Psychosocial Stress and Hypothalamic-Pituitary-Adrenal Axis Stress Reactivity: Variations by Race and Socioeconomic Status Among Adults at Risk of Diabetes. Issue 7 (18th September 2022)

• Record Type: Journal Article
• Authors: Kalesnikava, Viktoryia A.; Clarke, Philippa J.; Mukherjee, Bhramar; Sen, Srijan; Mezuk, Briana
• Is Part Of: Psychosomatic medicine. Volume 84:Issue 7(2022)
• Page Start: 813
• Page End: 821
• Publication Date: 2022-09-18
• Subjects: health disparities -- stress measurement -- chronic stress -- hypothalamic-pituitary-adrenal axis -- socioeconomic status -- diabetes -- AL = allostatic load -- Diabetes = type 2 diabetes mellitus -- GUTS = Generalized Unsafety Theory of Stress -- HPA axis = hypothalamic-pituitary-adrenal axis -- IQR = interquartile range -- LMM = linear mixed model -- NHB = non-Hispanic Black -- NHW = non-Hispanic White -- RSASS = Richmond Stress and Sugar Study -- SES = socioeconomic status -- ToH = Theory of Habituation -- TSST = Trier Social Stress Test; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000001112
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: 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.