Materials and Methods 2. Instruments 2. Perceived Stress Perceived stress was evaluated using self-administered Goldberg General Health Questionnaire GHQ ; the scoring system used in current study was the method resulting in that each participant could obtain score from 0 to Stressful Life Events Stressors were measured using a self-administered stressful life events questionnaire. Nutrition Practice A self-administered item food frequency questionnaire FFQ was applied to obtain information on dietary fruit and vegetable intake for each participant.
Physical Activity Daily physical activity was determined based on four types of physical activity, that is, leisure time activity, work activity, commuting activity, and home activity. Statistical Analysis Logistic quantile regression LQR was used as the main statistical method for modeling the relation of independent variables including stressful life events economic problems, job insecurity, social problems, and family conflicts adjusted by lifestyle factors physical activity, performance nutrition and smoking and demographic variables, that is, age, gender, marital status, education level, type of job, and place of residence with perceived stress as the bounded response variable.
Theoretical Background for Quantile Logistic Regression Ordinary least-squares regression models the relationship between one or more covariates and the conditional mean of the response variable given.
Results In this study, subjects aged over 19 years and over have participated. Table 1. Table 2. Figure 1. References B. Goodkin, T. Baldewicz, and N. Stratakis and G.
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Carroll, D. Sheffield, G. Smith, M. Ng and R. De La Revilla Ahumada, A. Bovier, E. Chamot, and T. Nguyen-Michel, J. Unger, J. Hamilton, and D. Augusto Landa, E. Berrios, and M. As such, the purpose of the present study was to test differing perspectives of social support perceived availability of support and received support in regards to the main and stress-buffering effects of dimensions of social support emotional, esteem, informational, and tangible on dimensions of burnout reduced sense of accomplishment, devaluation, emotional, and physical exhaustion.
There is an abundance of evidence demonstrating the beneficial effects of socially supportive relationships in sport Holt and Hoar, ; Rees and Freeman, ; Lu et al. Social support has been positively associated with objective performance outcome Freeman and Rees, , ; Rees and Freeman, , , Olympic performance Gould et al. Social support encompasses both structural i.
Functional components refer to the particular functions and purposes served by structural relationships, and there is general agreement that functional support can be categorized into dimensions of emotional support i.
Functional support, and the respective dimensions of support, are often further divided into two perspectives of support: perceived availability of support perceived support and received support Vangelisti, ; Lakey, Received support, on the other hand, refers to support actually received—the specific helping and supportive actions provided by friends, family, team-mates, and coaches Bianco and Eklund, ; Rees and Freeman, Conceptualizing social support as a complex construct perspectives: perceived, received and multivariate dimensions: emotional, esteem, informational, and tangible is relevant to concerns over matching the most appropriate dimensions and perspectives of social support to the particular demands of sport-related outcomes such as burnout Cutrona and Russell, ; Berg and Upchurch, Dimensions and perspectives of social support may be particularly salient factors in protecting against stress and reducing burnout in sport Eklund and Defreese, ; Gustafsson et al.
In line with the psychological stress perspective Cohen et al. In this regard, burnout is a deleterious adaptation to stress Raedeke et al. Recent reviews defined the experience of burnout as being characterized by distinct indicators, namely physical and psychological exhaustion, and a reduced sense of accomplishment and value toward sport Eklund and Defreese, ; Gustafsson et al.
While stress is considered to be a key antecedent to the formation of burnout dimensions alongside other contributing factors; Raedeke, ; Gustafsson et al. Received support is theorized to intervene in response to stress experienced e. Indeed, social support is typically associated with lower levels of burnout dimensions DeFreese and Smith, , , and may be considered an effective resource for protecting against the deleterious effects of stress and dimensions of burnout in sport Freeman et al.
There have been investigations into the relative impact of specific dimensions of social support upon global burnout e. However, there are limitations to using global measures. Global measures of social support and burnout ignore the possibility that certain dimensions of support might be more strongly associated with certain dimensions of burnout DeFreese and Smith, ; Freeman et al.
Indeed, the development of burnout is a highly individualistic experience Gould et al. For example, Lundkvist et al. There are also theoretical grounds for expecting discrepancies in the presence and magnitude of dimensional associations between social support and burnout, as certain dimensions of support might allow for functional adaptations to certain outcomes Cutrona and Russell, For example, certain dimensions of support might exclusively foster specific types of coping behavior in response to deleterious adaptations to stress such as burnout; Cohen and Wills, This can only be investigated using dimensional measures of social support and, to our knowledge, Freeman et al.
Freeman et al. These results suggest there may indeed be discrepancies in the presence and magnitude of associations between dimensions of social support and dimensions of burnout. Two principal models typically guide social support research: 1 the main effects model, and 2 the stress-buffering model Cohen and Wills, ; Cohen et al.
The main effects model proposes social support to have a direct effect on outcomes irrespective of whether individuals are under high or low levels of stress; the stress-buffering model proposes social support to be related to outcomes as a function of stress Cohen et al. Although perceived support is theorized to act primarily through the main effects model and received support through the stress-buffering model Bianco and Eklund, , researchers have often found evidence to the contrary.
For example, perceived support has been found to buffer the deleterious effects of stress upon outcomes Rees and Hardy, ; Freeman and Rees, , and researchers have cited that there is only limited evidence for received support buffering the deleterious effects of stress upon outcomes Rees and Freeman, ; Rees et al. Furthermore, it seems only two studies have directly investigated the stress-buffering effects of social support in relation to burnout in sport — yet these studies only investigated dimensional stress-buffering effects of received support upon global burnout Lu et al.
In short, our understanding of the dimensional operationalization of social support upon burnout through main and stress-buffering models remains unclear Rueger et al. A comparison of main and stress-buffering effects for perceived versus received support warrants a further consideration with regards to method of analyses. When perceived and received support are examined separately, both tend to be associated with main and stress-buffering effects, however, when examined together different effects tend to be observed Rees and Freeman, ; Freeman and Rees, It has been suggested that although perceived and received support are considered separate constructs Wethington and Kessler, ; Dunkel-Schetter and Bennett, ; Helgeson, , they may potentially influence each other and be conceptually related under certain circumstances Uchino, The purpose of the present study was to test differing perspectives of social support perceived availability of support and received support in regards to the main and stress-buffering effects of dimensions of social support emotional, esteem, informational, and tangible on dimensions of burnout reduced sense of accomplishment, devaluation, emotional and physical exhaustion.
Considering the dearth of evidence upon which to postulate fully differentiated hypotheses in line with this purpose e. Participants were athletes male; mean age of The study was approved by a University Ethics Committee and all participants provided informed consent.
An online questionnaire was constructed and disseminated opportunistically through online portals, with all questionnaire sections randomized and counter-balanced to control for order-effects. Participants were asked to indicate the degree of stress experienced by completing a 4-item measure representing four sources of sport-specific stress commonly drawn upon within the literature e.
This approach to assessing specific stress experienced resulting from each stressor is in line with the psychological stress perspective Cohen et al. Participants were required to respond on a 5-point Likert scale ranging from 1 not at all to 5 a lot.
The ARSQ has demonstrated good reliability and validity indices across independent samples Freeman et al. Dimensions of athlete burnout were assessed using the item Athlete Burnout Questionnaire ABQ; Raedeke and Smith, , which has demonstrated good construct and structural validity in independent samples Cresswell and Eklund, ; Raedeke and Smith, ; Gerber et al.
The data were screened for outliers, indices of non-normality, and missing values, of which there were none.
In order to compare, simultaneously, the main and stress-buffering potential for each dimension of perceived and received support upon dimensions of burnout, moderated hierarchical regression analyses were performed using a three-step process within the enter-method of regression Cohen and Wills, ; Freeman and Rees, First, stress was entered at Step 1.
Second, respective dimensions of perceived and received support e. Finally, the product terms for each support and stress e. Prior to analyses, all independent variables stress, dimensions of perceived support, and dimensions of received support were mean-centred Jaccard et al. The significance of increments in explained variance in dimensions of burnout over and above that accounted for by the already-entered variables was assessed at each step.
Descriptives and bivariate correlations between all variables in the study are presented in Table 1. Stress was positively associated with all dimensions of burnout, and higher levels of perceived and received support were associated with lower levels of reduced sense of accomplishment and devaluation except for the non-significant association between received tangible support and devaluation.
Table 1. Means, standard deviations, and bivariate correlations for study variables. Results from moderated hierarchical regression analyses are presented in Table 2. In summary, higher levels of stress were associated with higher levels on dimensions of burnout.
For all significant effects, higher levels of support were associated with lower levels of burnout. There were no significant main effects for perceived support upon emotional and physical exhaustion, and there were no significant main effects for any dimensions of received support upon any dimensions of burnout. Specifically, the relationship between stress and devaluation differed significantly from zero at levels of perceived emotional support less than 0.
The interaction was consistent with a stress-buffering explanation: higher levels of perceived emotional support negated the deleterious effects of higher levels of stress on devaluation rather than burnout.
Figure 1. The interactive relationship between stress and perceived emotional support upon devaluation A , with simple slopes analysis B.
Hypothesis 1 was supported. Stress had deleterious relationships with all dimensions of burnout, such that higher levels of stress were associated with higher levels of dimensions of burnout.
These results support stress-based models of burnout Eklund and Defreese, ; Gustafsson et al. Hypotheses 2 was partially supported. Differences were observed between the dimensional main effects for perceived versus received support upon dimensions of burnout.
Finally, Hypothesis 3 was supported. Differences were observed between the dimensional stress-buffering effects for perceived versus received support upon dimensions of burnout. With regards to Hypothesis 2, higher levels of perceived availability of support were associated with lower levels of reduced sense of accomplishment and devaluation with the exception of perceived availability of emotional support upon devaluation.
No effects for received support on dimensions of burnout were observed. Knowing this, people can reduce the strength of their stress response by reminding themselves that this particular threat may not be as immediate as they feel it is.
This is difficult to do, however, particularly for those who don't realize it is a possibility. Also, because of this, we may experience a greater level of the stress response when someone is rude to us in a high-stakes social situation than when driving a car in busy traffic, where our chances of being physically hurt are actually greater.
Likewise, this is why we can experience great levels of stress when speaking in public when there's no actual physical danger and relatively little social danger , but we feel threatened and find our hands shaking and sweating, and our feet are cold as the adrenaline and redirection of blood flow show their effects.
This also comes into play when we have negative experiences in our childhood that become stress triggers later in life when we feel that we may be hurt in similar ways but aren't actually in danger. There are several effective ways to do this and used together, they can help you to reverse your body's stress response when you don't need it, and minimize the number of times it's triggered unnecessarily throughout the day.
Struggling with stress? Our guide offers expert advice on how to better manage stress levels. Get it FREE when you sign up for our newsletter. Harvard Medical School. Understanding the stress response. Updated March Cleveland Clinic.
In addition to these direct physical changes, old age typically 65 and older can be associated with a loss of interoception—the ability to detect internal changes—and proprioception—ability to detect static and dynamic body positioning. The ability to quickly and accurately detect bodily states decreases as we age, and may result in a type of dissociation between top-down and bottom-up processing affecting both awareness of physiologic activation as well as the ability to effectively down-regulate responses.
Much of modern stress research assumes there are reliable mindbody connections—that acute stress responses influence bodily responses, and vice versa, that the biological milieu can shape psychological stress reactions.
Aging has dramatic effects on our brains and bodies. Though there is a great deal of individual variation, cognitive declines such as deterioration in short term memory, reaction times, and attention can occur even in the absence of neurological diseases e. In the body, loss of muscle mass, deficiencies of growth hormones, hardening of the vasculature, and blunted activation reduces the flexibility of responding to different environmental demands e.
Age related changes may also influence the relations between perception and physiological response. Proprioception and interoception both decline with old age. Proprioception declines are well documented Goble et al. Declines in interoception and proprioception are not the only dramatic physiological change that occurs in aging that are relevant for acute stress. As people age there is tremendous blunting of key physiological systems, like SNS responses. For example, Levenson and colleagues observed lower heart rate responses for anger, fear, and sadness in older adults compared to younger adults during a directed facial action task Levenson et al.
In some cases younger adults have twice as large SNS increases as older adults a finding that mirrors physical exercise. Importantly, in research with older adults, anger manipulations did not engender increases in peripheral finger skin temperature as has been observed in younger adults Levenson et al.
One possibility underlying this lack of change could be that the flexibility of the vasculature—is affected by neuropathy that occurs with aging and the extremities arms, hands, legs, feet tend to be affected first. However, it is important to note that the flexibility of the vasculature is compromised in an asymmetrical form with age—vessels can still constrict easily but are harder to dilate. A psychological interpretation of this finding is that older adults are better able to modulate responses to negative stimuli, especially short term ones.
These enhanced regulatory processes are related to better emotional well-being Charles, Importantly, though, this theoretical perspective also underscores that older adults have greater difficulties recovering from adverse experiences and these homeostatic regulatory processes could lead to more health damaging responses to sustained or especially intense negative affective experiences.
Therefore, stress states associated with more approach-orientation may be compromised earlier than states of threat and withdrawal, which might become the default response in older age. Evidence of declines in sensory perception of the body as we age, and how this decline can interrupt the mind-body connection, has been used as evidence of maturational dualism , a phenomenon that suggests that the bodily changes that co-occur with the aging process can influence the experience of affective states Mendes, For older adults, acute stressors may be experienced in the mind and brain but not be embodied in the same way as in younger adults.
The weakening of the mind-body connection in older adulthood is primarily due to a loss of peripheral perception and blunted physiological reactivity, and may blunt the ability to use internal states to guide decisions and behavior. There are intriguing clues in the literature regarding how the loss of mind-body connections in older age may influence acute stress responses.
For example, one study examined the somatic marker hypothesis in older adults Denburg et al. In previous papers, Damasio and his colleagues e. To examine this hypothesis, participants brain damaged and control were presented with four decks of cards with various gains and losses associated with the cards.
Two of the decks resulted in overall losses—large gains, but large losses as well—whereas the other two decks resulted in smaller gains, but smaller losses. They found that as participants turned over cards from the various decks, changes in skin conductance activity in the eccrine gland, indicating sympathetic activation innervated by acetylcholine co-occurred with choices from the riskier decks.
Importantly, these bodily changes preceded conscious reporting of which decks were risky by approximately 40 trials.
Thus, the somatic marker hypothesis claims that bodily changes can indicate psychological or mental states prior to conscious reporting. In this original article, normal participants were compared to patients with ventral medial lesions. While normal participants consciously reported which decks were risky by about the 40th trial, lesion patients were not able to learn this pattern. In the extension of this earlier study with older adults, similar to the studies on patients with VM lesions, they did not show preferences for the advantageous decks across five trials or cards; Denburg et al.
The remaining older participants either showed more preference for the disadvantaged deck or no preference. Of course another possibility is that the lack of choice of the advantageous decks was due to a combination of blunted reactivity and loss of interoception. An implication of aging effects on physiology is that older individuals may have to rely more on the external environment to determine their internal states. Although speculative, an implication of this theory is that older participants would be more susceptible to suggestions of an affective state since they might have to rely more on their external world to provide information about their internal states.
Although theory and evidence suggest that environmental cues can strongly influence affective states and meaning Barrett, , the loss of exquisite ability to detect internal states may make older participants more sensitive to environmental cues in determining their stress responses. There are also psychological and social aspects of aging that influence how we perceive and respond to stress exposures. One of the drivers of these changes is that as we age, our motivations, goals, and behaviors adapt to match the new circumstances of our life.
For example, the Selection, Optimization, and Compensation model proposed by Baltes and Baltes describes that in order to cope with changes during aging such as loss of resources and physical function, people tend to maximize their strengths and compensate for losses.
They select new realistic goals that add purpose to life, and there is a shift in goals from growth, in young adulthood, to maintenance or prevention in older adulthood. This shift is related to better well-being Ebner et al. Furthermore, our social networks decrease in size, because we reduce the number of superficial social connections. This leads to an overall more positive emotional tone from close personal relationships English and Carstensen, For example, being forced to retire because of problems with physical functioning is likely to have a less negative impact at age 80 when this event is an expected life course transition than being forced to leave the workforce because of a physical decline at age Stress reactivity profiles alone are not deterministic as they are largely influenced by recent and situational factors related to the stressor.
However, certain reactivity profiles may reflect an embedded history of stress, serving as a phenotypic signature of exposure. This can be determined by measuring both history and current reactivity. Integrating historical stress and acute stress processes should help us to better understand how stress impacts aging-related processes and chronic diseases of aging.
There is a disparate body of studies showing that types of chronic stressors or current life events can shape acute reactivity profiles. For example, a quantitative review of 30 years of research showed that general life stress was associated with worse cardiovascular heart rate and blood pressure recovery from acute stress Chida and Hamer, Meta-analytic and descriptive reviews show that chronic stress is associated with elevated long-term cortisol secretion Stalder et al.
However, greater levels of chronic stress conversely can dampen cardiovascular and neuroendocrine responses to acute stress Matthews et al.
Furthermore, in response to acute stress tasks, a history of childhood adversity has been associated with a blunted cortisol response Carpenter et al. There is a robust dynamic interplay between different time scales of stress early life stress, chronic stressors, life events, and acute stressors and thus we should predict and interpret acute stress reactivity profiles in the context of these important historical and contextual factors.
Information across the different time scales will provide us with a more nuanced understanding of what differentiates a healthy acute stress response from a burnt-out or disengaged one.
There is growing acceptance that stressors confer risk for disease outcomes Cohen et al. Moderators are critical in tracing how and for whom chronic stress confers biological risk, and may explain variability in aging trajectories Bherer et al. Here we briefly highlight known moderators of the stress—health relationship because a careful characterization of vulnerability and resilience processes is beyond the scope of this article, covered elsewhere Bonanno and Diminich, ; Southwick et al.
There are known resilience factors for an adaptive acute stress response. Personality traits and individual differences align in expected directions with experiencing threat or challenge during acute stress episodes.
People who believe more strongly in a just world, individuals with high, stable self-esteem Seery et al. Individual differences in resting neurological activity have also been linked to challenge and threat states. Specifically, individuals with higher left, relative to right, frontal cortical activity a neurological pattern previously linked to positive affect and well-being were more likely to respond to acute stress with challenge appraisals and challenge reactivity higher CO and lower TPR; Koslov et al.
Additionally, there is emerging evidence that physically active adults have healthier acute stress responses than those who are sedentary.
For example, physically inactive adults who ruminated after an acute laboratory stressor were found to have prolonged cortisol responses with delayed recovery whereas those who were physically active recovered as efficiently as low ruminating adults Puterman et al. Stress effects may have little impact on people who have high levels of resources, and high levels of social support in particular Southwick et al.
Social support has long been identified as a critical buffer to the deleterious effects of sustained stress Cohen and Willis, The positive impact of perceived social support the perception that support from others is available and satisfying; Gottlieb and Bergen, on health has received considerable empirical evidence.
Constructs related to social support such as loneliness and social isolation have been linked to stress-related physiological systems including neural, cardiovascular, immune, and neuroendocrine functioning Cohen, ; Taylor et al. For example, loneliness predicts earlier mortality Holt-Lunstad et al. There are likely many other positive dispositional factors that modulate the experience of stress, such as mindfulness, that need to be further explicated.
Repeated acute stressors, life events, chronic stressors, and cumulative life stressors contribute to disease through complex pathways, where the brain serves as the central mediator of the stress response. A history of feeling or being threatened might shift the appraisal of a current stimulus to more of a threat than challenge appraisal. The brain then plays a fundamental role in regulating the psychological, physiological, and behavioral responses to the stimuli.
Further, it dynamically responds to internal stimuli that facilitates adaptation. The brain is more than a mediator, however, since accumulated stress directly and meaningfully impacts neural functioning and structure. Exposure to chronic stress and major life events, especially during sensitive developmental periods, can result in alterations in neural function and structure, thus shaping future affective and physiological stress responses.
Where does stress live in the brain? The neural stress response is not localized in any particular area but rather reflected in intrinsic neural networks that change and adapt to demands, both external and internal. An example of this is seen with autonomic nervous system responses to stress. Human neuroimaging studies demonstrate that the distribution of neural networks in brain areas involved in visceral control — such as the medial and orbital prefrontal cortex, anterior cingulate cortex ACC , insula, amygdala, thalamus, and hippocampus among others — regulate autonomic nervous system functioning to coordinate hemodynamics and immune system response to external stimuli including stress Critchley et al.
For example, research from Gianaros and colleagues demonstrates that stress-evoked increases in blood pressure are associated with a number of functional changes in neural activation, including increased medial prefrontal cortex and periaqueductal grey activity, the latter of which is a critical subcortical region responsible for autonomic regulation reviewed in Gianaros and Wager, Given the longstanding evidence that sustained and exaggerated cardiovascular and inflammatory stress responses confer risk for cardiovascular disease processes Chida and Steptoe, , advances in mapping the neural regions activated by stress may lead to more precise predictions about who is vulnerable to stress-related disease.
Exposure to traumatic stressors, particularly when they occur early in life e. There is consistent evidence that early trauma exposure is associated with smaller hippocampal volume in adulthood Teicher et al. Additionally, early life trauma is linked to less cortical thickness of the prefrontal cortex Hanson et al. In this sample of adolescents, reduced connectivity mediated the link between child abuse exposure and internalizing symptoms, including depression and anxiety.
Altered neural development caused by early adversity may also lead to worse physical health in adulthood through pathways that lead to elevated peripheral inflammation Chiang et al.
While historical stressor exposure, such as early life trauma, can leave an indelible mark on the brain, chronic stress and cumulative stressor exposure during adulthood also produce changes to brain function and structures. Higher cumulative adversity has been associated with reduced gray matter in the several areas within the prefrontal cortex, including the mPFC, anterior cingulate, and insula Ansell et al.
Higher scores on global perceived stress have been associated with reduced white matter in the PFC Moreno et al. In a prospective cohort study of postmenopausal women, higher scores on perceived stress, averaged over nearly two decades, predicted smaller hippocampal grey matter Gianaros et al. This latter finding is important because the hippocampus is replete with glucocorticoid receptors and thus renders the hippocampus at risk for atrophy when exposed to the high doses of glucocorticoids observed in response to prolonged stress in animal models McEwen, ; Sapolsky, , as well as excitatory amino acid neurotransmitters and other endogenous mediators McEwen and Gianaros, Inflammatory processes, which are consistently upregulated during periods of acute and prolonged stress Marsland et al.
For example, endotoxin administration, a well-known inflammatory challenge, resulted in an exaggerated amygdala response to social stress when compared to those who received the placebo Muscatell et al. The neural responses to stress do not appear to be uniform between men and women, though there are few fMRI stress studies that study sex differences.
In a small study employing an acute laboratory stressor, men showed increased activation in the prefrontal cortex while women displayed elevated activity in limbic regions, including the ventral striatum and cingulate Wang et al.
In terms of structural changes due to stress, childhood trauma may impact the hippocampal volume of males more than females reviewed in Tiwari and Gonzalez, and may enlarge amygdala and decrease connectivity of salience hubs such as the dACC in females more than males Helpman et al.
Animal studies have delineated some of the mechanisms of sex differences. For example, in rats, chronic restraint stress leads to dendritic atrophy of the hippocampus more so in male rats than female rats Galea et al. Sex steroids, which have a myriad of effects on neurons and glial cells, and various stress response systems, help explain these differential effects McEwen and Milner, Sex differences in acute stress responses and stress-related psychiatric disorders are well established, require further study, and should be included in the development of prevention and treatment strategies Gobinath et al.
Together these findings suggest that high levels of cumulative life stress, especially experienced early in life, shape stress related neural pathways and brain architecture Fig. Sustained and exaggerated stress responses likely result in feed forward mechanisms, with important implications for allostatic load and disease risk.
In order to advance our understanding of how stress influences trajectories of aging and health, stress must be measured in context. Context includes individual and environmental factors, personal histories of stressor exposure stress in childhood in particular but also cumulative life stress , current chronic stressors, and existing protective factors.
Examining the impact of a single stressor exposure without measuring the contextual factors in which a person is experiencing the stressor limits the predictive ability: The historical context influences the habitual responses to stress that ultimately determine whether it will have cumulative effects, contributing to allostatic load and early disease.
Traditional models of stimulus-response framework are useful for seeing and studying individual components of the stress process, but these tend to be linear and limited to measures of conscious explicit recall.
To advance health research, we need to examine and describe context along with stressor exposures and stress responses, taking into account both analytically and theoretically the recursive and multilevel processes that link stress to health as described in Fig.
However, looking at these in tandem may help us uncover who is at highest risk for stress related disease. Relying only on retrospective measures for landmark events will also lead to a limited and possibly biased view of stress effects and stress resilience.
We need longitudinal studies, and ideally transgenerational studies, that collect social, individual, and physiological indices of well-being over time, as well as health behaviors.
Careful measurement of stress processes is essential to propelling stress science forward. This begins with choosing a stress measure from a theoretical, or at least conceptual lens, and that appropriately fits the research question.
The Stress Typology should be used to guide decisions and descriptions of stress measures. Importantly, the Typology provides a list of the psychosocial features that characterize stressor exposures, highlighting the need to identify and describe these i.
Identifying these features of the stressor should lead to insights into mechanisms by which the stressor impacts psychological responses and physiology and enhance the ability to harmonize across multiple stressors that might not be identical, but share common features e. We do not yet know all the key attributes that make a stressor toxic.
It is likely the Typology is missing key components that must be measured, and that some subjective components may not in fact be important. Much work is to be done in refining existing, and developing new stress measurement tools. Future research will also need to focus on cultural validation of existing stress measures. Furthermore, better measurement of profiles of acute stress reactivity e. Future research will also have an even more granular lens, with the ability to measure stress responses as they unfold in the moment.
With these new measurement techniques we can better assess stressor exposures and responses, including recovery speed, at multiple levels of analysis.
We can build models that encompass better measurement of lifespan exposures and responses, as well as short term or acute stress responses. In addition, with more specific measures and predictive models, we can lay the foundation for individual and social interventions, and policies, that are geared toward promoting the wellbeing and healthspan of our aging society.
The Stress Measurement Network has the goal to promote better theory and measurement of stress to deepen our understanding of stress processes and healthy aging. This paper is based partly on past meetings of the Network and we are grateful to our many colleagues who contributed to these discussions, and especially grateful to Lisbeth Nielsen, Ph. We are grateful to Lis Nielsen and Bruce McEwen for their impactful insights and comments on this manuscript. We are also grateful to Tom Kamarck, Ph.
Stressor exposure characteristics include the timescale of the stressor, the life period in which it occurs, and the assessment window of the measurement tool used. These can be either objectively recorded or self-reported by the participant.
Acute Stressors: These are short term exposures under either naturalistic or standardized laboratory conditions. Life Events: These are stressful events that are event-based — meaning they are episodic in nature, and have an identifiable onset — such as getting into an accident, being laid off, being broken up with, or receiving a life-threatening diagnosis.
Chronic Stressors: Stressors that are identified by participants, interviewer, or external raters as being demanding, distressing, and ongoing e. In utero: Exposure to maternal stress and associated hormones that traverse the umbilical cord and modify the resting allostatic state and response signatures prenatally. Childhood: Childhood is typically defined up to age 18 years old, though some measures focus on early childhood such as before age 5.
This can be measured cross-sectionally with retrospective measures, or this can be calculated from prospective studies that take measures over time. Current rating usually captures in-the-moment reports, can also be reporting on the past 10 min, past hour, etc. Proximity of assessment to stressor exposure.
This more typically applies to objective assessments since subjective assessments are harder to recall retrospectively.
The proximity of the assessment to the event can be current or retrospective. It can be assessed as a continuous variable, such as the number of minutes or years between when the exposure occurred and when it was assessed. Severity: Measured on a continuous scale, from low-to-high severity, that can be rated by others or self-rated.
Controllability: Measured on a continuous scale by others or self-rated. Tasks can also be defined as controllable giving a speech or uncontrollable cold-pressor test by task design.
Stressors can cross and affect multiple domains. Potential of the stressor to elicit potentially harmful emotional responses: There are qualities inherent to some stressors that lead to feelings of social threat or shame that are associated with worse adjustment outcomes.
Responses to stressful stimuli or a an acute event include appraisals and perceptions of the situation, as well as affective, emotional, and cognitive responses to it. Measures of trait affect are not included as these are not context-specific and thus we do not consider them stress responses, however, momentary emotional responses are considered a component of the stress response.
Subjective stress within a life domain: These measures typically include both extent of exposures existence of stressor, to frequency of experience as well as subjective ratings of how much distress the situation causes. Motivational states e. Emotional responses negative and positive affect ratings and specific emotions in response to stimuli. Cognitive appraisals threat vs.
Behavioral coping e. Emotion regulation e. Below are dimensions of stressors and stress responses to promote unified descriptions across studies and fields. National Center for Biotechnology Information , U. Front Neuroendocrinol. Author manuscript; available in PMC Jan Elissa S. Crosswell , a Stefanie E. Mayer , a Aric A. Prather , a George M. Alexandra D. Stefanie E. Aric A. George M. Author information Copyright and License information Disclaimer.
Crosswell: ude. Mayer: ude. Prather: ude. Slavich: ude. Epel , ude. Copyright notice. The publisher's final edited version of this article is available at Front Neuroendocrinol.
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