In this systematic review and meta-analysis, Rogerson et al. (2023) examined the effects of stress management interventions—including mind body therapies, mindfulness, relaxation, or talk therapies—on cortisol levels across 58 studies involving 3508 participants. They found that mindfulness and relaxation interventions were most effective at changing cortisol levels, and that these effects were observed more often in studies that assessed cortisol awakening responses than diurnal levels.

 

Rogerson, O., Wilding, S., Prudenzi, A., & O'Connor, D. B. (2024). Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis. Psychoneuroendocrinology, 159, 106415. https://doi.org/10.1016/j.psyneuen.2023.106415  

Bobba-Alves et al. (2023) examined the impact of chronic stress on bioenergetics and cellular aging processes. By longitudinally profiling three human fibroblast lines, the authors identified hypermetabolism as a central manifestation of allostatic load. Chronic glucocorticoid exposure increased cellular energy expenditure by 60%, emphasizing the extra energetic cost of chronic stress at the cellular level. In turn, this stress-induced hypermetabolism was linked with an accelerated aging phenotype (including epigenetic and telomere aging).

 

Bobba-Alves, N., Sturm, G., Lin, J., Ware, S. A., Karan, K. R., Monzel, A. S., Bris, C., Procaccio, V., Lenaers, G., Higgins-Chen, A., Levine, M., Horvath, S., Santhanam, B. S., Kaufman, B. A., Hirano, M., Epel, E., & Picard, M. (2023). Cellular allostatic load is linked to increased energy expenditure and accelerated biological aging. Psychoneuroendocrinology, 155, 106322. https://doi.org/10.1016/j.psyneuen.2023.106322

Lewis and colleagues (2023) distinguished between personal stressors and network stressors (i.e., those having to do with family members and friends) in predicting elevated blood pressure in African-American women, finding that network stressors were predictive, whereas personal stressors were not. These findings highlight the interdependence among communities and suggest that mitigating the heightened rates of blood pressure (BP) and hypertension among African-American women will likely require broader systemic and community-level change.

 

Lewis, T. T., Parker, R., Murden, R., Spikes, T., Erving, C., McKinnon, I. I., Van Dyke, M. E., Booker, B., Quyummi, A., Vaccarino, V., & Moore, R. H. (2023). Network stressors, personal stressors, and ambulatory blood pressure in African-American women—Does superwoman schema play a role? Health Psychology, 42(7), 485–495. https://doi.org/10.1037/hea0001309

Murray et al. (2023) validated an EMA-adapted Perceived Stress Scale to measure stress as it is experienced in daily life. The study confirmed the tool's consistency and accuracy in capturing stress levels. These findings support the use of this adapted version to better understand the influences of momentary stress in the general population.

 

Murray, A. L., Xiao, Z., Zhu, X., Speyer, L. G., Yang, Y., Brown, R. H., Katus, L., Eisner, M., & Ribeaud, D. (2023). Psychometric evaluation of an adapted version of the perceived stress scale for ecological momentary assessment research. Stress and Health. https://doi.org/10.1002/smi.3229

Slavich et al. (2023) propose an integrated, multilevel, and biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. The theory advances a testable framework for investigating the biopsychosocial roots of health disparities, how health-relevant biopsychosocial processes crystalize over time, and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. This theory also highlights several interventions for reducing social threat and promoting resilience.

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Slavich, G. M., Roos, L. G., Mengelkoch, S., Webb, C. A., Shattuck, E. C., Moriarity, D. P., & Alley, J. C. (2023). Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions. Health Psychology Review, 17(1), 5–59. https://doi.org/10.1080/17437199.2023.2171900

Smyth et al., (2023) offer a useful discussion of strategies, challenges, implications, and limitations when designing a within-persons study of stress-response dynamics in everyday life. The authors distinguish between reactivity, recovery, and pileup before moving into critical issues such as defining a baseline in everyday life, operationalizing reactivity, recovery, and pileup, in addition to discussing data and design issues that researchers should consider.

 

Smyth, J. M., Zawadzki, M. J., Marcusson-Clavertz, D., Scott, S. B., Johnson, J. A., Kim, J., Toledo, M. J., Stawski, R. S., Sliwinski, M. J., & Almeida, D. M. (2023). Computing Components of Everyday Stress Responses: Exploring Conceptual Challenges and New Opportunities. Perspectives on psychological science,18(1), 110–124. https://doi.org/10.1177/17456916221082108

Ellis et al. (2022) advance a new explanatory framework that integrates the threat-deprivation and harshness-unpredictability models to situate why, how, and which adverse environmental influences affect development, and how future research might go about systematically testing this model.

 

Ellis BJ, Sheridan MA, Belsky J, McLaughlin KA. Why and how does early adversity influence development? Toward an integrated model of dimensions of environmental experience. Dev Psychopathol. 2022 May; 34(2):447-471. https://doi.org/10.1017/S0954579421001838.

Amirkhan (2020) discusses both theoretical and empirical evidence of stress overload being a key factor in illness development and a lens through which we can understand illness disparities. The 10-item Stress Overload Scale-Short is recommended as a valid measure for both research and clinical settings (a) to investigate the role of stress overload in coronavirus and (b) to identify populations who may be particularly impacted by the coronavirus illness. 

 

Amirkhan J. H. (2021). Stress overload in the spread of coronavirus. Anxiety, Stress, and Coping, 34(2), 121–129. https://doi.org/10.1080/10615806.2020.1824271

Joseph et al., (2021) asked African American young adults to report on experiences of discrimination they confronted in their daily activities in real-time. Daily experiences of racism were common and most likely to occur at work. Both the discrimination they experienced and the discrimination they witnessed led to negative emotions in that moment, and this relationship was stronger for African American young adults living in areas with fewer African American neighbors. Experiencing discrimination also depleted coping resources in that moment, and this relationship was stronger for African American young adults who had experienced more racism in general.

 

Joseph, N. T., Peterson, L. M., Gordon, H., & Kamarck, T. W. (2021). The double burden of racial discrimination in daily-life moments: Increases in negative emotions and depletion of psychosocial resources among emerging adult African Americans. Cultural diversity & ethnic minority psychology, 27(2), 234–244. https://doi.org/10.1037/cdp0000337

Crosswell and Lockwood (2020) highlight strong evidence for the impact of psychological stress on disease risk. They encourage researchers across disciplines to carefully consider the most relevant operationalization of stress based on the research question to build a comprehensive understanding of the consequences of psychological stress on health and disease. In support of this goal, the authors offer best practices for psychological stress measurement and practical advice for selecting the appropriate measures—considering the critical distinction between stress exposure and stress responses, timescales, and population-specific stressors. We recommend considering the recommendations in this article alongside those made by Epel et al., (2018).

 

Crosswell, A. D., & Lockwood, K. G. (2020). Best practices for stress measurement: How to measure psychological stress in health research. Health Psychology Open, 7(2), 2055102920933072. https://doi.org/10.1177/2055102920933072

Roberts and colleagues (2020) discussed the state of psychological publications that highlight race. Findings emphasize a lack of diversity across all levels of publication from participants to research teams to editors of publications. Differences between subfields of psychology, region of research, and time of publication exist. The authors detail recommendations for both journals (e.g., evaluation of sample demographics, diversity task forces, and publishing diversity statistics) and authors (e.g., justify demographics of samples and have constraints on generality statements). 

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Roberts, S. O., Bareket-Shavit, C., Dollins, F. A., Goldie, P. D., & Mortenson, E. (2020). Racial Inequality in Psychological Research: Trends of the Past and Recommendations for the Future. Perspectives on psychological science, 15(6), 1295–1309. https://doi.org/10.1177/1745691620927709

Ali and Nater (2020) highlight salivary alpha-amylase (sAA) as a reliable marker of autonomic nervous system function that can be studied basally or in response to stress. The authors also emphasize methodological considerations for researchers who may wish to include sAA assessments in future studies.

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Ali, N., & Nater, U. M. (2020). Salivary Alpha-Amylase as a Biomarker of Stress in Behavioral Medicine. International journal of behavioral medicine, 27(3), 337–342. https://doi.org/10.1007/s12529-019-09843-x

Using the superwoman schema—a framework for considering the stressors specific for Black women—Allen et al. (2019) investigated psychosocial stress processes that moderate the impacts of racial discrimination in African American women in the San Francisco Bay Area. Results suggest that feeling obligated to present an image of strength and an obligation to suppress emotions were each protective, whereas feeling an intense motivation to succeed and feeling an obligation to help others exacerbated the independent health risk associated with experiencing racial discrimination. 

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Allen, A. M., Wang, Y., Chae, D. H., Price, M. M., Powell, W., Steed, T. C., Rose Black, A., Dhabhar, F. S., Marquez-Magaña, L., & Woods-Giscombe, C. L. (2019). Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress-coping model among African American women. Annals of the New York Academy of Sciences, 1457(1), 104–127. https://doi.org/10.1111/nyas.14188

Women living with HIV experience high levels of depressive symptoms and sleep disturbance. McIntosh et al., (2019) longitudinally modeled changes in sleep disturbance, depressive symptomology, and cortisol output for HIV+ women who took part in a 12-week cognitive behavioral stress management intervention (or control condition). Those receiving the intervention experienced decreases in sleep disturbance and depressive symptomology over time; declines in sleep disturbances then predicted lower cortisol output nine months later. This work identifies sleep disturbance as a behavioral target for cognitive behavioral stress management interventions.

 

McIntosh, R., Antoni, M., Seay, J., Fletcher, M. A., Ironson, G., Klimas, N., Kumar, M., & Schneiderman, N. (2019). Associations Among Trajectories of Sleep Disturbance, Depressive Symptomology and 24-Hour Urinary Cortisol in HIV+ Women Following a Stress Management Intervention. Behavioral sleep medicine, 17(5), 605–620. https://doi.org/10.1080/15402002.2018.1435545

Using three domains, Neblett (2019) discusses the challenges and offers recommendations to accurately include racism in health research. These domains include investigating differing levels of racism rather than just individual, measurement of racism, and identifying mechanisms and pathways through which racism is related to health outcomes. 

 

Neblett E. W. (2019). Racism and health: Challenges and future directions in behavioral and psychological research. Cultural Diversity & Ethnic Minority Psychology, 25(1), 12–20. https://doi.org/10.1037/cdp0000253

In the Generalized Unsafety Theory of Stress (GUTS), authors Brossschot et al. (2018) propose a novel model of stress, which assumes that stress-response systems are active by default, and inhibited by learned safety cues. This model challenges traditional stress-health models, which assume that stress degrades health through repeated activation of acute stress response systems, suggesting instead that prolonged stress responses are not solely triggered by external stressors but are a result of generalized and largely unconscious perceptions of unsafety. The authors argue that this model better accounts for common situations, like loneliness or low social status, where prolonged stress-responding can occur without and apparent stressor.  

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Brosschot JF, Verkuil B, Thayer JF. Generalized Unsafety Theory of Stress: Unsafe Environments and Conditions, and the Default Stress Response. Int J Environ Res Public Health. 2018 Mar 7;15(3):464. https://doi.org//10.3390/ijerph15030464.