From the Department of Psychology, (Mrug, Knight), CardioRenal Physiology and Medicine, Division of Nephrology, Department of Medicine, (J. Pollock, D. Pollock), and Division of Pediatric Nephrology, Department of Pediatrics (Seifert), University of Alabama at Birmingham, Birmingham, Alabama; and Department of Psychology (Johnson), University of Iowa, Iowa City, Iowa.
Psychosom Med. 2023;85(2):118-129. doi: 10.1097/PSY.0000000000001165. Epub 2022 Dec 27.
Early life stress (ELS) occurring during childhood and adolescence is an established risk factor for later cardiovascular disease and dysregulated reactivity to acute social stress. This study examined whether ELS associations with baseline cardiovascular functioning, cardiovascular stress reactivity and recovery, and emotional stress reactivity vary across levels of emotion-oriented, task-oriented, and avoidant coping styles.
The sample included 1027 adolescents and young adults (mean age = 19.29 years; 50% female; 64% Black, 34% non-Hispanic White) who reported on their ELS exposure and coping styles. Participants completed a standardized acute social stress test (the Trier Social Stress Test [TSST]), with heart rate (HR) and blood pressure (BP) measured before, during, and after the TSST. Self-reports of negative emotions during the TSST indexed emotional stress reactivity.
Multiple regression models adjusting for demographic factors and body mass index showed that ELS was associated with lower HR stress reactivity, avoidant coping was related to lower systolic BP and diastolic BP during stress and lower systolic BP during recovery, and higher emotion-oriented coping and lower task-oriented coping predicted greater emotional stress reactivity. A consistent pattern emerged where emotion-oriented coping amplified the associations between ELS and maladaptive stress responses (blunted cardiovascular stress reactivity and recovery; enhanced emotional stress reactivity), whereas lower levels of emotion-oriented coping were associated with resilient profiles among those who experienced ELS (lower resting HR, lower emotional stress reactivity, average HR and BP stress reactivity and recovery). However, low levels of emotion-oriented coping also conferred a risk of higher BP during recovery for those with high levels of ELS.
These results suggest that low to moderate levels of emotion-oriented coping promote optimal cardiovascular and emotional reactivity to acute stress among individuals exposed to ELS.
儿童期和青少年时期发生的早期生活压力(ELS)是日后发生心血管疾病和对急性社会压力反应失调的既定风险因素。本研究考察了 ELS 与基线心血管功能、心血管应激反应和恢复以及情绪应激反应的关联是否因情绪导向型、任务导向型和回避型应对方式的水平而异。
该样本包括 1027 名青少年和年轻成年人(平均年龄=19.29 岁;50%为女性;64%为黑人,34%为非西班牙裔白人),他们报告了 ELS 暴露情况和应对方式。参与者完成了一项标准化的急性社会压力测试(Trier 社会压力测试[TSST]),在 TSST 之前、期间和之后测量心率(HR)和血压(BP)。在 TSST 期间自我报告的负面情绪反映了情绪应激反应。
调整人口统计学因素和体重指数的多元回归模型显示,ELS 与较低的 HR 应激反应相关,回避型应对与应激期间和恢复期间的收缩压和舒张压较低以及恢复期间的收缩压较低有关,而较高的情绪导向型应对和较低的任务导向型应对预测了更大的情绪应激反应。出现了一种一致的模式,即情绪导向型应对放大了 ELS 与适应不良应激反应之间的关联(心血管应激反应和恢复减弱;情绪应激反应增强),而较低水平的情绪导向型应对与经历 ELS 的个体的弹性特征相关(静息 HR 较低,情绪应激反应较低,平均 HR 和 BP 应激反应和恢复)。然而,较低水平的情绪导向型应对也为 ELS 水平较高的个体在恢复期间血压升高带来了风险。
这些结果表明,在经历 ELS 的个体中,低至中等水平的情绪导向型应对促进了对急性应激的最佳心血管和情绪反应。