Key result
Higher perceived stress was associated with a lower cortisol response to the Trier Social Stress Test (-7.5%; 95% CI -13.1% to -1.5%), an association modified by neighborhood socioeconomic status.
Why the study?
The extent to which commonly used self-report psychosocial stress measures correlate with neurobiological stress processes across diverse populations remained unresolved.
Are self-reported psychosocial stress measures associated with hypothalamic-pituitary-adrenal axis reactivity in adults at risk for type 2 diabetes?
Cohort (n=125)
Are self-reported psychosocial stress measures associated with hypothalamic-pituitary-adrenal axis reactivity in adults at risk for type 2 diabetes?
Effect estimate: -7.5% (95% CI -13.1% to -1.5%)
Self-reported perceived and domain-specific stress measures are associated with altered HPA axis reactivity to acute stressors, with effects modified by neighborhood socioeconomic status.
Self-reported stress may indicate altered HPA reactivity in T2D risk; leaves open causal pathways and neighborhood effects for prospective study.
OBJECTIVE: Although stress is posited to play a key role in health disparities, the extent to which commonly used self-report psychosocial stress measures are related to neurobiological stress processes, especially across diverse populations, is unresolved. This study examined how two measures of psychosocial stress, perceived stress and domain-specific stress, covary with the acute neurobiological stress response. METHODS: The Richmond Stress and Sugar Study includes a racially and socioeconomically diverse cohort of adults at risk for type 2 diabetes ( n = 125; mean age = 57 years, 48% Black, and 61% high neighborhood socioeconomic status [SES]). Hypothalamic-pituitary-adrenal axis reactivity was assessed by salivary cortisol response to the Trier Social Stress Test (TSST), a laboratory stressor. RESULTS: Higher perceived stress was associated with a lower cortisol response to the TSST (-7.5%; 95% confidence interval [CI] = -13.1% to -1.5%) but was not associated with cortisol recovery after the TSST (3%; 95% CI = -0.6% to 6.8%). In contrast, domain-specific stress was not associated with cortisol response (-2.1%; 95% CI = -20.7% to 20.9%) but was inversely associated with cortisol recovery (3.7%; 95% CI = 0.6% to 7.0%). SES modified these associations: both perceived stress and domain-specific stress were associated with TSST cortisol response only among participants from high-SES neighborhoods. There was minimal evidence of effect modification by race. CONCLUSIONS: Both self-report measures of psychosocial stress were associated with hypothalamic-pituitary-adrenal axis reactivity to an acute stressor. These associations varied by perceived versus domain-specific measurement scales and by neighborhood SES. Further efforts to refine stress measures and clarify biological linkages between social status and health are needed.
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Kalesnikava et al. (2022) conducted a cohort in at risk for type 2 diabetes (n=125). Higher perceived stress vs. Lower perceived stress was evaluated on cortisol response to the Trier Social Stress Test (TSST) (-7.5%, 95% CI -13.1% to -1.5%). Higher perceived stress was associated with a lower cortisol response to the Trier Social Stress Test (-7.5%; 95% CI -13.1% to -1.5%), an association modified by neighborhood socioeconomic status.
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