Low socioeconomic status (SES) may be associated with a high risk of lifestyle-related diseases such as cardiovascular diseases. Expected final online publication date for the Annual Review of Psychology Volume 70 is January 4, 2019. Issues that we address include the definition of a stressful event, characteristics of diseases that are impacted by events, differences in the effects of chronic and acute events, the cumulative effects of events, differences in events across the life course, differences in events for men and women, resilience to events, and methodological challenges in the literature. We organize this review in a somewhat provocative manner, with each section focusing on an important issue in the literature where we feel that there has been some misunderstanding of the evidence and its implications. In this review, we highlight that knowledge but also emphasize misunderstandings and weaknesses in this literature with the hope of triggering further theoretical and empirical development. The foci of these three traditions have informed elements of a stage model of disease, wherein events appraised as stressful are viewed as triggering affective states that in turn engender behavioral and biological responses having possible downstream implications for disease.Īfter over 70 years of research on the association between stressful life events and health, it is generally accepted that we have a good understanding of the role of stressors in disease risk. The biological tradition focuses on brain-based perturbations of physiological systems that are otherwise essential for normal homeostatic regulation and metabolic control.
The psychological tradition focuses on individuals’ perceptions of the stress presented by life events on the basis of their appraisals of the threats posed and the availability of effective coping resources. The epidemiological tradition focuses on defining which circumstances and experiences are deemed stressful on the basis of consensual agreement that they constitute threats to social or physical well-being. We provided a short history of three traditions in the study of stress: the epidemiological, psychological, and biological. In this article, we argued that the term stress has served as a valuable heuristic, helping researchers to integrate traditions that illuminate different stages of the process linking stressful life events to disease.
Exposure to childhood abuse is also associated with less suppression of default mode brain regions associated with self-referential processing in the face of irrelevant threat information, but heightened ability to suppress similar processing for irrelevant positive information. Results suggest exposure to childhood abuse is associated with blunted recruitment of brain regions supporting task-set maintenance but hypervigilance for task-irrelevant information, regardless of whether distractors are emotionally neutral or emotional. No differential effects were observed for transient control. Severity of avoidance symptoms was associated with sustained activation in lateral prefrontal regions, whereas hyperarousal/re-experiencing symptoms were associated with sustained activity in temporal regions. Additionally, they had less suppression of brain regions involved in self-referential processes for threat blocks, but greater suppression of these regions for positive blocks. Women with a history of childhood abuse demonstrated decreased recruitment of frontal-parietal regions involved in cognitive control and enhanced recruitment of a ventral attention surveillance network during blocks of both versions of the Stroop task. This paradigm allowed us to examine both sustained (activation persisting across blocks) and transient (event-specific activation) aspects of cognitive control. Participants underwent fMRI scanning while completing hybrid block/event-related versions of a classic color-word and an emotional Stroop paradigm (threat and positive words). Participants were young adult women (ages 23–30): one group with a history of childhood physical or sexual abuse (N = 15) and one with no trauma exposure (N = 17), as assessed through the Trauma History Questionnaire and a two-stage interview adapted from the National Crime Victims Survey. The current study examined whether such alterations are increased in the face of emotionally-distracting as compared to emotionally neutral information, and whether such alterations occur in brain regions that exert cognitive control in a more top-down sustained manner or a more bottom-up transient manner. Although limited, the literature suggests alterations in activation of cognitive control regions in adults and adolescents with a history of childhood abuse.
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