Higher Levels Of Chronic Stress Research Articles

Treatment of chronic stress in employees: Subjective, cognitive and neural correlates

This study reports the effect of an affect-focused intervention program, the Affect School, on stress, psychological symptoms, cognitive functioning and neural activity. Fifty employees in social service and education, with high levels of chronic stress, were randomly divided into a treatment (N=27) and control (N=23) group. Complete sets of data were available in 20 participants in the treatment group and 17 in the control group. The Perceived Stress Questionnaire assessed stress and the Symptom Check List-90 psychological symptoms before and after treatment. Episodic-memory functioning under focused and divided attention conditions was also assessed. Prior and after the Affect School, seven participants in the treatment group were studied with functional magnetic resonance imaging (fMRI) during episodic memory processing. After the Affect School there was a reduction in stress and psychological symptoms for the treatment group but not in the control group. The controls showed a reduction in episodic memory functioning whereas the performance of the treatment group remained intact. The fMRI scanning indicated a qualitative change in the neural network subserving episodic memory. These preliminary results suggest that the Affect School is effective on individuals with high stress.

The role of daily positive emotions during conjugal bereavement.

The role of daily positive emotions in the stress process was examined in a sample of 34 recently bereaved older adult widows. Humor coping and perceived stress were measured in questionnaires, and positive emotions, depression, anxiety, and stress were assessed daily for 98 days. Results highlight the critical role of daily positive emotions in the months immediately following conjugal loss. Intraindividual analyses revealed significant reductions in the magnitude of the stress-depression correlation on days in which greater positive emotions were present. Results also suggest that different vulnerability and resilience factors are implicated in the emotion differentiation process. For widows with greater humor coping skills, there was less overlap in daily ratings of positive emotions and depressive symptoms. In contrast, higher levels of chronic stress resulted in less differentiation of emotional responses.

Stress‐induced increase in morning cortisol variance

AbstractEmpirical evidence for the role of the hypothalamo‐pituitary‐adrenal axis in chronic stress is contradictory. Findings of enhanced cortisol concentrations conflict with hypocortisolism in chronic stress. Both, high and low cortisol levels, have been reported to go along with psychological and somatic complaints. To integrate conflicting empirical results and theoretical assumptions it is hypothesized, that (1) the cortisol distribution becomes broader under the influence of persisting stress. Because of the association between extreme cortisol values and stress related complaints it is supposed, that (2) stress related complaints will increase in prevalence in chronic stress. A high level of chronic stress was assured by recruiting a sample of nursing staff; a waiting list controlled cognitive‐behavioral stress management intervention was implemented to vary stress systematically. As expected a high level of stress was accompanied by a broader morning cortisol distribution. After the intervention the distribution was less broad and corresponded with representative normative values. However, subjects grouped on basis of (extreme) cortisol values did not differ in the amount of stress, coping or psychophysiological complaints. The results suggest a stress‐induced variation of basal cortisol concentrations. The assumption of specific complaints depending on cortisol status could not be confirmed. Copyright © 2004 John Wiley & Sons, Ltd.

A Growth Curve Analysis of the Course of Dysthymic Disorder: The Effects of Chronic Stress and Moderation by Adverse Parent-Child Relationships and Family History.

Using mixed effects models, the authors examined the effects of chronic stress, adverse parent-child relationships, and family history on the 7.5-year course of dysthymic disorder. Participants included 97 outpatients with early-onset dysthymia who were assessed with semistructured interviews at baseline and 3 additional times at 30-month intervals for 7.5 years. Results indicated that higher levels of chronic stress 6 months prior to each follow-up predicted greater depression severity at follow-up, controlling for depression severity at the start of the chronic stress assessment. In addition, adverse parent-child relationships and family history of dysthymic disorder moderated this association. For patients with poorer parent-child relationships, chronic stress was associated with increased depression severity at follow-up, whereas patients with a higher familial loading for dysthymic disorder were less responsive to chronic stress over time.

Stress, social support and depression in single and married mothers.

This study examined the effect of stress and social support on the relationship between single-parent status and depression. A secondary data analysis of the 1994-95 National Population Health Survey was conducted. Single and married mothers who participated in the survey were derived from the general sample (N = 2,921). Logistic regression techniques were used to assess the mediating and moderating effects of stress and social support on the relationship between family structure and depression. Bivariate analyses showed that, compared to married mothers, single mothers were more likely to have suffered an episode of depression (12-month prevalence), to report higher levels of chronic stress, more recent life events and a greater number of childhood adversities. Single mothers also reported lower levels of perceived social support, social involvement and frequency of contact with friends and family than married mothers. The results of the multivariate analyses showed that, together, stress and social support account for almost 40% of the relationship between single- parent status and depression. We also found a conditional effect of stress on depression by family structure. Life events were more strongly related to depression in married than in single mothers. A substantial part of the association between single-parent status and depression can be accounted for by differences in exposure to stress and social support. Our results suggest that it is important to examine multiple sources of stress, as exposure to both distal and proximal stressors were higher among single mothers. Limitations and directions for future research are discussed.

Social stress and women's risk for recurrent depression.

The lives of depressed women appear to be stressful. Based on data from a community sample of women with histories of depression, support for an interpersonal stress perspective on women's depression is presented. Women often find themselves embedded in environments with high levels of chronic stress and negative life events. Compared to never-depressed women, those who are currently depressed, and even those with prior but not current depression, are relatively more likely to experience divorce and marital difficulties, spouses with psychiatric disorders, problematic relationships with their children, children with high rates of disorder, and recent elevated rates of personal stressful life events. Such life challenges may increase the likelihood of further depressive experiences. While both psychosocial and genetic factors may contribute to the interpersonal vulnerabilities, once caught up in depression-maintaining environments, treatments for women may require intervention in the family and interpersonal domains.

Chronic stress influences cardiovascular and neuroendocrine responses during acute stress and recovery, especially in men.

This study tests the influence of chronic stress on cardiovascular and neuroendocrine responses to and recovery from acute stressors and whether the effects are gender specific. Sixty-two healthy, middle-aged persons (50% women) performed mental-arithmetic and public-speaking tasks and relaxed thereafter for 1 hr while their cardiovascular and neuroendocrine function was measured. Participants with higher levels of chronic stress showed lower systolic blood pressure (SBP) and epinephrine (E; men only) and marginally lower levels of norepinephrine (NE) responses to the tasks and showed lower levels of cortisol and marginally lower NE responses during recovery. Relative to women, men had high diastolic blood pressure (DBP) responses to the tasks and high SBP, DBP, and E responses during recovery. Gender differences in cardiovascular disease in midlife may be due to gender differences in the inability to recover quickly, in addition to enhanced acute-stress response.

Stress, infection and preterm birth: a biobehavioural perspective.

Preterm birth is currently the most important problem in maternal-child health in the United States. Epidemiological studies have suggested that two factors, maternal stress and maternal urogenital tract infection, are significantly and independently associated with an increased risk of spontaneous preterm birth. These factors are also more prevalent in the population of sociodemographically disadvantaged women who are at increased risk for preterm birth. Studies of the physiology of parturition suggest that neuroendocrine and immune processes play important roles in the physiology and pathophysiology of normal and preterm parturition. However, not all women with high levels of stress and/or infection deliver preterm, and little is understood about factors that modulate susceptibility to pathophysiological events of the endocrine and immune systems in pregnancy. We present here a comprehensive, biobehavioural model of maternal stress and spontaneous preterm delivery. According to this model, chronic maternal stress is a significant and independent risk factor for preterm birth. The effects of maternal stress on preterm birth may be mediated through biological and/or behavioural mechanisms. We propose that maternal stress may act via one or both of two physiological pathways: (a) a neuroendocrine pathway, wherein maternal stress may ultimately result in premature and/or greater degree of activation of the maternal-placental-fetal endocrine systems that promote parturition; and (b) an immune/inflammatory pathway, wherein maternal stress may modulate characteristics of systemic and local (placental-decidual) immunity to increase susceptibility to intrauterine and fetal infectious-inflammatory processes and thereby promote parturition through pro-inflammatory mechanisms. We suggest that placental corticotropin-releasing hormone may play a key role in orchestrating the effects of endocrine and inflammatory/immune processes on preterm birth. Moreover, because neuroendocrine and immune processes extensively cross-regulate one another, we further posit that exposure to both high levels of chronic stress and infectious pathogens in pregnancy may produce an interaction and multiplicative effect in terms of their combined risk for preterm birth. Finally, we hypothesise that the effects of maternal stress are modulated by the nature, duration and timing of occurrence of stress during gestation. A discussion of the components of this model, including a theoretical rationale and review of the available empirical evidence, is presented. A major strength of this biobehavioural perspective is the ability to explore new questions and to do so in a manner that is more comprehensive than has been previously attempted. We expect findings from this line of proposed research to improve our present state of knowledge about obstetric risk assessment for preterm birth by determining the characteristics of pregnant women who are especially susceptible to stress and/or infection, and to broaden our understanding of biological (endocrine, immune, and endocrine-immune interactions) mechanisms that may translate social adversity during pregnancy into pathophysiology, thereby suggesting intervention strategies.

The Effects of Physically Active Leisure on Stress-Health Relationships

In this article, the effects of physically active leisure on the relationships between stress and health are examined using structural equation modeling (SEM). The analyses are based on data from Canada's 1994 National Population Health Survey (n = 17,626). Overall, physically active leisure was found to directly contribute to higher levels of physical health and wellbeing, and lower levels of mental ill-health among Canadians. When the respondents experienced higher levels of chronic stress, life event stress, and/or work stress, involvement in physically active leisure appeared to help them maintain good health and wellbeing. Also, higher levels of participation in physically active leisure helped paid workers suppress levels of work stress. Agencies involved in health promotion and lifestyle intervention should give greater consideration to physically active leisure. As a significant component of an active lifestyle, physically active leisure can contribute to better health, and provide a valuable resource for coping with stress.

Maternal stress is associated with bacterial vaginosis in human pregnancy.

Maternal infection, particularly bacterial vaginosis (BV) in pregnancy, is one of the leading causes of adverse perinatal outcomes. The determinants of individual differences in susceptibility, or vulnerability, to maternal infections are poorly understood. This study examines whether chronic maternal stress predisposes women to infection during pregnancy, and if so, whether the effects of chronic stress on infection are independent of other established risk factors. We conducted a cross-sectional, clinical prevalence study of chronic maternal stress and BV status in a sample of 454 pregnant women at 14.3+/-0.3 weeks gestation (+/-SEM). BV was diagnosed by Gram-stain of vaginal fluid samples; chronic maternal stress was assessed using the Cohen Perceived Stress Scale. Other established risk factors for BV, including maternal age, race/ethnicity, marital status, SES, and behaviors related to feminine hygiene, sexual practices, and substance use, were measured using a structured interview. Of the 454 women enrolled in this study, 224 (49%) were BV positive (Nugent score 7-10), 64 (14%) had intermediate vaginal flora (Nugent score 4-6), and 166 (37%) were BV negative (Nugent score 0-3). BV+ women had significantly higher chronic stress levels than BV- women (24.6+/-0.5 vs. 22.2+/-0.6 units (+/-SEM), respectively; t = 3.19; p < .01). Maternal sociodemographic variables (African-American race/ethnicity) and behavioral characteristics (vaginal douching, number of lifetime sexual partners, and use of illicit drugs) also were significantly associated with the presence of BV. After controlling for the effects of these variables, using a multivariable logistic regression model, chronic maternal stress remained a significant and independent predictor of BV status. Women in the moderate-stress group (third quartile) and high-stress (fourth quartile) group were 2.3 times (95% CI = 1.2-4.3) and 2.2 times (95% CI = 1.1-4.2) more likely to be BV+ than women in the low-stress group (bottom quartile). High levels of chronic stress during pregnancy are associated with bacterial vaginosis. The effect of chronic maternal stress is independent of the effects of other established sociodemographic and behavioral risk factors for BV.

Decreased Sensitivity to Glucocorticoid Fast Feedback in Chronically Stressed Rats

A number of changes in anterior pituitary corticotrophs occur after chronic footshock. These include increased ACTH and beta-endorphin content and a loss of glucocorticoid negative feedback on corticotropin-releasing hormone (CRH)-stimulated ACTH and beta-endorphin secretion, without changes in sensitivity to ovine CRH examined in vitro. The present studies were undertaken to determine whether the in vitro changes were reflected by similar changes in vivo. We developed a fast feedback paradigm using a 5-min swim stress as challenge, with injection of saline or corticosterone immediately prior to swim. Corticosterone reliably decreased ACTH and beta-endorphin responses to swim over the 30-min period studied. This feedback inhibition did not occur in rats that were either exposed to 30 min of chronic footshock for 7 or 14 days or in rats that were treated with corticosterone daily for 14 days in a regimen that has been reported to decrease hippocampal glucocorticoid receptors. By contrast, in rats exposed to the less intense stimulus of 30 min swim for 14 days, the fast feedback action of corticosterone was intact. These results suggest that both fast and delayed feedback corticosterone-inhibitory mechanisms may be blocked by relatively high levels of chronic stress or by chronic treatment with corticosterone, possibly as a consequence of decreased hippocampal glucocorticoid receptor number.