Acute Stress Situations Research Articles

Author Reply: Arousal Reappraisal as an Affect Regulation Strategy.

The biopsychosocial (BPS) model of challenge and threat posits that resource and demand appraisals interact in situations of acute stress to determine affective responses, and concomitant physiological responses, motivation, and decisions/behaviors. Regulatory approaches that alter appraisals to regulate challenge and threat affective states have the potential to facilitate coping. This reply clarifies the conceptualization of one such regulatory approach, arousal (or stress) reappraisal, and suggests avenues for future research. However, it is important to note that arousal reappraisal (or any brief psychological intervention) is not a "silver bullet" for improving stress outcomes, nor should this strategy be expected to positively impact all individuals. More work is needed to better elucidate how psychological and biological stress processes interact to shape health.

Effects of a fixed herbal drug combination (Ze 185) to an experimental acute stress setting in healthy men – An explorative randomized placebo-controlled double-blind study

BackgroundConsidering the negative effects of stress on health, there is a growing interest in stress-reducing interventions. The present study examines the effects of a fixed combination of valerian, passion flower, lemon balm, and butterbur extracts (Ze 185) on biological and affective responses to a standardized psychosocial stress paradigm. PurposeThe aim of the present study was to investigate the efficacy of Ze 185 on cortisol and anxiety stress responses to acute psychosocial stress in healthy subjects. Study DesignThis study was a randomized, placebo-controlled, double blind study with 3 parallel groups. Methods72 healthy male participants were randomized to 3 groups (Ze 185, placebo or no treatment) during 4 days prior to a standardized psychosocial stress paradigm. Principle outcomes were salivary cortisol and self-reported anxiety responses to stress assessed at the fourth day. ResultsThe stress paradigm induced significant and large cortisol and self-reported anxiety responses. Groups did not differ significantly in their salivary cortisol response to stress, but participants in the Ze 185 condition showed significantly attenuated responses in self-reported anxiety in comparison to placebo (F(3, 41) = 3.33, p = 0.03) and no treatment (F(3, 43) = 2.77, p = 0.05). ConclusionThe results show that Ze 185 significantly attenuated the subjective emotional stress response during an acute stress situation, without affecting biological stress responses. Given that a circumscribed biological stress response is to be considered as an adaptive mechanism, Ze 185 reduces self-reported anxiety response to stress without affecting assumingly adaptive biological stress responses.

How Do Stress Exposure and Stress Regulation Relate to Borderline Personality Disorder?

Borderline personality disorder (BPD) is a severe and frequent disorder characterized by a pervasive pattern of instability affecting impulse control, emotional regulation, cognitive processing, self-image and interpersonal relationships. Patients’ personal histories are often marked by stressful or traumatic experiences, either unique or repeated. Moreover, while clinical signs of the disorder include both chronic and acute features, acute features are mostly triggered by acute stressful situations. Such features include transient cognitive distortion, intense anger, uncontrollable impulsivity, and self-harm behavior – including suicide – and contribute to the burden of the disease. In this paper, we review the various aspects (epidemiological, clinical, and physiological) contributing to the relationship between BDP and stress. In particular, we explore the statistical association between stress exposure and the emergence of BPD while taking into account other psychopathologies, such as post-traumatic stress disorder. Then, the different aspects of stress responses (namely, the phenomenological, behavioral, hormonal, neuro-vegetative and neural responses) are reviewed in BPD patients. Pathophysiological hypotheses are formulated to explain the differences in responses between BPD patients and healthy subjects and their relation to BPD symptoms. Although the pathogenesis remains uncertain, our conclusions seem to reflect a specific biological and neural pattern of altered stress perception and regulation in BPD.

Distraction coping predicts better cortisol recovery after acute psychosocial stress

The aim of this study was to explore whether different manifestations of state coping predict cortisol response and recovery in an acute stress situation. Fifty-nine healthy adults (59.3% female) were exposed to the Trier Social Stress Test (TSST), and salivary cortisol was measured repeatedly before and after stress. Hierarchical linear modeling was used to test for relationships between factor-analytically derived measures of state coping and cortisol response and recovery. Independent of sex, age, BMI, chronic stress and depression, denial coping was related with higher peak levels of cortisol (β=0.0798, SE=0.0381, p=0.041) while distraction coping predicted steeper recovery after TSST (linear effect: β=−0.0430, SE=0.0184, p=0.023) and less pronounced curvature (quadratic effect: β=0.0043, SE=0.0017, p=0.016). Our results demonstrate the stress-buffering effect of distraction coping on hypothalamic-pituitary-adrenal (HPA) axis activity in situations without sufficient control.

Coping with acute stress in the military: The influence of coping style, coping self-efficacy and appraisal emotions

It is of utmost importance to better understand how professionals in high-risk organizations, such as the military and police, appraise and cope with acute stress situations. The goal of this two-wave study was to investigate the role of two individual characteristics, coping style and coping self-efficacy, for recruits' appraisal emotions and subsequent coping behavior during a high-stress exercise at the end of a 18–33week training period. Three different military samples were studied (officer cadets, special infantry and Marine corps recruits, and recruits). Multi-group comparison showed that coping style was directly related to coping behavior. Coping self-efficacy was indirectly related to coping behavior through threat and challenge emotions. Together, these findings provide insights for appraisal research and practice.

The serotonin transporter polymorphism (5-HTTLPR) and coping strategies influence successful emotion regulation in an acute stress situation: Physiological evidence

IntroductionEmotion regulation is an important everyday-life skill to reduce harm and stress. Consequently, research shows associations between psychopathologies and emotional dysregulation. The serotonin transporter polymorphism (5-HTTLPR) has repeatedly been associated to phenotypes and syndromes related to emotional dysregulation. However, there is no study showing any direct effects of 5-HTTLPR genotype and emotion regulation. Hence, the aim of the present study was to draw a link between 5-HTTLPR to emotion regulation. MethodN=91 healthy participants filled in a coping questionnaire, provided gene samples and participated in an emotion regulation experiment. In a within-subject design they viewed emotional pictures and were either instructed to suppress their emotions or not. During the emotion regulation task, skin conductance responses (SCR) were recorded. ResultsEmotion regulation abilities measured by SCR were influenced by 5-HTTLPR and coping strategies, together explaining 30% of variance. S-allele carriers showed increased SCRs when watching aversive stimuli in the uninstructed condition. However, when receiving an emotion regulation instruction, they were able to downregulate their arousal resulting in comparable SCRs as observed in LL-carriers. DiscussionThis is the first study showing an impact of 5-HTTLPR on physiological emotion regulation. Results show that S-allele carriers have the same emotional arousal as L-allele carriers, when they get a supportive instruction to suppress unwanted feelings. These findings have implications for psychotherapeutic treatments.

Effect of Alternate Nostril Breathing Exercise on Experimentally Induced Anxiety in Healthy Volunteers Using the Simulated Public Speaking Model: A Randomized Controlled Pilot Study.

A randomized controlled pilot study was carried out to determine the effect of a 15-minute practice of ANB exercise on experimentally induced anxiety using the simulated public speaking model in yoga-naïve healthy young adults. Thirty consenting medical students were equally divided into test and control groups. The test group performed alternate nostril breathing exercise for 15 minutes, while the control group sat in a quiet room before participating in the simulated public speaking test (SPST). Visual Analog Mood Scale and Self-Statements during Public Speaking scale were used to measure the mood state at different phases of the SPST. The psychometric scores of both groups were comparable at baseline. Repeated-measures ANOVA showed a significant effect of phase (p < 0.05), but group and gender did not have statistically significant influence on the mean anxiety scores. However, the test group showed a trend towards lower mean scores for the anxiety factor when compared with the control group. Considering the limitations of this pilot study and the trend seen towards lower anxiety in the test group, alternate nostril breathing may have potential anxiolytic effect in acute stressful situations. A study with larger sample size is therefore warranted. This trial is registered with CTRI/2014/03/004460.

Military leadership and emotion regulation in acute situations that contain moral dilemmas

The aim was to gain a deeper understanding of individual emotion-focused coping strategies and institutionalised norms as regards emotion regulation in a short-and long-term perspective in relation to acute stressful situations that contain moral dilemmas. 15 participants at different hierarchical levels in the Swedish Armed Forces (SAF) were interviewed. Several individual emotion regulation strategies and organisational norms for emotional expressiveness were identified. These were integrated into a theoretical model. The study contributes by explicating a context-specific emotion culture that gives limited space for emotional expression as it is necessary to remain firm and cold in acute situations that include moral dilemmas. Leaders must be able to minimise emotional displays in order to contribute to operational efficiency (termed emotional containing capacity). Potential conflicts between a well-developed emotional containing capacity in acute situations and long-term adaptation to organisational norms in daily life after missions and practical implications are discussed.

Military leadership and emotion regulation in acute situations that contain moral dilemmas

The aim was to gain a deeper understanding of individual emotion-focused coping strategies and institutionalised norms as regards emotion regulation in a short-and long-term perspective in relation to acute stressful situations that contain moral dilemmas. 15 participants at different hierarchical levels in the Swedish Armed Forces (SAF) were interviewed. Several individual emotion regulation strategies and organisational norms for emotional expressiveness were identified. These were integrated into a theoretical model. The study contributes by explicating a context-specific emotion culture that gives limited space for emotional expression as it is necessary to remain firm and cold in acute situations that include moral dilemmas. Leaders must be able to minimise emotional displays in order to contribute to operational efficiency (termed emotional containing capacity). Potential conflicts between a well-developed emotional containing capacity in acute situations and long-term adaptation to organisational norms in daily life after missions and practical implications are discussed.

Is arsenic exposure during pregnancy associated with saliva cortisol in 2 years old children from Arica, Chile? Preliminary results.

Introduction: Exposure to inorganic arsenic (iAs) during pregnancy generates lower expression of glucocorticoid receptors in hypothalamus of offspring in murine models. This association has not been studied in children exposed in utero to low concentrations of iAs. The aim is to study the association between low-level iAs exposure during pregnancy and salivary cortisol in 2-years-old children belonging to Arica, Chile. Methods: In this prospective cohort study, a sample of pregnant women was recruited from 5 public health services in Arica. Participation was voluntary and written consent was mandatory. Urine samples to assess total iAs (μg/L) and sociodemographic data were collected from 242 mothers during 2nd trimester of pregnancy. Data related to acute stressful situations and salivary samples, both in children and mothers, were collected when children were around 2-years-old to assess salivary cortisol. Descriptive statistics and multiple linear regression models were fitted to study the association between iAs and salivary cortisol, adjusting by other variables. The modifying effect of PPD variable was evaluated. Results: For these preliminary results we included the analysis of forty-one mother-child pairs. The median of total urine iAs was 14.8μg/L (IQR: 9.2μg/L). The cortisol mean was 0.98μg/dL (SD: 0.19μg/dL). iAs distribution was positively biased and cortisol distribution was symmetric. iAs exposure was transformed in quartile to perform multiple linear regression. iAs was positively associated with salivary cortisol in children whose mothers had postpartum depression (PPD) and inversely associated when the mother did not have PPD. Child’s acute sickness and circadian rhythm were associated with salivary cortisol in children whose mothers had PPD. Conclusions: Preliminary results indicate that iAs was associated with salivary cortisol. However, the addition of a biomarker for acute stressful situations is needed to confirm our preliminary results.

Distraction coping predicts better cortisol recovery after acute psychosocial stress

Abstract The aim of this study was to explore whether different manifestations of state coping predict cortisol response and recovery in an acute stress situation. Fifty-nine healthy adults (59.3% female) were exposed to the Trier Social Stress Test (TSST), and salivary cortisol was measured repeatedly before and after stress. Hierarchical linear modeling was used to test for relationships between factor-analytically derived measures of state coping and cortisol response and recovery. Independent of sex, age, BMI, chronic stress and depression, denial coping was related with higher peak levels of cortisol (β = 0.0798, SE = 0.0381, p = 0.041) while distraction coping predicted steeper recovery after TSST (linear effect: β = −0.0430, SE = 0.0184, p = 0.023) and less pronounced curvature (quadratic effect: β = 0.0043, SE = 0.0017, p = 0.016). Our results demonstrate the stress-buffering effect of distraction coping on hypothalamic-pituitary-adrenal (HPA) axis activity in situations without sufficient control.

Cardiomyocyte exosomes regulate glycolytic flux in endothelium by direct transfer of GLUT transporters and glycolytic enzymes.

Cardiomyocytes (CMs) and endothelial cells (ECs) have an intimate anatomical relationship, which is essential for maintaining the metabolic requirements of the heart. Little is known about the mechanisms that regulate nutrient flow from ECs to associated CMs, especially in situations of acute stress when local active processes are required to regulate endothelial transport. We examined whether CM-derived exosomes can modulate glucose transport and metabolism in ECs. In conditions of glucose deprivation, CMs increase the synthesis and secretion of exosomes. These exosomes are loaded with functional glucose transporters and glycolytic enzymes, which are internalized by ECs, leading to increased glucose uptake, glycolytic activity, and pyruvate production in recipient cells. These findings establish CM-derived exosomes as key components of the cardio-endothelial communication system which, through intercellular protein complementation, would allow a rapid response from ECs to increase glucose transport and a putative uptake of metabolic fuels from blood to CMs. This CM-EC protein complementation process might have implications for metabolic regulation in health and disease.

Glucose Starvation in Cardiomyocytes Enhances Exosome Secretion and Promotes Angiogenesis in Endothelial Cells.

Cardiomyocytes (CMs) and endothelial cells (ECs) have an intimate anatomical relationship that is essential for maintaining normal development and function in the heart. Little is known about the mechanisms that regulate cardiac and endothelial crosstalk, particularly in situations of acute stress when local active processes are required to regulate endothelial function. We examined whether CM-derived exosomes could modulate endothelial function. Under conditions of glucose deprivation, immortalized H9C2 cardiomyocytes increase their secretion of exosomes. CM-derived exosomes are loaded with a broad repertoire of miRNA and proteins in a glucose availability-dependent manner. Gene Ontology (GO) analysis of exosome cargo molecules identified an enrichment of biological process that could alter EC activity. We observed that addition of CM-derived exosomes to ECs induced changes in transcriptional activity of pro-angiogenic genes. Finally, we demonstrated that incubation of H9C2-derived exosomes with ECs induced proliferation and angiogenesis in the latter. Thus, exosome-mediated communication between CM and EC establishes a functional relationship that could have potential implications for the induction of local neovascularization during acute situations such as cardiac injury.

Central corticosterone disrupts behavioral and neuroendocrine responses during lactation

Administration of a high dose of chronic peripheral corticosterone during the postpartum period has been shown to lead to reduced maternal care, but the interference of acute corticosterone, mimicking a situation of acute stress, on maternal behavior has not been well established. Therefore, the aim of our study was to investigate the influence of acute central corticosterone on behavioral and neuroendocrine responses during lactation. On day 7 of lactation, female rats were treated with vehicle (5μL; i.c.v.) or corticosterone (10ng/5μL; i.c.v.) 30 min before the start of the experiment. To evaluate maternal behavior, the pups were returned to the side of their home cages opposite the previous nest, and the resulting behavior of the lactating rats was filmed for the next 30min. Plasma levels of oxytocin and the amount of milk consumed by the pups were evaluated 15min after the onset of suckling. In addition, the double-labeled c-Fos/oxytocin neurons in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) and c-Fos immunoreactivity in medial preoptic area (MPOA) neurons were quantified for each lactating rat. Corticosterone decreased maternal care, plasma oxytocin levels, milk consumption by the pups, the activation of oxytocinergic neurons in hypothalamic nuclei, and c-Fos immunoreactivity in MPOA neurons. Our results indicate that changes in the behavioral responses of lactating rats treated with corticosterone may be related to disruption of the neuroendocrine control of oxytocin secretion.

Relationship between balance control and psychological factors

The goal of the study was to capture the relationship between motor balance and psychological factors, using sport-motoric tests as well as subjective self-evaluations. The balance control of 118 patients of a psychosomatic rehabilitation clinic was examined at the beginning and end of rehabilitation using various motor tests. Additionally, psychological variables including self-esteem (MSWS), degree of anxiety (BAI) and depressive symptoms (BDI) were assessed. To examine subjective self-evaluation a numerical analog scale and a questionnaire with open questions were used. Content analysis was performed on the questionnaire. In the area of physical self-esteem, especially sportiness, low to moderate correlations were found between self-esteem and balance. No significant relationship was found between anxiety or depressive symptoms and balance. In the open questions most patients described a distinct connection between emotional distress and balance. The participation in the tests was often a topic in their therapy. The expected relationship between psychological factors and motor balance could be only partially confirmed. A question is raised as to whether this relationship appears merely in situations of acute stress, as detected in the patients answers to the open questions. Addressing the study in psychotherapie an indication that balance tasks are well suited for the subjective experience and discussion of psychosomatic relationships.

Molecular characterization, tissue distribution, and ultrastructural localization of adipokinetic hormones in the CNS of the firebug Pyrrhocoris apterus (Heteroptera, Insecta)

Adipokinetic hormones (AKHs) are a group of insect metabolic neurohormones, synthesized and released from an endocrine retrocerebral gland, the corpus cardiacum (CC). Small amounts of AKH have also been identified in the brain, although their role in this organ is not clear. To address this gap in the knowledge about insect brain biology, we studied the nucleotide sequence, tissue distribution, and subcellular localization of AKHs in the brain and CC of the firebug Pyrrhocoris apterus. This insect expresses two AKHs; the octapeptides Pyrap-AKH and Peram-CAH-II, the presence of which was documented in the both studied organs. In situ hybridization and quantitative reverse-transcription (q-RT)-PCR revealed the expression of the genes encoding for both AKHs not only in the CC, but also in brain. Electron microscopy analysis of the brain revealed the presence of these hormones in specialized secretory granules localized predominantly in the cellular bodies of neurons. The hormones might be transported from the granules into the axons, where they could play a role in neuronal signaling. Under acute stress induced by the injection of 3μmol KCl, the level of AKHs in the brain increased to a greater extent than that in the CC. These results might indicate an enhanced role of brain-derived AKHs in defence reaction under acute stress situations.

Parabrachial nucleus (PBn) pituitary adenylate cyclase activating polypeptide (PACAP) signaling in the amygdala: Implication for the sensory and behavioral effects of pain

The intricate relationships that associate pain, stress responses and emotional behavior have been well established. Acute stressful situations can decrease nociceptive sensations and conversely, chronic pain can enhance other pain experiences and heighten the emotional and behavioral consequences of stress. Accordingly, chronic pain is comorbid with a number of behavioral disorders including depression, anxiety abnormalities and associated stress-related disorders including post traumatic stress disorder (PTSD). The central nucleus of the amygdala (CeA) represents a convergence of pathways for pain, stress and emotion, and we have identified pituitary adenylate cyclase activating polypeptide (PACAP) immunoreactivity in fiber elements in the lateral capsular division of the CeA (CeLC). The PACAP staining patterns colocalized in part with those for calcitonin gene related peptide (CGRP); anterograde fiber tracing and excitotoxic lesion studies demonstrated that the CeLC PACAP/CGRP immunoreactivities represented sensory fiber projections from the lateral parabrachial nucleus (LPBn) along the spino-parabrachioamygdaloid tract. The same PBn PACAP/CGRP fiber system also projected to the BNST. As in the BNST, CeA PACAP signaling increased anxiety-like behaviors accompanied by weight loss and decreased feeding. But in addition to heightened anxiety-like responses, CeA PACAP signaling also altered nociception as reflected by decreased latency and threshold responses in thermal and mechanical sensitivity tests, respectively. From PACAP expression in major pain pathways, the current observations are novel and suggest that CeA PACAP nociceptive signaling and resulting neuroplasticity via the spino-parabrachioamygdaloid tract may represent mechanisms that associate chronic pain with sensory hypersensitivity, fear memory consolidation and severe behavioral disorders.

Enkephalin knockout male mice are resistant to chronic mild stress.

Enhanced stress reactivity or sensitivity to chronic stress increases the susceptibility to mood pathologies such as major depression. The opioid peptide enkephalin is an important modulator of the stress response. Previous studies using preproenkephalin knockout (PENK KO) mice showed that these animals exhibit abnormal stress reactivity and show increased anxiety behavior in acute stress situations. However, the consequence of enkephalin deficiency in the reactivity to chronic stress conditions is not known. In this study, we therefore submitted wild-type (WT) and PENK KO male mice to chronic stress conditions, using the chronic mild stress (CMS) protocol. Subsequently, we studied the CMS effects on the behavioral and hormonal level and also performed gene expression analyses. In WT animals, CMS increased the expression of the enkephalin gene in the paraventricular nucleus (PVN) of the hypothalamus and elevated the corticosterone levels. In addition, WT mice exhibited enhanced anxiety in the zero-maze test and depression-related behaviors in the sucrose preference and forced swim tests. Surprisingly, in PENK KO mice, we did not detect anxiety and depression-related behavioral changes after the CMS procedure, and even measured a decreased hormonal stress response. These results indicate that PENK KO mice are resistant to the CMS effects, suggesting that enkephalin enhances the reactivity to chronic stress.

Protocol for a systematic review of the association between chronic stress during the life course and telomere length.

BackgroundThe effects of stress on ill health have become evident in recent years. Under acute stress situations, a cascade of physiological events helps the body mount an appropriate adaptive response. However, under chronic stress situations, this physiological response may lead to wear and tear on the body that accelerates the decline in physiological functioning and increases the risk of chronic conditions. Recent evidence for social stress experienced during childhood suggests serious consequences many years later, even later life. Telomere length, a marker of cell aging, may provide a link between chronic social stress and age-associated physical and mental decline and risk of chronic conditions. This study examines whether chronic social stress is associated with telomere length throughout the life course.Methods/DesignWe will perform a systematic review of the literature on the relationship between chronic social stress, for example, due to violence, extreme poverty, or caregiving of people with disabling conditions (exposure), and telomere length (outcome) by searching electronic databases in MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and gray literature from their start date onwards. We will limit the search to studies performed on human populations. Two reviewers will conduct standardized screening, eligibility assessment, data abstraction, and scientific quality assessment. All study designs investigating the association between chronic social stress and telomere length in healthy or diseased adults and children will be eligible for inclusion in the review. We will extract individual demographic and socioeconomic characteristics, research setting, method of measuring telomere length, reported outcome, and determinants of interest. Studies will also be stratified by 1) age into 3 groups: childhood (0 to 18 years), adulthood (19 to 64 years) and late life (65+); 2) cell type; 3) study design; and 4) telomere length assessment method. Where feasible, study results will be combined through meta-analyses to obtain a pooled measure of associations. Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement.DiscussionThis systematic review will provide knowledge on the existing evidence for chronic social stress and its association with telomere lengths throughout the life course.

Hyperglycemia, oxidative stress, and the diaphragm: a link between chronic co-morbidity and acute stress?

It is well established that prolonged, controlled mechanical ventilation is associated with contractile dysfunction of the diaphragm due to impaired function of the mitochondrial respiratory chain as a result of aggravated oxidative and nitrosative stress. Sepsis and circulatory failure induce a similar response pattern. Callahan and Supinski now show that streptozotocin-induced insulin-dependent diabetes causes a comparable response pattern, both with respect to function and physiology - that is, reduced fiber force and, consequently, muscle contractility - but also as far as the underlying mechanisms are concerned. In other words, the authors elegantly demonstrate that the consequences of a chronic metabolic disease and that of acute critical illness may lead to the same phenotype response. It remains to be elucidated whether the underlying co-morbidity (for example, diabetes) adds to or even synergistically enhances the effect of an acute stress situation (for example, sepsis, mechanical ventilation). In addition, extending their previous work during shock states, the authors also show that administration of a preparation of the enzymatic anti-oxidant superoxide dismutase can reverse the deleterious effects of diabetes. These data are discussed in the context of the fundamental role of hyperglycemia in relation to metabolism-dependent formation of reactive oxygen species.