Estimation of psychological stress in humans: a combination of theory and practice

Eight weeks of high-intensity interval training versus stretching do not change the psychoneuroendocrine response to a social stress test in emotionally impulsive humans

PURPOSE

Research supports physical activity as a method to heighten stress resistance and resilience through positive metabolic alterations mostly affecting the neuroendocrine system. High-intensity interval training (HIIT) has been proposed as a highly effective time-saving method to induce those changes. However, existing literature relies heavily on cross-sectional analyses, with few randomised controlled trials highlighting the necessity for more exercise interventions. Thus, this study aims to investigate the effects of HIIT versus an active control group on the stress response to an acute psychosocial stressor in emotionally impulsive humans (suggested as being strong stress responders).

METHODS

The study protocol was registered online (DRKS00016589) before data collection. Sedentary, emotionally impulsive adults (30.69 ± 8.20 y) were recruited for a supervised intervention of 8 weeks and randomly allocated to either a HIIT (n = 25) or a stretching group (n = 19, acting as active controls). Participants were submitted to a test battery, including saliva samples, questionnaires (self-efficacy- and perceived stress-related), visual analogue scales (physical exercise- and stress-related), and resting electroencephalography and electrocardiography assessing their reaction to an acute psychological stressor (Trier Social Stress Test) before and after the exercise intervention.

RESULTS

HIIT increased aerobic fitness in all participants, whereas stretching did not. Participants from the HIIT group reported perceiving exercising more intensively than those from the active control group (ƞp2 = 0.108, p = 0.038). No further group differences were detected. Both interventions largely increased levels of joy post-TSST (ƞp2 = 0.209, p = 0.003) whilst decreasing tension (ƞp2 = 0.262, p < 0.001) and worries (ƞp2 = 0.113, p = 0.037). Finally, both interventions largely increased perceived levels of general self-efficacy (ƞp2 = 0.120, p = 0.029).

CONCLUSION

This study suggests that 8 weeks of HIIT does not change the psychoneuroendocrine response to an acute psychological stress test compared to an active control group in emotionally impulsive humans. Further replications of supervised exercise studies highly powered with active and passive controls are warranted.

Immersive virtual reality: An effective strategy for reducing stress in young adults

Background

Psychological stress is ubiquitous in young adults, but traditional relaxation strategies such as mindfulness or meditation are not consistently utilised. Immersive virtual reality (VR) is being increasingly used in mental health contexts with improved clinical outcomes. However, there is limited research exploring the perceived usefulness of VR for individuals without a mental health diagnosis.

Aim

To identify if an immersive VR experience was effective in reducing stress for young adults and to explore the experience of the participants.

Methods

Twenty-one young adults aged 18-25 years participated in an immersive VR experience. Heart rate was measured pre- and post-test to objectively establish the efficacy of VR to facilitate relaxation. Participants were invited to participate in a semi-structured interview (n = 18) to gain a rich understanding of their experience.

Results

Four themes emerged from analysis of the interviews: I felt relaxed and calm, It was time-efficient and easy to use, It took me to another place and It was different than I thought it would be. Heart rate reduced during the immersive VR experience.

Conclusion

These findings suggest that immersive VR can reduce psychological stress, and it is perceived by young adults as a useful and time-effective strategy to reduce psychological stress.

Towards a biochemical approach to occupational stress management

Given the immense and growing cost of occupational stress to society through lost productivity and the burden to healthcare systems, current best practices for detecting, managing and reducing stress in the workplace are clearly sub-optimal and substantially better methods are required. Subjective, self-reported psychology and psychiatry-based instruments are prone to biases whereas current objective, biology-based measures produce conflicting results and are far from reliable. A multivariate approach to occupational stress research is required that reflects the broad, coordinated, physiological response to demands placed on the body by exposure to diverse occupational stressors. A literature review was conducted to determine the extent of application of the emerging multivariate technology of metabolomics to occupational stress research. Of 170 articles meeting the search criteria, three were identified that specifically studied occupational stressors using metabolomics. A further ten studies were not specifically occupational or were of indirect or peripheral relevance. The occupational studies, although limited in number highlight the technological challenges associated with the application of metabolomics to investigate occupational stress. They also demonstrate the utility to evaluate stress more comprehensively than univariate biomarker studies. The potential of this multivariate approach to enhance our understanding of occupational stress has yet to be established. This will require more studies with broader analytical coverage of the metabolome, longitudinal sampling, combination with experience sampling methods and comparison with psychometric models of occupational stress. Progress will likely involve combining multi-omic data into a holistic, systems biology approach to detecting, managing and reducing occupational stress and optimizing workplace performance.

Early life stress exposure associated with reduced polyunsaturated-containing lipids in low-income children

BACKGROUND

Psychosocial stress in early childhood is associated with adult obesity and cardiometabolic disease. The association of psychosocial stress with the metabolome in childhood is unknown.

METHOD

Low-income children (n = 28, mean age 1.8 years), recruited from the community, participated. Psychosocial stress was measured by diurnal salivary cortisol (cortisol intercept and slope) and by mother-reported chaos in the home using the Confusion, Hubbub, and Order Scale (CHAOS). At mean age 6.1 years, anthropometry was collected and fasting metabolites measured using an untargeted metabolomics and shotgun lipidomics platform.

RESULTS

Cortisol slope was inversely associated with fatty acid (FA) 20:3, FA 20:4 and polyunsaturated fatty acids (PUFA) metabolites. A higher CHAOS score was associated with lower very long-chain PUFA metabolites and a trend towards lower long-chain PUFA containing triglycerides.

CONCLUSIONS

Psychosocial stress in early childhood, measured with both biological markers and parent report, was associated with lower PUFAs later in childhood. Future work should examine potential mechanisms of association, including dietary intake or direct effects on polyunsaturated fatty acid levels or metabolism.

IMPACT

In this longitudinal study, the key message is that diurnal cortisol patterns and greater parent-reported psychosocial stress exposure in early childhood are associated with lower plasma polyunsaturated fatty acid containing lipids 5 years later, potentially indicating altered dietary intake or metabolism associated with psychosocial stress. Untargeted metabolomics and lipidomics can be used to assess changes in metabolism response to psychosocial stress. Stress exposure in early childhood may be associated with the future metabolome. Future work should examine potential pathways of association, including dietary intake and direct effects on metabolism.

Facial Expression Recognition With Machine Learning and Assessment of Distress in Patients With Cancer

OBJECTIVES

To estimate the effectiveness of combining facial expression recognition and machine learning for better detection of distress.

SAMPLE & SETTING

232 patients with cancer in Sichuan University West China Hospital in Chengdu, China.

METHODS & VARIABLES

The Distress Thermometer (DT) and Hospital Anxiety and Depression Scale (HADS) were used as instruments. The HADS included scores for anxiety (HADS-A), depression (HADS-D), and total score (HADS-T). Distressed patients were defined by the DT cutoff score of 4, the HADS-A cutoff score of 8 or 9, the HADS-D cutoff score of 8 or 9, or the HADS-T cutoff score of 14 or 15. The authors applied histogram of oriented gradients to extract facial expression features from face images, and used a support vector machine as the classifier.

RESULTS

The facial expression features showed feasible differentiation ability on cases classified by DT and HADS.

IMPLICATIONS FOR NURSING

Facial expression recognition could serve as a supplementary screening tool for improving the accuracy of distress assessment and guide strategies for treatment and nursing.

Macrophage plays important role in cortisol and serotonin induced adipogenesis in vitro

Psychological stress is an important cause to induce various metabolic disorders such as obesity, type II diabetes, and cardiovascular disorders by affecting the visceral adipose tissue. Pathophysiology of these diseases is often accompanied by the hyperactive immune system. The hyperactive immune system causes immune cells to infiltrate in the adipose tissue to increase the severity of metabolic disorders and to affect the levels of stress associated hormones, such as cortisol and serotonin. Cortisol and serotonin, alone or together, could regulate several aspects of the metabolic and immunological deregulations by manipulating the lipid accumulation or adipogenesis in cells. During adipogenesis, macrophages are recruited. Previous reports from the Aich laboratory established the roles of cortisol and serotonin to influence adipogenesis in pre-adipocytes 3T3-L1 in the presence and absence of macrophages. In the current study, we reported the role of macrophage RAW264.7, especially its polarized states, on differentiated murine adipocytes 3T3-L1 in the presence or absence of cortisol and serotonin. The current study also compares the differential role of macrophage recruitment on pre- and differentiated adipocytes.

Cortisol regulates immune and metabolic processes in murine adipocytes and macrophages through HTR2c and HTR5a serotonin receptors

Epidemiological studies implicate stress as an important factor contributing to the increasing prevalence of metabolic disorders. Studies have correlated visceral obesity and atherosclerosis with hyper-cortisolemia, a sequela of chronic psychological stress in humans and animals. Although several hormonal markers of stress have been associated with various metabolic disorders, the mechanism by which these hormones alter metabolic functions have not been established. We used an in vitro model system, culturing 3T3-L1 pre-adipocytes and RAW 264.7 macrophages in the presence or absence of cortisol, to analyze cell signaling pathways mediating changes in metabolic functions. Our analysis revealed that cortisol up-regulated the expression and function of two serotonin (S) receptors, HTR2c and HTR5a. HTR2c and HTR5a were also directly involved in mediating cortisol enhanced adipogenesis when pre-adipocytes were cultured alone or in the presence of macrophages. Finally, cortisol treatment of pre-adipocytes co-cultured with macrophages enhanced adipogenesis in both macrophages and pre-adipocytes.

Extraction of facial features as indicators of stress and anxiety

Stress and anxiety heavily affect the human wellbeing and health. Under chronic stress, the human body and mind suffers by constantly mobilizing all of its resources for defense. Such a stress response can also be caused by anxiety. Moreover, excessive worrying and high anxiety can lead to depression and even suicidal thoughts. The typical tools for assessing these psycho-somatic states are questionnaires, but due to their shortcomings, by being subjective and prone to bias, new more robust methods based on facial expression analysis have emerged. Going beyond the typical detection of 6 basic emotions, this study aims to elaborate a set of facial features for the detection of stress and/or anxiety. It employs multiple methods that target each facial region individually. The features are selected and the classification performance is measured based on a dataset consisting 23 subjects. The results showed that with feature sets of 9 and 10 features an overall accuracy of 73% is reached.