Should we suppress or reappraise our stress?: the moderating role of reappraisal on cortisol reactivity and recovery in healthy adults

Background: People differ in their ability to regulate their physiological stress response. Individual differences in emotion regulation strategies such as suppression and reappraisal may explain this differential response to stress.

Objective: The aim of the current study was to assess whether daily use of suppression and reappraisal as well as their interaction predicted physiological stress reactivity and/or recovery, as assessed by variations in cortisol levels.

Method: Thirty-eight healthy young adults (13 men) completed the Emotion Regulation Questionnaire and were exposed to a psychosocial stressor, throughout which salivary cortisol was measured.

Results: Linear regressions showed main effects of reappraisal and suppression on cortisol reactivity and a main effect of suppression on cortisol recovery, where both strategies were positively associated with stress phases. Moreover, results showed a significant interaction of suppression by reappraisal in predicting both cortisol reactivity and recovery. Simple slope tests revealed that reappraisal moderated the association between suppression and both phases of cortisol responsivity.

Conclusion: Our results suggest that reappraisal represents a protective factor against the deleterious effects of suppression on stress responsivity. This study underlines the importance of investigating emotion regulation strategies as a means to understand individual differences in vulnerability to stress-related psychopathologies such as anxiety and depression.     

Cortisol reactivity in the laboratory predicts ineffectual attentional control in daily life

Objective: The objective was to examine an executive control difficulty perspective on individual differences in cortisol reactivity using a daily protocol.

Design: Fifty participants competed a laboratory stressor task and individualdifferences in cortisol reactivity were quantified.

Main outcome measures: Daily attentional control, conflicting thoughts, error reactivity, worry and mindfulness were assessed.

Results: The findings support the idea that as cortisol responses to stress get larger (as an individual difference), attentional control ceases to function as it should in terms of variables that should predict (mindfulness) and follow from (e.g. worry) it.

Conclusion: The findings support the idea that individual differences in cortisol reactivity can be conceptualised in terms of ineffectual attentional control.     

Effects of a prevention program for divorced families on youth cortisol reactivity 15 years later

Objective: We examined whether an empirically based, randomised controlled trial of a preventive intervention for divorced mothers and children had a long-term impact on offspring cortisol regulation.

Design: Divorced mothers and children (age 9–12) were randomly assigned to a literature control condition or the 11-week New Beginnings Program, a family-focused group preventive intervention for mothers and children in newly divorced families.

Main Outcome Measures: Fifteen years after the trial, offspring salivary cortisol (n = 161) was measured before and after a social stress task.

Results: Multilevel mixed models were used to predict cortisol from internalizing symptoms, externalizing symptoms, group assignment and potential moderators of intervention effects. Across the sample, higher externalizing symptoms were associated with lower cortisol reactivity. There was a significant group-by-age interaction such that older offspring in the control group had higher reactivity relative to the intervention group, and younger offspring in the control group exhibited a decline across the task relative to younger offspring in the intervention group.

Conclusions: Preventive interventions for youth from divorced families may have a long-term impact on cortisol reactivity to stress. Results highlight the importance of examining moderators of program effects.     

Does the level of physical exercise affect physiological and psychological responses to psychosocial stress in women?

ObjectivesTo test the Cross-Stressor Adaptation hypothesis for females by examining whether physically exercising young women show reduced physiological and psychological stress responses to a psychosocial stressor.DesignForty-seven healthy young women with different levels of physical exercise (17 not or rarely exercising, 15 moderately exercising, 15 vigorously exercising) underwent the Trier Social Stress Test for Groups (TSST-G); physiological and psychological stress responses during and after stress induction were compared.MethodANOVAs with repeated measures were used to compare stress reactivity and recovery between the three exercise groups. Heart rate and salivary free cortisol were used as indicators of physiological stress response, state anxiety, mood, and calmness as indicators of psychological stress response. For physiological stress reactivity, the areas under the curve with respect to the ground (AUC_G) were compared.ResultsIn all three exercise groups, experimentally induced stress led to a significant rise in heart rate, cortisol, and state anxiety; mood and calmness significantly decreased. As hypothesized, the pattern of the physiological stress response differed for the three exercise groups, with lowered reactivity in the more active groups. However, the psychological stress response partly went in the opposite direction: Exercising participants reported a higher mood decrease, suggesting a dissociation of the physiological and psychological stress responses.ConclusionsThe findings suggest that the Cross-Stressor Adaptation hypothesis is also valid for young women; however, only with regard to physiological stress response. The unexpected findings for psychological stress response need to be further explored in experimental studies.     

Effortful control and parenting: Associations with HPA axis reactivity in early childhood

While activation of the hypothalamic‐pituitary‐adrenal (HPA) axis is an adaptive response to stress, excessive HPA axis reactivity may be an important marker of childhood vulnerability to psychopathology. Parenting, including parent affect during parent–child interactions, may play an important role in shaping the developing HPA system; however, the association of parent affect may be moderated by child factors, especially children's emerging self‐regulatory skills. We therefore tested the relationship between parent affectivity and 160 preschoolers’ cortisol reactivity during a laboratory visit, examining children's effortful control (EC) as a moderator. Greater parent negative affectivity was related to greater initial and increasing cortisol over time, but only when children were low in EC. Higher parent positive affectivity was related to a higher baseline cortisol for children with low EC and lower baseline cortisol for children with high EC. Results indicate that children's EC moderates the extent to which parent affect shapes stress reactive systems in early childhood.     

Response of the pituitary-adrenal axis in terms of type a behaviour,hostility and vital exhaustion in healthy middle-aged men

Abstract

Pituitary-adrenal axis was studied in terms of Type A behaviour, hostility and vital exhaustion among 69 healthy middle-aged men. The results showed that psychological factors could explain a significant proportion of the biologically manipulated responses of HPA axis, but they worked in different ways. Type A behaviour was related to a high level of mean basal ACTH and a low level of cortisol response to ACTH stimulation after dexamethasone suppression; hostility was related to a high level of mean basal cortisol and a high cortisol in cortisol/ACTH ratio, while vital exhaustion was characterized by a low level of mean basal ACTH and a decreased ACTH in relation to cortisol. The adrenocortical patterns, i.e. a high ACTH-low cortisol; a high cortisol; and a low ACTH-low mean basal cortisol, as related to Type A behaviour, hostility and exhaustion, respectively, are in line with the traditional physiological stress model and suggest that different adrenocortical responses might be able to identify different mental stress processes. Sense of control has been suggested to be a key concept for psychological understanding of this finding.     

Parent support is less effective in buffering cortisol stress reactivity for adolescents compared to children

The goal of the present study was to investigate developmental differences in the effectiveness of parent support to alleviate hypothalamic‐pituitary‐adrenal (HPA) axis stress responses of children (ages 9–10, N = 40) and adolescents (ages 15–16, N = 41). We experimentally manipulated the provision of parent support during the speech preparation period before a modified Trier Social Stress Test (TSST) and examined its effect on levels of salivary cortisol secreted in response to this laboratory stressor. Analyses revealed a significant interaction of condition and age group such that social support from the parent (versus a stranger) significantly eliminated the cortisol stress response in children, but had no effect on the response among adolescents.     

Emotion regulation and biological stress responding: associations with worry,rumination, and reappraisal

ABSTRACT

Individual differences in the habitual use of emotion regulation strategies may play a critical role in understanding psychological and biological stress reactivity and recovery in depression and anxiety. This study investigated the relation between the habitual use of different emotion regulation strategies and cortisol reactivity and recovery in healthy control individuals (CTL; n?=?33) and in individuals diagnosed with social anxiety disorder (SAD; n?=?41). The tendency to worry was associated with increased cortisol reactivity to a stressor across the full sample. Rumination was not associated with cortisol reactivity, despite its oft-reported similarities to worry. Worry and rumination, however, were associated with increased cortisol during recovery from the stressor. The only difference between CTL and SAD participants was observed for reappraisal. In the CTL but not in the SAD group, reappraisal predicted recovery, such that an increased tendency to reappraise was associated with greater cortisol recovery. These results suggest an important role of the habitual use of emotion regulation strategies in understanding biological stress reactivity and recovery.     

Adolescent Personality: Associations With Basal,Awakening, and Stress‐Induced Cortisol Responses

The purpose of the present study was to investigate the associations between personality facets and hypothalamic‐pituitary‐adrenal (HPA) axis functioning. Previous studies have mainly focussed on stress‐induced HPA‐axis activation. We hypothesized that other characteristics of HPA‐axis functioning would have a stronger association with personality based on the neuroendocrine literature. Data (n = 343) were used from the TRacking Adolescents' Individual Lives Survey (TRAILS), a large prospective cohort study of Dutch adolescents. We studied the association between facets of Neuroticism, Extraversion, and Conscientiousness and basal cortisol, the cortisol awakening response (CAR), and four measures of stress‐induced HPA‐axis activity. Basal cortisol levels were related to facets of all three personality traits. The CAR and stress‐induced cortisol were not related to personality. Possibly due to its more trait‐like nature, basal cortisol seems more informative than stress‐induced cortisol when investigating trait‐like characteristics such as personality facets.     

Cortisol and behavioral reaction of low and high sensation seekers differ in responding to a sport-specific stressor

Background/objectives: Sensation seeking is closely related to practicing high-risk sports. This domain offers individuals an opportunity to achieve an increased level of arousal. Moreover, stress reactivity implies interindividual differences in the capacity to respond to a stressor. The purpose of this study was to examine whether high sensation seekers (HSS) compared to low sensation seekers (LSS) experience lower levels of stress on a physiological and psychological basis. Stress was induced in a sport-specific experimental paradigm with a climbing task through a jump into the rope.

Methods: Two extreme groups (n?=?28 male athletes) were examined in a mixed-factorial design (between: HSS vs. LSS; within: repeated measurements of several variables related to stress reactivity - cortisol, heart rate, anxiety).

Results: In response to the stressor HSS compared to LSS released a significantly lower amount of cortisol and needed less time for the climbing task. Heart rate and anxiety were not significant.

Conclusions: Individuals seem to react physiologically differently to a sport-specific stressor, depending on their level of sensation seeking. HSS seem to be less strained, and seem to perform better. These findings might be relevant not only for the evaluation of (sport-) psychological interventions but also for other contexts (e.g., special forces).     

Psychological and Neuroendocrine Reactivity to Ostracism

This study used the ostracism detection theory to investigate how ostracism impacts individuals in two ways: (1) immediate poststressor needs, mood, ruminative thoughts, and desire to affiliate, and (2) short‐term affective and cortisol reactivity. A total of 58 college students were randomly assigned to the inclusion or ostracism conditions of Cyberball, a virtual ball‐tossing game. Immediately following the experimental manipulation, ostracized participants reported more thwarted psychological need states, more negative mood, and fewer positive ruminative thoughts, relative to their included counterparts. Ostracized participants reported a greater interest in affiliating with others in online or in‐person settings. In the short‐term, ostracized males reported more hostility than included males, although the scores were within expected norms for most males. There was no relation between Cyberball condition and gender across time for depression, anxiety, or positive affect. Approximately 20 min after the onset of the stressor, women in the luteal phase and women taking oral contraceptives in the ostracized group displayed higher cortisol than their counterparts in the included group. Relative to baseline, however, cortisol did not reliably increase after the onset of the stressor. Ostracized females taking oral contraceptives showed the greatest decline in cortisol, compared to included oral contraceptive users. Overall, results suggest that most of the negative effects of ostracism are immediate and limited to psychological, not neuroendocrine, responses.     

Performance feedback,self-esteem,and cardiovascular adaptation to recurring stressors

Background and Objectives: This study sought to examine the effects of performance feedback and individual differences in self-esteem on cardiovascular habituation to repeat stress exposure.

Methods: Sixty-six university students (n?=?39 female) completed a self-esteem measure and completed a cardiovascular stress-testing protocol involving repeated exposure to a mental arithmetic task. Cardiovascular functioning was sampled across four phases: resting baseline, initial stress exposure, a recovery period, and repeated stress exposure. Participants were randomly assigned to receive fictional positive feedback, negative feedback, or no feedback following the recovery period.

Results: Negative feedback was associated with a sensitized blood pressure response to a second exposure of the stress task. Positive feedback was associated with decreased cardiovascular and psychological responses to a second exposure. Self-esteem was also found to predict reactivity and this interacted with the type of feedback received.

Conclusions: These findings suggest that negative performance feedback sensitizes cardiovascular reactivity to stress, whereas positive performance feedback increases both cardiovascular and psychological habituation to repeat exposure to stressors. Furthermore, an individual’s self-esteem also appears to influence this process.     

Racial exclusion causes acute cortisol release among emerging-adult African Americans: The role of reduced perceived control

ABSTRACT

Racial discrimination contributes to stress-related health disparities among African Americans, but less is known about the acute effects of racial exclusion on the hypo-pituitary-adrenocortical response and psychological mediators. Participants were 276 Black/African American emerging-adults (54% female; M _age = 21.74, SD = 2.21) who were randomly assigned to be excluded or included by White peers via the game Cyberball. Racial exclusion (vs. inclusion) predicted: greater negative affect (F(1, 276) = 104.885, p < .0001), lower perceived control (F(1, 276) = 205.523, p < .0001), and greater cortisol release (F(1, 274) = 4.575, p = .033). Racial exclusion’s impact on cortisol release was mediated by lower perceived control (95% CI: .027, .112), but not negative affect (?.041, .013). These findings suggest that racial exclusion contributes to acute cortisol release, and that reduced perceived control is a consequence of racial discrimination that has important implications for the health of those who experience discrimination.     

Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women

Gender differences in the neuroendocrine and cardiovascular response to psychological stress may contribute to the gender differences in the prevalence of diseases associated with hypothalamic-pituitary-adrenal (HPA) axis reactivity such as cardiovascular disease (CVD), diabetes and hypertension. We measured plasma ACTH, cortisol, heart rate (HR), and blood pressure (BP) responses in 8 men and 8 women (55-75 years) exposed to the Matt Stress Reactivity Protocol (MSRP), a psychological challenge. The MSRP elicited significant increases in HR, systolic-, and diastolic BP, ACTH and cortisol (all p<0.01). Men had significantly greater cortisol and diastolic BP responses compared to women (p<0.05). Additionally, a positive correlation between the ACTH and cortisol responses was only found in the males (r=0.71, p<0.05). There were no group differences in HR, systolic BP, or ACTH responses. We conclude, that among older adults, men respond to psychological stress with greater increases in cortisol, compared to women. This greater activation of the HPA axis could translate into an elevated risk for CVD, diabetes and hypertension and may be related to the higher prevalence of these diseases in males. Gender differences in brain structures and/or cognitive processes may be responsible for these sexually dimorphic stress responses.     

Intranasal oxytocin and salivary cortisol concentrations during social rejection in university students

Oxytocin facilitates pro-social behaviour and is proposed as a regulatory factor controlling stress reactivity. Previous research on oxytocin and stress has focused on achievement-related stressors among male participants. The aims of the study were to (1) examine the influence of oxytocin on the affective and cortisol response to the Yale Interpersonal Stressor (YIPS), a live social rejection paradigm, and (2) to replicate the finding that women exhibit a greater cortisol response to interpersonal stress than men (Stroud et al. 2002). Sex differences in stress responses: Social rejection versus achievement stress. Biol Psychiat 53:318-327. Ninety-six undergraduate students underwent the YIPS, where participants were excluded from two separate conversations by two same-sex confederates. Salivary cortisol concentrations and mood were repeatedly measured throughout the study. Participants were administered, in a double-blind design, a single dose of intranasal oxytocin (24 IU) or placebo prior to beginning the YIPS. The YIPS elicited a significant negative mood response that was more pronounced in females than in males. However, no significant cortisol response to the stressor and no sex difference in cortisol reactivity were observed. A significant effect of drug condition on cortisol levels was observed. Participants who were administered oxytocin exhibited a decrease in cortisol levels, relative to placebo, during the YIPS, F (4, 184)=4.50, p<0.05. The study failed to replicate the sex difference in the cortisol response to interpersonal stress reported by Stroud et al. (2002). Intranasal oxytocin, however, appeared to reduce cortisol concentrations during an interpersonal challenge.     

Social support coping style predicts women’s cortisol in the laboratory and daily life: the moderating role of social attentional biases

Background and Objectives: Social stress and associated coping responses can profoundly influence women’s stress physiology and health. Implicit social attentional biases can also influence psychological and physiological stress responses. The purpose of this study was to explore whether a coping style characterized by greater use of social support predicts indices of cortisol activity in laboratory and daily life contexts among female university students. We hypothesized that the relation of this coping style to cortisol activity would be moderated by women’s attentional biases.

Methods: Seventy-four women (M_age?=?19.44, range: 17.8–27.8, 64% White) completed an interpersonal stress task and an attentional bias task in the lab, along with a self-report coping inventory. Participants provided five saliva samples during the lab protocol, followed by three saliva samples per day for three consecutive weekdays. Outcome measures included cortisol response to lab tasks (AUCg), diurnal cortisol slope, diurnal AUCg, and cortisol awakening response (CARi).

Results: A coping style characterized by greater use of social support predicted lower lab AUCg and lower, flatter average diurnal cortisol slope for women with attentional avoidance compared to women with attentional vigilance (ps?<?.05).

Conclusions: Responding to stress by using social support is linked to lower cortisol responses to social stress and diurnal cortisol activity for women with implicit avoidance of social threat cues.     

Resilience and hypothalamic-pituitary-adrenal axis reactivity under acute stress in young men

The present study examined the relationship between resilience (measured using the Resilience Scale for Adults) and hypothalamic-pituitary-adrenal (HPA) axis reactivity. We examined the subjective and cortisol responses of 28 healthy young men to an acute stressor (public speech task). Eight saliva samples were collected in order to obtain the response curve (anticipation, reactivity, recuperation) for each subject. ANOVA indicated that highly resilient individuals tended to display less mood deterioration than less resilient individuals (marginal p(time x group interaction) = 0.075). They also revealed that the former tended to secrete less cortisol overall than the latter during the experiment (marginal p(main group effect) = 0.087) but this effect was not uniform across time (p(time x group interaction) = 0.029). Additional analyses performed to identify the source of this interaction revealed that resilience moderates cortisol secretion in anticipation of the stressor (i.e. highly resilient individuals secreted less cortisol than less resilient ones, p = 0.05) but that it is not conductive to lower HPA reactivity amidst stress (i.e. there was no difference between groups in the increase in cortisol secretion from baseline to peak). The recovery slopes were likewise not statistically different. The implications of these findings regarding health are discussed.     

Cortisol,stress, and attentional bias toward threat

Abstract

Attentional bias toward threatening stimuli is a central characteristic of anxiety and acute stress. Recent small-scale studies have provided divergent perspectives on the association between the stress hormone cortisol and attentional bias toward threat cues. In a larger sample size than previous studies, we examined this association by investigating the impact of cortisol on attentional bias in two studies using a psychological stressor (N=35) and a physical stressor (N=65), respectively. Attentional bias and salivary cortisol were measured prior to and following the administration of a stressful task designed to increase cortisol levels. Results across these studies were equivocal relative to the association between baseline cortisol and baseline attentional bias. In addition, the association between acute change in cortisol and change in attentional bias appeared to differ as a function of the presence or absence of psychological stress. There was a trend toward a stronger negative association between acute cortisol change and attentional bias change among women relative to men. These results imply that the association between cortisol and attentional bias may be moderated by additional factors, such as gender or presence of stress.     

Benefits of belonging: Experimental manipulation of social inclusion to enhance psychological and physiological health parameters

Objective: Acute changes in social belonging are important triggers for alterations in health and well-being, yet research has emphasised the negative effects of ‘exclusion’ at the expense of evaluating the potentially positive effects of ‘inclusion’. This study examined the impact of acute belonging on physiological and psychological outcomes.

Design and main outcome measures: A healthy population (N?=?138) were randomly allocated to ‘included’ or ‘excluded’ conditions. Condition-dependent differences in pre/during-task heart rate and pre/post-task self-reports of negative/positive mood, and social self-esteem, were assessed.

Results: Included participants showed decreased heart rate and negative mood, and increased social self-esteem. No inclusion-related change in positive mood was shown. An increase in heart rate was observed in excluded participants though no changes in negative/positive mood or social self-esteem were shown. Shifts in social self-esteem acted as a mechanism through which inclusion/exclusion impacted upon negative and positive mood alterations. Results remained significant in presence of covariates (sex, global self-esteem, rumination and social anxiety).

Conclusion: Findings suggest that acting to enhance belonging through ‘inclusion’ resulted in adaptive physiological and psychological outcomes. Neutral and potentially protective responses were observed in the immediate aftermath of ‘exclusion’. Self-esteem served as one route through which these effects were transmitted.     

Stress experience and performance during an oral exam: the role of self-efficacy,threat appraisals,anxiety, and cortisol

Background and Objectives: High self-efficacy may reduce emotional and physiological stress responses in the context of an examination. The present study investigated how these stress responses develop on an exam day, and sequential indirect effects between self-efficacy, threat appraisals, stress responses and performance.

Design and Methods: The sample comprised 92 students (46 women). Self-efficacy, threat appraisals and state anxiety were assessed on a control day one week before an oral exam. Additionally, anxiety was assessed three times on the exam day. Salivary cortisol samples were collected at all time points.

Results: Pre-exam anxiety and cortisol decreased until grades were announced. For both responses, greater levels were related to a steeper decline. However, changes in anxiety and cortisol were unrelated. Self-efficacy was negatively related to threat appraisals and anxiety on the control day. Greater threat appraisals were associated with higher pre-exam anxiety and a steeper anxiety decrease on the exam day, which in turn, was related to better performance.

Conclusions: High levels of self-efficacy may reduce threat appraisals and anxiety in the lead up to an exam, which are related to the intensity and decline of anxiety on the exam day. A steeper decline of anxiety may be beneficial to performance.