Busse David, Yim Ilona S, Campos Belinda, Marshburn Christopher K
Department of Psychology and Social Behavior, University of California, Irvine, 4562 Social and Behavioral Sciences Gateway, Irvine, CA, 92697-7085, USA.
Department of Chicano/Latino Studies, University of California, Irvine, Irvine, CA, USA.
J Behav Med. 2017 Aug;40(4):539-552. doi: 10.1007/s10865-017-9830-6. Epub 2017 Feb 2.
Numerous studies suggest that discrimination is associated with poor physical and mental health outcomes. Whereas the cardiovascular system has been extensively studied as a potential pathway linking discrimination with disease, the role of the hypothalamic-pituitary-adrenal (HPA) axis remains understudied. We conducted a systematic review of research on discrimination and related constructs as predictors and correlates of HPA axis activity. Twenty seven studies (10 experimental, 17 observational) met inclusion criteria. Studies suggest that discrimination is associated with alterations in HPA axis activity and that the direction of this association depends on the timing and chronicity of the discrimination experience. There is also evidence of important modulating variables (race, socioeconomic status) and contextual confounders (emotional, situational) that warrant further study. Accounting for the HPA axis in addition to the cardiovascular system will contribute to a more comprehensive understanding of the biobehavioral pathways contributing to physical and mental health inequities related to discrimination.
大量研究表明，歧视与身心健康状况不佳有关。虽然心血管系统作为将歧视与疾病联系起来的潜在途径已得到广泛研究，但下丘脑 - 垂体 - 肾上腺（HPA）轴的作用仍未得到充分研究。我们对关于歧视及相关概念作为HPA轴活动的预测因素和相关因素的研究进行了系统综述。27项研究（10项实验性研究，17项观察性研究）符合纳入标准。研究表明，歧视与HPA轴活动的改变有关，且这种关联的方向取决于歧视经历的时间和持续性。也有证据表明重要的调节变量（种族、社会经济地位）和背景混杂因素（情绪、情境）值得进一步研究。除了心血管系统外，考虑HPA轴将有助于更全面地理解导致与歧视相关的身心健康不平等的生物行为途径。
