body resistance training acts partially like an acute stressor which leads to the typical SNS and PNS - but not HPA axis - stress responses. We conclude that resistance trainings might be an alternative to classical relaxation programs which would have the additional advantage that it is a physical training at the same time. However, more research is needed to develop specific trainings which entirely fulfill this goal.

Interleukin-6 secretion upon acute psychosocial stress as a potential predictor of psychotherapy outcome in posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is a severe mental disorder that can develop after a traumatic event. PTSD has been reported to be associated with activation of the innate immune system, as measured by increased levels of pro-inflammatory cytokines. While it is well known that PTSD patients display increased levels of interleukin 6 (IL-6) when compared with healthy controls, the relationship between cytokine secretion and treatment outcome has been hardly investigated yet. The aim of this study was to assess the potential association of inflammatory activation and therapy outcome in PTSD. Before therapeutic intervention, we applied the Trier Social Stress Test (TSST) as a method to elicit psychosocial stress and an acute inflammatory response. IL-6 levels were measured in blood plasma of PTSD patients at different time points before and after the TSST. Severity of depressive, trauma-related, and somatic symptoms was assessed before and 8 weeks after trauma-focused treatment in a multimodal day clinic setting. We showed that high reactivity of IL-6 to psychosocial stress at the beginning of the therapy was associated with a negative therapy outcome in PTSD, especially regarding depressive symptoms. This study suggests plasma IL-6 reactivity as a potential molecular marker to predict treatment outcome in PTSD.

Less immune activation following social stress in rural vs. urban participants raised with regular or no animal contact, respectively.

Urbanization is on the rise, and environments offering a narrow range of microbial exposures are linked to an increased prevalence of both physical and mental disorders. Human and animal studies suggest that an overreactive immune system not only accompanies stress-associated disorders but might even be causally involved in their pathogenesis. Here, we show in young [mean age, years (SD): rural, 25.1 (0.78); urban, 24.5 (0.88)] healthy human volunteers that urban upbringing in the absence of pets (n = 20), relative to rural upbringing in the presence of farm animals (n = 20), was associated with a more pronounced increase in the number of peripheral blood mononuclear cells (PBMCs) and plasma interleukin 6 (IL-6) concentrations following acute psychosocial stress induced by the Trier social stress test (TSST). Moreover, ex vivo-cultured PBMCs from urban participants raised in the absence of animals secreted more IL-6 in response to the T cell-specific mitogen Con A. In turn, antiinflammatory IL-10 secretion was suppressed following TSST in urban participants raised in the absence of animals, suggesting immunoregulatory deficits, relative to rural participants raised in the presence of animals. Questionnaires, plasma cortisol, and salivary α-amylase, however, indicated the experimental protocol was more stressful and anxiogenic for rural participants raised in the presence of animals. Together, our findings support the hypothesis that urban vs. rural upbringing in the absence or presence of animals, respectively, increases vulnerability to stress-associated physical and mental disorders by compromising adequate resolution of systemic immune activation following social stress and, in turn, aggravating stress-associated systemic immune activation.

Neuroendocrine coordination and youth behavior problems: A review of studies assessing sympathetic nervous system and hypothalamic-pituitary adrenal axis activity using salivary alpha amylase and salivary cortisol.

Externalizing and internalizing behavior problems can have deleterious psychosocial consequences for youth. Both sympathetic nervous system (SNS) and hypothalamic-pituitary adrenal (HPA) axis activity and reactivity may contribute to behavior problems but have largely been studied separately, with inconsistent findings. Because the SNS and HPA axis interact to carry out physiological processes (e.g., responding to stressors), considering SNS and HPA axis activity jointly may elucidate disparate findings. This review discusses studies that simultaneously assessed SNS and HPA axis (re)activity and youth behavior problems using measures of salivary alpha amylase (sAA) and salivary cortisol. Multiple patterns of SNS and HPA axis coordination were associated with problem behaviors, especially when considering individual differences and youth's psychosocial context. Importantly, many study findings may be artifacts of widespread methodological differences. The reviewed studies lay the foundation for future research on neuroendocrine coordination as a contributing factor to youth problem behaviors and some recommendations for future research are discussed.

Associations of prenatal depressive symptoms with DNA methylation of HPA axis-related genes and diurnal cortisol profiles in primary school-aged children.

Epigenetic DNA modifications in genes related to the hypothalamic-pituitary-adrenal (HPA) axis are discussed as a mechanism underlying the association between prenatal depression and altered child HPA activity. In a longitudinal study, DNA methylation changes related to prenatal depressive symptoms were investigated in 167 children aged 6 to 9 years. At six candidate genes, 126 cytosine-guanine dinucleotides were considered without correcting for multiple testing due to the exploratory nature of the study. Further associations with the basal child HPA activity were examined. Children exposed to prenatal depressive symptoms exhibited lower bedtime cortisol (p = .003, ηp2 = 0.07) and a steeper diurnal slope (p = .023, ηp2 = 0.06). For total cortisol release, prenatal exposure was related to lower cortisol release in boys, and higher release in girls. Furthermore, prenatal depressive symptoms were associated with altered methylation in the glucocorticoid receptor gene (NR3C1), the mineralocorticoid receptor gene (NR3C2), and the serotonin receptor gene (SLC6A4), with some sex-specific effects (p = .012-.040, ηp2 = 0.03-0.04). In boys, prenatal depressive symptoms predicted bedtime cortisol mediated by NR3C2 methylation, indirect effect = -0.07, 95% confidence interval [-0.16, -0.02]. Results indicate relations of prenatal depressive symptoms to both child basal HPA activity and DNA methylation, partially fitting a mediation model, with exposed boys and girls being affected differently.

The Use of Smartphones as a Digital Security Blanket: The Influence of Phone Use and Availability on Psychological and Physiological Responses to Social Exclusion.

OBJECTIVE: Mobile phones are increasingly becoming a part of the social environment, and when individuals feels excluded during a socially stressful situation, they often retreat to the comfort of their phone to ameliorate the negativity. This study tests whether smartphone presence does, in fact, alter psychological and physiological responses to social stress. METHODS: Participants (N = 148, 84% female, mean age = 20.4) were subjected to a peer, social-exclusion stressor. Before exclusion, participants were randomized to one of the following three conditions: (1) phone-present with use encouraged, (2) phone-present with use restricted, or (3) no phone access. Saliva samples and self-report data were collected throughout the study to assess salivary alpha amylase (sAA), cortisol, and feelings of exclusion. RESULTS: Participants in both phone-present conditions reported lower feelings of exclusion compared with individuals who had no access to their phone (F(2,143) = 5.49, p = .005). Multilevel modeling of sAA responses revealed that the individuals in the restricted-phone condition had a significantly different quadratic trajectory after the stressor compared with the phone use (υ = -0.12, z = -2.15, p = .032), and no-phone conditions (υ = -0.14, z = -2.64, p = .008). Specifically, those in the restricted-phone condition showed a decrease in sAA after exclusion, those in the no-phone condition showed a gradual increase, and phone users exhibited little change. Cortisol responses to the stressor did not vary by condition. CONCLUSIONS: Taken together, these results suggest that the mere presence of a phone (and not necessarily phone use) can buffer against the negative experience and effects of social exclusion.

Stronger hypothalamus-pituitary-adrenal axis habituation predicts lesser sensitization of inflammatory response to repeated acute stress exposures in healthy young adults.

Effective adjustment of the stress systems to repeated stress is regarded as an adaptive response of the organism facing environmental threats. Given the intertwined relationship between the stress systems and the inflammatory system, it could be expected that inflammatory processes should adapt to repeated stress as well. However, only little is known about adaptational processes of the different components of the immune system in response to repeated stress, and how these might be related to adaptational processes of the hypothalamus-pituitary-adrenal (HPA) axis. We here examined N=22 healthy participants (mean age 23years, 50% female) and exposed them to a standardized laboratory stressor twice, 24h apart. Plasma interleukin 6 (IL-6), salivary cortisol and psychometric parameters were assessed repeatedly up to 120min post stress. Results revealed a significant day by time interaction for cortisol (F=5.06; p=0.013) and IL-6 (F=4.42; p=0.041), indicating habituation of HPA axis and sensitization of inflammatory stress responses. Cortisol habituation and inflammatory sensitization were inversely related when controlling for sex (r=-0.44; p=0.044). Explorative analyses revealed significant associations between the IL-6 response on the second exposure with perceived stress (r=0.58; p=0.004), vital exhaustion (r=0.57; p=0.009), depression (r=0.47; p=0.026) and purpose in life (r=-0.50; p=0.04). These findings may help to increase understanding of the still only rudimentary understood interplay of adaptational processes of endocrine and immune responses to repeated stress and might indicate a link between inflammatory disinhibition and psychological indicators of well-being.

Increased alpha-amylase response to an acute psychosocial stress challenge in healthy adults with childhood adversity.

Childhood adversity is highly prevalent and linked to lasting psychological and physiological consequences. A potential mechanism for negative health outcomes is altered stress reactivity. While previous research has addressed associations of childhood adversity with stress system reactivity, sympathetic nervous system (SNS) stress reactivity is understudied. We therefore set out here to examining salivary alpha-amylase (sAA) reactivity in relation with childhood adversity. Forty-one healthy adult subjects (n = 24 male; n = 17 female) aged 18-34 years underwent the Trier Social Stress Test (TSST) and completed the Childhood Trauma Questionnaire (CTQ). Saliva for measurement of sAA was collected at three time points; before the TSST, immediately after, and 10 min post-TSST. We found that those with childhood trauma had a higher overall sAA response to the TSST, as seen in a repeated measures ANOVA (CTQ by time interaction: F(1.8,71.5) = 6.46, p = .01) and an independent samples t-test indicating higher sAA baseline to peak response (t = 3.22, p = .003). There was also a positive correlation between sAA reactivity and the CTQ subscales of childhood physical abuse (r = .46, p = .005) and emotional abuse (r = .37, p = .024). Healthy adults with low-to-moderate childhood adversity had a heightened sAA response immediately following the stressor. Higher SNS reactivity could be a link to negative health outcomes in adults with early adversity. Future research should address whether altered sAA reactivity is predictive of negative health outcomes in those with childhood adversity.

Trajectories of relationship stress and inflammatory processes in adolescence.

Researchers have identified cross-sectional links between interpersonal stress and inflammation. Little is known, however, about how these dynamics unfold over time, what underlying immune pathways might exist, or whether moderators such as race could alter the strength of the connection between interpersonal stress and inflammatory processes. We examined whether adolescent girls whose relationship trajectories were characterized by chronic stress would exhibit a proinflammatory phenotype marked by systemic inflammation, heightened cytokine responses to bacterial challenges, and resistance to the anti-inflammatory properties of cortisol. Significant Stress × Race interactions revealed that family stress trajectories predicted glucocorticoid sensitivity and peer stress trajectories predicted cytokine production for White but not Asian girls. Relationship stress trajectories were not associated with systemic inflammation, however. These findings suggest that particular subgroups of adolescent girls who face chronic and elevated stress in their close relationships may be at risk for disruptions to the immune system.

Acute psychosocial stress induces differential short-term changes in catecholamine sensitivity of stimulated inflammatory cytokine production.

BACKGROUND: We have previously shown that psychosocial stress induces acute changes in glucocorticoid (GC) sensitivity of pro-inflammatory cytokine production. However, hormones of the sympathetic adrenal medullary system complement endocrine regulation of inflammatory responses. The current study therefore aimed at investigating the effects of repeated acute stress exposure on catecholamine sensitivity of inflammatory cytokine production. METHODS: Twenty healthy male participants were subjected to the Trier Social Stress Test on two consecutive days. Blood samples were taken before and repeatedly after stress. Whole blood was stimulated with lipopolysaccharide and incubated with increasing concentrations of epinephrine (E) and norepinephrine (NE) for 18h. Tumor-necrosis-factor (TNF) alpha and interleukin (IL)-6 were measured in culture supernatants. RESULTS: Overall, incubation with E and NE induced dose-dependent suppression of TNF-alpha (NE: F=77.66, p<.001; E: F=63.38, p<.001), and IL-6 production (NE: F=28.79, p<.001; E: F=24.66, p<.001). Acute stress exposure resulted in reduced sensitivity of TNF-alpha (NE: F=6.36, p<.001; E: F=4.86, p=.005), but not IL-6 (NE: F=1.07, p=.38; E: F=0.88, p=.50) to the inhibitory signals of E and NE. No evidence of habituation of these effects was found (all p⩾.22). CONCLUSIONS: The present findings extend our knowledge on changes in inflammatory target tissue sensitivity in response to acute psychosocial stress from glucocorticoid-dependent effects to catecholamine-dependent effects. Stress-induced decreases in catecholamine sensitivity thereby suggest intracellular processes aiding in maintaining a healthy endocrine-immune interplay. Longitudinal studies will have to investigate the processes leading from a supposedly beneficial short-term catecholamine resistance in response to acute stress to basal catecholamine resistance observed in relation to negative health outcomes.