Impact Of Psychosocial Stress Research Articles

Impact of psychosocial stress on facial emotion recognition in schizophrenia and controls: an experimental study in a forensic sample.

Psychotic disorders have been associated with dysregulated stress reactions and adaptation. Little is known about the neuroendocrine responses to psychosocial stress in justice-involved individuals with schizophrenia. Using an experimental research design, the present study aims to examine differences in the subjective and neuroendocrine responses to psychosocial stress and its impact on facial emotion recognition (FER) and performance on an arithmetic task in chronically ill justice-involved individuals with schizophrenia (PAT) and a healthy control group. PAT undergoing treatment in forensic psychiatric inpatient wards (n = 17) and a healthy control group (n = 17) were assessed regarding sociodemographic and clinical characteristics. Additionally, salivary cortisol levels, measured before and after performing a psychosocial stress task [Montreal Imaging Stress Task (MIST)], and performance on an arithmetic problem-solving task and two FER tasks were recorded. Two participants dropped out, one from each group. Therefore, the final sample consisted of 32 individuals. Significant group differences in FER were recorded. There was a significant rise in subjective perception of momentary strain relating to the induction of psychosocial stress in both groups. Notably, the pre-stress level of subjective strain was higher in the PAT group than controls. Acute psychosocial stress induced an increase in FER performance in a sub-task related to naming emotions in individuals with schizophrenia spectrum disorder. The results underline the importance of psychosocial and therapeutic interventions aimed at strengthening stress resilience in individuals with schizophrenia spectrum disorders.

Repeated witness social stress causes cardiomyocyte contractile impairment and intracellular Ca2+ derangement in female rats

The impact of psychosocial stressors on cardiovascular health in women is of growing interest in both the popular and scientific literature. Rodent models are useful for providing direct experimental evidence of the adverse cardiovascular consequences of psychosocial stressors, yet studies in females are scarce. Here, we investigated the effects of repeated exposure to witness social defeat stress (WS) on cardiomyocyte contractile function and intracellular Ca2+ homeostasis in young adult wild-type Groningen female rats. Female rats bore witness to an aggressive social defeat episode between two males for nine consecutive days or were exposed to a control procedure. Stress-related behaviors were assessed during the first and last WS/control exposure. Twenty-four hours after the last exposure, plasma corticosterone levels were measured, and cardiomyocytes were isolated for analyses of contractile properties and Ca2+ transients, and expression levels of proteins involved in intracellular Ca2+dynamics. The results show an impairment of the intrinsic cardiac mechanical properties and prolonged intracellular Ca2+decay in WS female rats showing social stress-related behavioral (larger amounts of burying behavior) and neuroendocrine (elevated plasma corticosterone levels) phenotypes. Further, the results implicate alterations in the sarcoplasmic reticulum Ca2+-ATPase/phospholamban complex in the contractile defects described in cardiomyocytes of WS female rats. In conclusion, this study highlights the utility of the WS model as an ethologically relevant social stressor for investigating pathophysiological processes that occur in the heart of female subjects and may increase vulnerability to social stress-related cardiovascular risk.

Impact of acute psychosocial stress on attentional control in humans. A study of evoked potentials and pupillary response

Psychosocial stress has increased considerably in our modern lifestyle, affecting global mental health. Deficits in attentional control are cardinal features of stress disorders and pathological anxiety. Studies suggest that changes in the locus coeruleus-norepinephrine system could underlie the effects of stress on top-down attentional control. However, the impact of psychosocial stress on attentional processes and its underlying neural mechanisms are poorly understood. This study aims to investigate the effect of psychosocial stress on attentional processing and brain signatures. Evoked potentials and pupillary activity related to the oddball auditory paradigm were recorded before and after applying the Montreal Imaging Stress Task (MIST). Electrocardiogram (ECG), salivary cortisol, and subjective anxiety/stress levels were measured at different experimental periods. The control group experienced the same physical and cognitive effort but without the psychosocial stress component. The results showed that stressed subjects exhibited decreased P3a and P3b amplitude, pupil phasic response, and correct responses. On the other hand, they displayed an increase in Mismatch Negativity (MMN). N1 amplitude after MIST only decreased in the control group. We found that differences in P3b amplitude between the first and second oddball were significantly correlated with pupillary dilation and salivary cortisol levels. Our results suggest that under social-evaluative threat, basal activity of the coeruleus-norepinephrine system increases, enhancing alertness and decreasing voluntary attentional resources for the cognitive task. These findings contribute to understanding the neurobiological basis of attentional changes in pathologies associated with chronic psychosocial stress.

The Impact of Psychosocial Stress on Self-Assessment of Quality of Life in the Context of the Covid-19 Pandemic and Various Quarantine Restrictions

The Impact of Psychosocial Stress on Self-Assessment of Quality of Life in the Context of the Covid-19 Pandemic and Various Quarantine Restrictions

Abstract MP47: IFNγ-Mediated Associations Between Chronic Stress Related-Neural Activity And PCSK9: Data From The Washington, D.C. Cardiovascular Health And Needs Assessment

Introduction: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key player in dyslipidemia and is linked to cardiovascular disease risk. To our knowledge, the potential link between psychosocial stressors, PCSK9 levels, and related dyslipidemia has not been evaluated. Hypothesis: IFNγ mediates the association between amygdalar activity (AmygA) and PCSK9. Methods: Participants from the D.C. Cardiovascular Health and Needs Assessment (DC-CHNA), a community-engaged cohort study, were recruited to the NIH Clinical Center and underwent phenotyping, including 18 FDG PET/CT to assess AmygA as a marker of chronic stress-related neural activity. Cytokines, PCSK9, and lipoprotein (a) (Lp(a)) were measured using ELISA-based techniques. Regression modeling identified associations between AmygA and PCSK9 and between PCSK9 and Lp(a) while adjusting for atherosclerotic cardiovascular disease (ASCVD) 10-year risk score and body mass index (BMI). Mediation analysis was used to evaluate IFNγ, TNFα, and IL-6 as potential mediators. Results: The DC-CHNA consisted of 60 African American participants (mean age 61±11 years, 93% female) at risk for ASCVD. AmygA associated with PCSK9 and IFNγ after adjusting for ASCVD and BMI; additionally, IFNγ associated with PCSK9 ( Figure ). Mediation analysis indicated that IFNγ mediated 45.8% of the AmygA and PCSK9 relationship. TNFα and IL-6 did not mediate the relationship. Lastly, PCSK9 associated with Lp(a) independent of ASCVD risk factors (β=0.34, p=0.013). Conclusions: The role of psychosocial stressors in PCSK9 related-dyslipidemia is not well known. Thus, we show that AmygA, a measure of chronic stress, associated with PCSK9 in an IFNγ-mediated fashion. PCSK9 then associated with Lp(a) which is notable as Lp(a) is thought to be largely genetically determined and highly atherogenic. Future research should further this hypothesis-generating study by prospectively investigating the impact of psychosocial stressors on PCSK9 and dyslipidemia in larger, diverse populations.

The Impact of Psychosocial Stress from Life Trauma and Racial Discrimination on Epigenetic Aging-A Systematic Review.

The purpose of this review was to explore the effects of psychosocial stress from life trauma and racial discrimination on epigenetic aging. A systematic review of the last 10 years was conducted using four databases: PubMed/MEDLINE, Web of Science, PsychInfo, and CINAHL. Articles were identified using the following terms: ([(DNA methylation) AND (epigenetic clock)] OR [(DNA methylation) AND (epigenetic age)]) AND (discrimination OR trauma)). Original research articles published in English measuring life trauma, post-traumatic stress, experience of discrimination, and epigenetic clocks or aging were analyzed using PRISMA guidelines. Ten articles met inclusion criteria. The study sample size ranged from 96 to 1163 and most study populations had a mean age under 50 and included predominantly White male participants. One study identified accelerated epigenetic aging associated with discrimination using Hannum's clock; 33% of studies evaluating life trauma reported epigenetic age acceleration using GrimAge or Horvath's clock; 25% of studies evaluating childhood trauma reported epigenetic age acceleration using Horvath's clock; and 71% of studies assessing post-traumatic stress observed epigenetic age acceleration with all clocks, while one study reported deceleration using Horvath's clock. The experiences of life trauma, post-traumatic stress, and discrimination may be associated with accelerated epigenetic aging that can be consistently detected using different epigenetic clocks. Additional studies inclusive of diverse populations and other psychosocial stressors are needed. Nursing scholars and other health scientists who utilize epigenetic age acceleration to assess health risks may need to consider including psychosocial stressors in their studies as covariates.

Impact of psychosocial stressors on emotional and behavioral problems in Chinese adolescents during the COVID-19 period: the explanatory value of loneliness.

BackgroundChinese adolescents experienced a variety of stressors during the COVID-19 home confinement period. This study aimed to investigate the prevalence of emotional and behavioral problems (EBPs) among adolescents during the COVID-19 period. The study also examined the relationships between psychosocial stressors and adolescents’ EBPs, and explored the potential explanatory value of loneliness for any associations observed.MethodsWe conducted a cross-sectional study which included 6,587 adolescents in Taizhou, China between April 16 and May 14, 2020. Adolescents’ EBPs were assessed by the Strengths and Difficulties Questionnaire (SDQ), while subjective feelings of loneliness were assessed using one item from the Children’s Depression Inventory. We applied structural equation modelling to assess direct and indirect associations (explained by loneliness) between psychosocial stressors (study problems, parent-child relationship, and family or friends with COVID-19) and the total difficulties and prosocial scores.ResultsThe prevalence of EBPs in the sample was 31.6% for total difficulties and 37.5% for prosocial problems. After adjustment for a range of covariates, the presence of study problems, poor parent-child relationship and family or friends with COVID-19 were significantly associated with a higher SDQ total difficulties score (β=6.20, 21.46, 5.21; P<0.01) and a lower prosocial score (β=−0.79, −4.35, −1.65; P<0.01). There was an explanatory effect of loneliness on these associations, which explained 27–37% of the total effect on the total difficulties score and 11–37% on the prosocial score.ConclusionsThe presence of psychosocial stressors during the home confinement period was related to higher EBPs in adolescents, and the relationship was partially explained by loneliness. Targeted psychosocial interventions towards loneliness and COVID-19 related stressors may improve adolescents’ psychological health.

Abstract P194: Psychosocial Stressors And Cardiovascular Disease Risk Factors In Young African American Women: A Systematic Review

Background: Emerging evidence suggests that psychosocial factors are related to morbidity and mortality due to cardiovascular disease (CVD). African American women experience a unique multitude of psychosocial stressors, including racism, discrimination, poverty, neighborhood stress, anxiety, and depression. The impact of these stressors on CVD risk in African American women during early adulthood (age 19-24 years) is limited. Objective: In this systematic review, we synthesized and evaluated the existing evidence on the relationship between psychosocial stress and CVD risk in young adult African American women. Methods: We conducted a comprehensive search of the literature in PubMed, APA PsycINFO, and CINAHL for studies published between January 1975 and May 2020 that examined psychosocial stress and CVD risk factors in young adult African American women. Eligible studies measured at least one psychosocial stress exposure, a CVD risk factor, or subclinical CVD outcome (e.g., body mass index, blood pressure, carotid intima-media thickness), and included African American women age 19-24 years or reported sex-stratified analyses. We excluded reviews, editorials, case studies, and gray literature. Two reviewers independently screened studies for eligibility and appraised the quality of the included studies using the Newcastle-Ottawa Scale. Results: The literature search yielded 1,100 potentially relevant articles for review. Of these, we identified nine studies that met our inclusion criteria: six cross-sectional and three prospective cohort studies. The mean age of participants ranged from 19 to 22 years. Of the nine studies, eight found that stress (i.e., perceived stress, racial discrimination, internalized racism, depression) was related to higher body mass index and blood pressure. In one longitudinal study, a greater frequency of everyday discrimination was associated with a nearly 2-fold higher odds of excessive weight gain (&gt;40 pounds) during pregnancy. Overall, the majority of studies (n=6) were rated as excellent ; the remainder were good and fair. The lowest risk of bias was the selection and outcome measurement. Conclusion: This systematic review found sufficient evidence to support a relationship between psychosocial stress and CVD risk factors in young adult African American women. However, future studies that follow women from childhood to early adulthood are needed to gain a better understanding of the impact of psychosocial stress on the progression of CVD risk. Further investigation on specific stressors relevant to early adulthood, including self-identity and social role stress, are needed to understand the full extent to which psychosocial stress impacts CVD risk in young African American women.

Gendered racism and subjective cognitive complaints among older black women: The role of depression and coping

Objective: Psychosocial stress is a risk factor for cognitive impairment and a potential pathway through which disparities in cognitive functioning emerge and disproportionately disadvantage older Black adults. Gendered racism is a psychosocial stressor that has negative implications for Black women’s mental and physical health. This study tested the association between lifetime experiences of gendered racism and subjective cognitive complaints, taking into account the extent to which depressive symptoms and coping styles may explain this association. Method: Data from 75 older Black women (M age = 62.43, SD = 6.23 years) were collected using an online survey assessing lifetime experiences of gendered racism, depressive symptoms, coping styles (i.e. spirituality, social support, problem-oriented/engagement, and disengagement), and subjective cognitive complaints (i.e. memory, attention, executive functioning, language, and overall cognition). The association between gendered racism and subjective cognitive complaints was examined with simple linear regression. Two mediation models examined depressive symptoms and coping styles as independent mediators of this association. Results: More gendered racism across the lifetime was associated with more subjective cognitive complaints separately through depressive symptoms and disengagement coping, but no other coping styles. Conclusion: Gendered racism is linked to increased subjective cognitive complaints via depressive symptoms and disengagement coping. The study highlights the importance of taking into account lived experiences (gendered racism) that are inextricably linked to social positioning (race and gender) within neuropsychology. Results evidence the negative impact of psychosocial stress, specifically gendered racism, on older Black women's subjective cognitive functioning, and illuminate avenues for clinical intervention and social justice advocacy.

Impact of stress on clinical outcomes of non-surgical periodontal therapy in patients with severe generalized periodontitis

Relevance.Aim – to assess the impact of psychosocial stress on the clinical outcomes in severe periodontitis patients treated with Nonsurgical Periodontal Therapy (NPT).Materials and methods.Patients received 2 psychological questionnaires to score their stress levels, while clinical data were obtained 1 week before and six weeks after the completion of NPT.Results.A total of 55 patients were consecutively included in the study and subsequently categorized into different stress levels (low stress level n = 22 and moderate/high stress level n = 33). All clinical parameters were found to be comparable at baseline between groups. While reduction in full-mouth bleeding scores was found to be statistically significantly lower in group with higher stress levels, a similar improvement in the other clinical parameters was observed at the completion of NPT.Conclusion.Psychosocial stress seems to influence negatively the results of NPT and highly stressed patients may represent a risk category for disease progression.

Impact of Psychosocial Stress on the Morbidity of Healthcare Professionals

Abstract We have analysed the impact of psychosocial risks on the health of hospital staff, in an attempt to determine whether there is a correlation between the risk level assessed and the number of days of medical absenteeism through diseases with psychosocial stress as a contributory or aggravating factor. There is a strong correlation between the risk level assessed by sectors of activity and the number of days of medical absenteeism through diseases caused or favoured, potentially aggravated by occupational psychosocial stress.

A systematic review of the impact of psychosocial factors on immunity: Implications for enhancing BCG response against tuberculosis.

BackgroundTuberculosis (TB) remains an urgent global public health priority, causing 1.5 million deaths worldwide in 2018. There is evidence that psychosocial factors modulate immune function; however, how this may influence TB risk or BCG vaccine response, and whether this pathway can be modified through social protection, has not been investigated. This paper aims to: a) systematically review evidence of how psychosocial factors influence the expression of biomarkers of immunity, and b) apply this general evidence to propose plausible TB-specific pathways for future study.MethodsPapers reporting on the impact of psychosocial stressors on immune biomarkers in relation to infectious disease risk were identified through a search of the databases MEDLINE, PsycINFO, Global Health and PsycEXTRA alongside reference list and citation searching of key papers. Data extraction and critical appraisal were carried out using a standardised form. The findings were tabulated and synthesised narratively by infectious disease category, and used to propose plausible mechanisms for how psychosocial exposures might influence immune outcomes relevant to TB and BCG response.Results27,026 citations were identified, of which 51 met the inclusion criteria. The literature provides evidence of a relationship between psychosocial factors and immune biomarkers. While the direction and strength of associations is heterogenous, some overarching patterns emerged: adverse psychosocial factors (e.g. stress) were generally associated with compromised vaccine response and higher antibody titres to herpesviruses, and vice versa for positive psychosocial factors (e.g. social support).ConclusionsThe evidence identifies pathways linking psychosocial factors and immune response: co-viral infection and immune suppression, both of which are potentially relevant to TB and BCG response. However, the heterogeneity in the strength and nature of the impact of psychosocial factors on immune function, and lack of research on the implications of this relationship for TB, underscore the need for TB-specific research.

A critical analysis of J.C. Smuts’ theory of holism

IntroductionDue to the lack of a clear definition, the word holism has become a vague and unexplicit concept open to uncertain interpretations. In view of the increasing interest in holistic medicine and healthcare solutions, as well as the frequent labelling of non-reductive research models as holistic, a more specific definition of holism is essential to provide a structured foundation of the concept. MethodsIn order to reach a more explicit definition of the word holism, an integrative literature review methodology was utilised to critically analyse J.C. Smuts original theory of holism as presented in his book ‘Holism and Evolution’. ResultsThe results point to a diverted theory with one part presenting an advanced view of the physicality of reality, while the second part lacks a logical foundation. ConclusionIn line with current biological systems theories and neurological research, a new definition of holism is suggested, taking into consideration the element of evolution through a mainly intrinsic process, with an emphasis on individual abilities of self-maintenance and resilience towards the impact of psychosocial stressors.

The impact of psychosocial stress and stress management on immune responses in patients with cancer

The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress-management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress-management interventions may provide important adjuncts to clinical cancer care going forward.

Occupational factors and a risk of cardiovascular diseases

The paper gives Russian and foreign authors' data on a relationship between occupational factors and cardiovascular diseases. It considers the impact of psychosocial stress on the risk of hypertension, coronary heart disease, and cardiovascular events in representatives of different professional groups.

Impact of psychosocial stress on gonadotrophins and sexual behaviour in females: role for cortisol?

This review focuses on the importance of cortisol in mediating the inhibitory effects of psychosocial stress on reproduction in females. In particular, we have summarized our research in sheep where we have systematically established whether cortisol is both sufficient and necessary to suppress reproductive hormone secretion and inhibit sexual behaviour. Our findings are put into context with previous work and are used to develop important concepts as well as to identify productive further lines of investigation. It is clear that cortisol is necessary to inhibit some, but not all, aspects of reproduction in female sheep. These actions vary with reproductive state, and there are important interactions with gonadal steroids. The impact of cortisol on the tonic secretion of gonadotrophin-releasing hormone and luteinizing hormone has been investigated extensively, but less is known about the surge secretion of these hormones and their effects on sexual behaviour. Furthermore, there are separate effects of cortisol in the brain (hypothalamus) and at the anterior pituitary, illustrating that there are different mechanisms of action. Thus, although cortisol is important in mediating some of the effects of stress on reproduction, we need to look beyond cortisol and investigate some of the other mechanisms and mediators that relay the effects of stress on reproduction. In this regard, we propose that a group of neurons in the hypothalamus that co-synthesize kisspeptin, neurokinin B and dynorphin, termed KNDy cells, play important roles in mediating the effects of cortisol on reproduction. This hypothesis needs to be rigorously tested.

Abstract A63: The impact of psychosocial stress on pubertal mammary gland development in a rat model of spontaneous breast cancer

Abstract Social stressors cause reproducible changes in neuroendocrine physiology and can thereby disrupt developmental processes leading to increased susceptibility to disease later in life. Social circumstances that manifest as psychological stressors place individuals at a distinct disadvantage in health and disease. Recent research has highlighted that a myriad of psychosocial and environmental stressors, including those that are common in the medically underserved (e.g. social marginalization and isolation, economic uncertainty, and racism), can result in changes in cellular gene expression and phenotype. Less is known about the specific physiological, cellular and molecular pathways that mediate deviations that result from psychosocial stress, particularly from a developmental perspective when the risk factors are set in motion. We expect that these pathways will be tissue and disease specific. Therefore, we have chosen to focus specifically on breast cancer and use an animal model, Sprague-Dawley rats, where there is an established effect of social marginalization/isolation on mammary gland development and increased mammary cancer risk. When exposed to post-weaning social isolation, a well-characterized psychosocial stressor, Sprague-Dawley rats exhibit more invasive tumors than their group-housed counterparts and a greater overall tumor burden. The shift toward malignancy in social isolates is also associated with changes in pubertal mammary gland development. Because the mammary gland is particularly susceptible to environmental stressors during development, we hypothesized that puberty is a critical developmental window during which social isolation can increase the risk of mammary gland tumor burden later in life. To this end, we isolated or group-housed female pubertal rats and characterized ductal development in a variety of ways. To determine gross morphology, we analyzed the architecture of mammary gland whole mounts. During early puberty, animals exposed to psychosocial stressors showed a decrease in terminal end buds, structures involved in ductal extension. These early changes correlated with decreased ductal extension in the social isolates later in puberty. To investigate the possible impact of the mammary microenvironment on cell proliferation in ductal extension, we made media conditioned with the mammary adipose tissue from group or isolated rats and tested its relative ability to drive mammary epithelial cell proliferation. These results indicate a potential relationship between exposure to psychosocial stressors and disruption of pubertal mammary gland development, which may increase cancer risk. Citation Format: Marianna Johnson, Joscelyn N. Hoffmann, Hannah You, Kyle Kunze, Sully Fernandez, Matthew Brady, Martha McClintock, Suzanne Conzen. The impact of psychosocial stress on pubertal mammary gland development in a rat model of spontaneous breast cancer. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A63.

The impact of psychosocial stressors on postpartum weight retention.

Excessive gestational weight gain and postpartum weight retention are implicated in future morbidity in women. To understand whether psychosocial stressors contribute to weight retention, we used data collected in a cohort of postpartum women and analyzed measures of stress, depression, social support, and health-related quality of life. Depressive symptoms at delivery and worse health-related quality of life and lower stress at 3months postpartum were associated with 3-month weight retention. Interventions targeting depression and improving quality of life may further reduce weight retained.

Early and recent psychosocial stress and telomere length in older adults.

Psychosocial stress has been associated with an increased risk for mental and somatic health problems across the life span. Some studies in younger adults linked this to accelerated cellular aging, indexed by shortened telomere length (TL). In older adults, the impact of psychosocial stress on TL may be different due to the lifetime exposure to competing causes of TL-shortening. This study aims to assess whether early and recent psychosocial stressors (childhood abuse, childhood adverse events, recent negative life events, and loneliness) were associated with TL in older adults. Data were from the Netherlands Study of Depression in Older Persons (NESDO) in which psychosocial stressors were measured in 496 persons aged 60 and older (mean age 70.6 (SD 7.4) years) during a face-to-face interview. Leukocyte TL was determined using fasting blood samples by performing quantitative polymerase chain reaction (qPCR) and was expressed in base pairs (bp). Multiple regression analyses, adjusted for age, sex, and chronic diseases, showed that childhood abuse, recent negative life events and loneliness were unrelated to TL. Only having experienced any childhood adverse event was weakly but significantly negatively associated with TL. Our findings did not consistently confirm our hypothesis that psychosocial stress is associated with shorter TL in older adults. Healthy survivorship or other TL-damaging factors such as somatic health problems seem to dominate a potential effect of psychosocial stress on TL in older adults.

The impact of psychosocial stress on healthy skin.

Dermatologists are only too aware of the significant role psychosocial stress plays in the exacerbation of skin disease; indeed, it is often the first precipitant patients mention when they attend outpatient clinics. Of late, research has focused on understanding the 'brain-skin' axis, a complex interplay between the nervous and immune systems and the skin. In particular, there is an evolving body of literature exploring the underlying pathophysiological mechanisms by which psychosocial stress influences skin homeostasis. This article provides a broad overview of the literature, emphasizing the importance of individual stress perception and summarizing the varied roles of the major cutaneous stress-response pathways. Both central [the hypothalamic-pituitary-adrenal (HPA) axis and the locus ceruleus-norepinephrine (LC-NE) sympathetic adrenomedullary system] and peripheral (the intracutaneous HPA axis and the release of mediators from peripheral sensory and autonomic nerves) pathways are discussed. Moreover, how activation of these pathways affects the skin's immune system, barrier function, wound healing and susceptibility to infection is reviewed. Although this field of research is rapidly expanding, several important questions remain unanswered, including: what is the precise role of mast cells in the cutaneous stress response?; what is the role of regulatory T-cells?; can therapeutic intervention be harnessed to prevent the stress-induced exacerbation of skin disease? It is anticipated that an improved understanding of the underlying mechanisms through which psychosocial stress affects the homeostasis of healthy skin will not only increase knowledge of the brain-skin axis but will also improve the holistic management of stress-responsive cutaneous disease.