Anticipatory Stress Response Research Articles

Predictors of anticipatory cortisol reactivity to subsequent stressors

Understanding the nature, predictors, and consequences of anticipatory biological stress responses are important in understanding long-term effects of repeated stressors. We examined anticipatory cortisol responses after an individual has actually experienced and reacted to a stressor once and is anticipating a second similar stressor. We hypothesized that how an individual reacts to the first stressor may predict that individual's anticipatory responses to further stressors. In Session 1, 77 male participants delivered speeches and performed arithmetic tasks in front of two evaluators. In Session 2 one week later, participants were told that they would do the same tasks again in front of evaluators. Stress cortisol reactivity in Session 1 (increase in cortisol from pre-stressor to post-stressor) predicted anticipatory cortisol reactivity in Session 2 (increase in cortisol from baseline to immediately pre-stressor). In addition, trait measures of low self-esteem and a “Submissive and Disconnected” interpersonal orientation predicted stronger anticipatory cortisol reactivity in Session 2. If the cortisol response to an initial stressor does in fact shape consequent anticipatory cortisol responses, this self-perpetuating nature of the initial cortisol response may contribute to negative long-term effects of repeated stressors on health. One factor that may be able to counteract this effect is a dominant and confident interpersonal orientation, which may lead to lower anticipatory cortisol reactions regardless of the response to the initial stressor.

Sympathetic Arousal during a Touch-Based Healing Ritual Predicts Increased Well-Being.

Objective. There is mounting evidence that more elaborate treatment rituals trigger larger nonspecific effects. The reasons for this remain unclear. In a pilot field study, we investigated the role of psychophysiological changes during a touch-based healing ritual for improvements in subjective well-being. Methods. Heart rate, respiratory rate, and skin conductance levels (SCL) were continuously assessed in 22 subjects before, during, and after a touch-based healing ritual. Participants rated their expectations and subjective well-being was assessed before and after the ritual by the “Short Questionnaire on Current Disposition”. Results. Subjective well-being increased significantly from before to after the ritual. The analysis of psychophysiological changes revealed a significant increase in respiratory rate from baseline to ritual, while skin conductance, heart rate, and heart rate variability did not change. Increases in SCL as well as decreases in respiratory rate from baseline to ritual were significantly associated with improvements in subjective well-being. Regression analyses showed increases in SCL to be the only significant predictor of improvements in well-being. Conclusion. Higher sympathetic arousal during a touch-based healing ritual predicted improvements in subjective well-being. Results suggest the occurrence of an anticipatory stress response, that is, a state of enhanced sympathetic activity that is known to precede relaxation.

Using extended contact to improve physiological responses and behavior toward people with schizophrenia

Extended contact has been shown to improve explicit and implicit attitudes toward a number of outgroups, but not yet toward people with mental health conditions. Using people with schizophrenia as the target group, this experiment is the first to demonstrate that extended contact can reduce explicit prejudice, buffer stress responses to future interactions, improve non-verbal behavior, and improve the quality of interactions in a manner detectable by the target group member. Participants watched a video of a brief, positive interaction between two strangers, one of whom they were led to believe had schizophrenia. Control participants watched the same video without being told that the person had schizophrenia. They then participated in a social interaction with a confederate whom they were led to believe had the disorder. Participants' cardiovascular and electrodermal activity were monitored immediately before the interaction. The interaction was also secretly recorded to allow independent judges to assess the participants' non-verbal behaviors. The confederate also rated the positivity of each interaction. Participants in the extended contact condition reported more positive attitudes toward people with schizophrenia, displayed more positive non-verbal behaviors, and had a more positive interaction with the confederate. Moreover, just prior to the interaction, participants in the extended contact condition displayed smaller anticipatory stress responses, as reflected in smaller changes in interbeat interval and non-specific skin conductance responses during this phase. Together, these findings support the use of the extended contact as an intervention that could lead to genuine changes in attitudes toward and treatment of people with severe mental health disorders.

Differentiating anticipatory from reactive cortisol responses to psychosocial stress

Most psychosocial stress studies assess the overall cortisol response without further identifying the temporal dynamics within hormone levels. It has been shown, however, that the amplitude of anticipatory cortisol stress levels has a unique predictive value for psychological health. So far, no "best practice" in how to investigate the anticipatory cortisol stress response has emerged. The goal of the current research was to develop a protocol that would allow for a sensitive and easy-to-implement laboratory-based investigation into anticipatory cortisol stress levels. We initially tested 26 healthy men in either an anticipation- or stress-only condition of the Trier Social Stress Test (TSST) to map the distinct timelines of anticipatory and reactive cortisol release profiles (study 1). Subsequently, we administered the TSST to 50 healthy men such that the cortisol responses to anticipatory and reactive stress components could be dissociated (study 2). In both studies we sampled saliva cortisol at high frequency (at baseline, during 10min of anticipation and during and after 10min of acute stress) and the current mood state pre- and post-stress. We found anticipatory responder rates of 20% and 40%, with peak anticipatory cortisol levels between 14 and 20min after onset of anticipation. Visible changes in reactive cortisol levels occurred only after the termination of the acute stressor. We conclude that the best practice to detect a maximum number of anticipatory responders in the TSST would be to extend the anticipation phase to 15min. In doing so, the anticipatory cortisol peak could be captured at a time-point of the actual stressor that is uninfluenced by reactive cortisol levels. Overall, we could reveal several features of anticipatory responders. Most importantly, there was a positive correlation between anticipatory and reactive stress responses. There was no association between anticipatory cortisol and alpha-amylase as well as subjective-psychological stress responses. Future studies will have to determine whether the anticipatory responders differ with respect to various stress-sensitive parameters like sex, personality, psychological wellbeing or chronic stress.

Development and Validation of the Prolonged Activation and Anticipatory Race-Related Stress Scale

This article describes two separate studies that were conducted to develop and validate a measure of the prolonged stress activation and anticipatory race-related stress response in African American adults (Prolonged Activation and Anticipatory Race-Related Stress Scale [PARS]). In Study 1, an exploratory factor analytic procedure ( N = 292) resulted in a17-item measure with four underlying factors: (a) Perseverative Cognition, (b) Secondary Appraisal, (c) Anticipatory Race-Related Stress Scale–Psychological, and (d) Anticipatory Race-Related Stress Scale–Physiological. In Study 2 ( N = 227), a confirmatory factor analytic procedure was conducted to evaluate and compare the underlying factor structure for several competing models of the PARS. This procedure supported a four-factor oblique solution as having the best fit to the data. Study 2 also provided evidence for the convergent validity of the PARS in that its factor scores correlated, in the anticipated direction, with scores on measures of related constructs.

Visuo-spatial path learning, stress, and cortisol secretion following military cadets’ first parachute jump: the effect of increasing task complexity

The present field experiment examined how multi-trial visuo-spatial learning and memory performance are impacted by excessive arousal, instigated by a potentially life-threatening event (i.e., a first parachute jump). Throughout a parachute training activity, subjective and neuroendocrine (i.e., cortisol) stress levels were assessed of 61 male military cadets who were randomly assigned to a control (n = 30) or a jump stress condition (n = 31). Post-stress learning and memory capacity was assessed with a 10-trial path-learning task that permitted emergence of learning curves. Pre-activity cortisol concentrations indicated a significant neuroendocrine anticipatory stress response in the stress group. Following parachuting, subjective stress levels and salivary cortisol reactivity differed significantly between groups. Visuo-spatial path-learning performance was impaired significantly after jump stress exposure, relative to the control group. Moreover, examination of the learning curves showed similar learning and memory performance at onset of the trials, with curves bifurcating as the task became more complex. These findings are in accordance with leading theories that acknowledge a moderating effect of task complexity. In sum, the present study extends knowledge concerning anticipatory stress effects, endogenously instigated cortisol reactivity, and the influence of extreme arousal on visuo-spatial path learning.

BDNF Val 66Met polymorphism is associated with higher anticipatory cortisol stress response, anxiety, and alcohol consumption in healthy adults

The brain-derived neurotrophic factor (BDNF) is a key protein in maintaining neuronal integrity. The BDNF gene is thought to play an important role in the pathophysiology of mood and anxiety disorders. The aim of this study was to investigate, for the first time in a single study, the association between BDNF Val(66)Met polymorphism, anxiety, alcohol consumption, and cortisol stress response. 98 healthy university students (54 females and 44 males), genotyped for the Val(66)Met polymorphism, participated in a physical-stress procedure (cold pressure test, CPT) after having been informed that they would undergo a painful experience. Indices of anxiety and of stress were collected from repeated measurement of salivary cortisol, blood pressure, and heart rate. BDNF Met carriers, were more anxious during the CPT (p<0.001), drank more alcohol per week, (p<0.05), and showed significantly higher anticipatory cortisol response (p<0.05), but not in response to the CPT, than Val/Val homozygotes. The association of BDNF Val(66)Met polymorphism with HPA axis reactivity to stress was not modulated by gender. These results suggest that Met carriers are particularly sensitive in anticipating stressful events, which extends previous findings on the moderating role of the BDNF Val(66)Met polymorphism in the face of stressful life events.

Anticipatory Stress Response in PTSD: Extreme Stress in Children

Anticipatory stress chronically activates the stress response in children with post-traumatic stress disorder (PTSD). Effects of the allostatic load may begin even before birth in a stressful environment. The purpose of this paper is to discuss the anticipatory stress response in children with PTSD. The paper discusses the etiology, the impact of the disorder on long-term health, cognitive and behavioral manifestations, and clinical management and treatment options. A review on current literature is presented and includes several key studies. Anticipatory stress in PTSD has acute and long-term health implications for the child. The psychiatric nurse plays a key role in preventing the long-term effects of PTSD.

Infant anticipatory stress.

In humans, anticipatory stress involves activation of the limbic-hypothalamic-pituitary-adrenal axis, which releases stress hormones such as cortisol in response to an impending stressor. Conditioning of the stress response to anticipate and prepare for future challenges is a hallmark of adaptation. It is unknown whether human infants in the first year of life have developed the neural circuitry to support the anticipation of stressful events in an attachment context. Here, we show that human infants at six months of age produce an anticipatory stress response, as indicated by the release of stress hormones, when re-exposed after 24 h to a context in which they demonstrated a stress response to a disruption in the parent-infant relationship. Although infant stress response (cortisol elevation) was greater to the stressful event (parent unresponsiveness) than to the second exposure to the stress context (room, chair, presence of parent and experimenter, etc.), it was greater in the stress group than in the control group on both days. Results suggest that human infants have the capacity to produce an anticipatory stress response that is based on expectations about how their parents will treat them in a specific context.

Prescribing love for the heart? Stress reduction and medical effects of altruism, compassion and love

Objective Talking points on the therapeutic significance of love offered by neurobiology and positive psychology. Discussion Love is difficult to define. Looked at neurobiologically, it is closely associated with the concept of pleasure, reward and ‘positive psychology’, i.e., joyful mental states, and therefore has become a feature not only of psychological but also of basic science research and clinical medicine. Though not identical, altruism and compassion show physiological commonalities with the neurobiology of love. This understanding utilizes limbic ‘neural emotionality’, using as substrates, among others, endogenous morphine, dopamine and nitric oxide signaling. Particularly in love responses, oxytocin and vasoppressin additionally fit in. Love in the beginning can be stressful. This is also true of other stress-reducing practices that incorporate a stress component initially, i.e., relaxation and placebo responses. This initial uprise is termed anticipatory stress response (ASR). The initial activation of this stress component of the total response – i.e., relaxation and/or love response – is significant and represents a protective mechanism. Activation is started, then followed by relaxation, i.e., stress release, only if the situation allows for it, guaranteeing an appropriate environment. Stress and love therefore act as biological counterplayers. This function of love is of particular importance for the cardiovascular system and is expressed via stress response pathways and their subsequent down-regulation. Thus, emotional (i.e., non-cognitive) processes became adducts to stress activation, terminating it quickly. Altruistic and compassionate behaviors exactly fulfil this need and thus show stress-reducing capacities. Physiological alterations following such behaviors can be profound and lasting, as demonstrated for the autonomous and the central nervous or the cardiovascular systems. This potential has led to a broad array of studies demonstrating positive medical effects of love, social bonding, volunteering and compassion, especially of benefit for the heart and the brain, implying that this self-healing potential could be used in various therapeutic situations, including integrative medicine. Conclusions Love facilitates health and stress reduction. This effect can be observed clinically and biologically. Thus, love and companionship not only ensure the survival of individuals and their species, but also support beneficial motivation and health behaviors.

The impact of assessing simulated bad news consultations on medical students’ stress response and communication performance

Seventy second-year medical students volunteered to participate in a study with the aim of evaluating the impact of the assessment of simulated bad news consultations on their physiological and psychological stress and communication performance. Measurements were taken of salivary cortisol, systolic and diastolic blood pressure, heart rate, state anxiety and global stress using a Visual Analogue Scale. The subjects were asked to take three salivary cortisol samples on the assessment day as well as on a quiet control day, and to take all other measures 5 min before and 10 min after conducting the bad news consultation. Consultations were videotaped and analyzed using the information-giving subscale of the Amsterdam Attitude and Communication Scale (AACS), the Roter Interaction Analysis System (RIAS), and the additional non-verbal measures, smiling, nodding and patient-directed gaze. MANOVA repeated measurements were used to test the difference between the cortisol measurements taken on the assessment and the control day. Linear regression analysis was used to determine the association between physiological and psychological stress measures and the students' communication performance. The analyses were restricted to the sample of 57 students who had complete data records. In anticipation of the communication assessment, cortisol levels remained elevated, indicating a heightened anticipatory stress response. After the assessment, the students' systolic blood pressure, heart rate, globally assessed stress level and state anxiety diminished. Pre-consultation stress did not appear to be related to the quality of the students' communication performance. Non-verbal communication could be predicted by pre-consultation physiological stress levels in the sense that patient-directed gaze occurred more often the higher the students' systolic blood pressure and heart rate. Post-consultation heart rate remained higher the more often the students had looked at the patient and the more information they had provided. However, the heart rate appeared to diminish the more often the students had reassured the patient. These findings suggest that in evaluating students' communication performance there is a need to take their stress levels into account.

Neuroendocrine and blood pressure responses to rectal distensions in individuals with high and low visceral pain sensitivity

The mechanisms of interindividual variations in visceral pain sensitivity remain poorly understood. We characterized the neuroendocrine responses to rectal distensions in healthy individuals with high vs. low rectal pain sensitivity. Rectal sensory and pain thresholds were determined, and a series of random painful distensions was carried out. Eighteen subjects were stratified into groups with a low rectal pain threshold ("High Sensitivity" group) vs. a high rectal pain threshold ("Low Sensitivity" group) by median split, and were compared with regard to adrenocorticotropic hormone (ACTH) and cortisol, cardiovascular, and emotional responses. Distensions led to an anticipatory stress response, reflected by elevated baseline anxiety, and increased baseline ACTH and cortisol in both groups. In response to distensions, the "Low Sensitivity" group showed significantly greater ACTH and cortisol concentrations analysis of variance (ANOVA time x group for ACTH: p<.05; for cortisol: p<.01), and elevated diastolic blood pressures (BP) (ANOVA group: p<.01) when compared to the "High Sensitivity" group. Painful rectal distensions are associated with a pronounced anticipatory stress response, reflected by elevated anxiety and elevated stress hormones. Individuals with high rectal pain sensitivity differ from those with low pain sensitivity in distension-induced hormonal and blood pressure responses, suggesting that neuroendocrine responses may be relevant to the pathophysiology of visceral hyperalgesia.

Surgical anticipatory stress manifests itself in immunocyte desensitization: Evidence for autoimmunoregulatory involvement

The immunocyte behavior (conformational changes and locomotion in response to signal molecule challenge) in patients about to undergo elective cardiac surgery was studied to elucidate the effect of psychological anticipatory stress on the immune system. Granulocytes and monocytes from 10 patients and 35 non-surgical controls were examined. Computer-assisted microscopic image analysis, capable of measuring cellular conformational and velocity changes, was used to measure the responsiveness of these immunocytes to peptidergic and cytokine stimulation. Immunocyte desensitization would appear to account for the reduction in their abilities to respond to chemotaxic challenge associated with the pre-cardiac surgery state. Their abilities to respond to d-Ala2-Met-enkephalinamide (DAMA) were observed only at much higher concentrations than previously reported (10–11 M vs. 10-9 M prior to surgery). This finding, together with the observed decrease in adrenocorticotropin levels compared to non-surgical controls, suggests that neutral endopeptidase activity was elevated just prior to surgery. Indeed, neutral endopeptidase activity is statistically elevated in the pre-cardiac surgery state. Furthermore, glucocorticoid levels remained constant, within normal resting limits, in both groups. Thus, surgical anticipatory stress may manifest itself, in part, as a desensitization of various immunocytes. Thus, a psychological anticipatory stress response may be a precipitant of the desensitization. Although this desensitization seemed not to involve the entire hypothalamic-pituitary-adrenal axis, the data suggest that psychological anticipatory stress may initially involve and influence autoimmunoregulation.