|Part of a series on|
Social stress is stress that stems from one's relationships with others and from the social environment in general. Based on the appraisal theory of emotion, stress arises when a person evaluates a situation as personally relevant and perceives that s/he does not have the resources to cope or handle the specific situation.[clarification needed] An event which exceeds the ability to cope does not necessarily have to occur in order for one to experience stress, as the threat of such an event occurring can be sufficient.
There are three main categories of social stressors. Life events are defined as abrupt, severe life changes that require an individual to adapt quickly (ex. sexual assault, sudden injury). Chronic strains are defined as persistent events which require an individual to make adaptations over an extended period of time (ex. divorce, unemployment). Daily hassles are defined as minor events that occur, which require adaptation throughout the day (ex. bad traffic, disagreements). When stress becomes chronic, one experiences emotional, behavioral, and physiological changes that can put one under greater risk for developing a mental disorder and physical illness.
Humans are social beings by nature, as they typically have a fundamental need and desire to maintain positive social relationships. Thus, they usually find maintaining positive social ties to be beneficial. Social relationships can offer nurturance, foster feelings of social inclusion, and lead to reproductive success. Anything that disrupts or threatens to disrupt their relationships with others can result in social stress. This can include low social status in society or in particular groups, giving a speech, interviewing with potential employers, caring for a child or spouse with a chronic illness, meeting new people at a party, the threat of or actual death of a loved one, divorce, and discrimination. Social stress can arise from one's micro-environment (e.g., family ties) and macro-environment (e.g., hierarchical societal structure). Social stress is typically the most frequent type of stressor that people experience in their daily lives and affects people more intensely than other types of stressors.
- 1 Definitions
- 2 Measurement
- 3 Mental health
- 4 Physical health
- 5 Physiology
- 6 See also
- 7 References
Researchers define social stress and social stressors in various ways. Wadman, Durkin, and Conti-Ramsden (2011) defined social stress as "the feelings of discomfort or anxiety that individuals may experience in social situations, and the associated tendency to avoid potentially stressful social situations". Ilfield (1977) defined social stressors as "circumstances of daily social roles that are generally considered problematic or undesirable". Dormann and Zapf (2004) defined social stressors as "a class of characteristics, situations, episodes, or behaviors that are related to psychological or physical strain and that are somehow social in nature".
Social stress is typically measured through self-report questionnaires. In the laboratory, researchers can induce social stress through various methods and protocols.
There are several questionnaires used to assess environmental and psychosocial stress. Such self-report measures include the Test of Negative Social Exchange, the Marital Adjustment Test, the Risky Families Questionnaire, the Holmes–Rahe Stress Inventory, the Trier Inventory for the Assessment of Chronic Stress, the Daily Stress Inventory, the Job Content Questionnaire, the Perceived Stress Scale, and the Stress and Adversity Inventory.
In addition to self-report questionnaires, researchers can employ structured interview assessments. The Life Events and Difficulties Schedule (LEDS) is one of the most popular instruments used in research. The purpose of this type of measure is to probe the participant to elaborate on his/her stressful life events, rather than answering singular questions. The UCLA Life Stress Interview (LSI), which is similar to the LEDS, includes questions about romantic partners, closest friendships, other friendships, and family relationships.
In rodent models, social disruption and social defeat are two common social stress paradigms. In the social disruption paradigm, an aggressive rodent is introduced into a cage housing male rodents that have already naturally established a social hierarchy. The aggressive "intruder" disrupts the social hierarchy, causing the residents social stress. In the social defeat paradigm, an aggressive "intruder" and another non-aggressive male rodent fight.
In human research, the Trier Social Stress Task (TSST) is widely used to induce social stress in the laboratory. In the TSST, participants are told that they have to prepare and give a speech about why they would be a great candidate for their ideal job. The experimenter films the participant while s/he gives the speech and informs the participant that a panel of judges will evaluate that speech. After the public speaking component, the experimenter administers a mathematics task that involves counting backwards by certain increments. If the participant makes a mistake, the experimenter prompts him/her to start again. The threat of negative evaluation is the social stressor. Researchers can measure the stress response by comparing pre-stress salivary cortisol levels and post-stress salivary cortisol levels. Other common stress measures used in the TSST are self-report measures like the State-Trait Anxiety Inventory and physiological measures like heart rate.
In a laboratory conflict discussion, couples identify several specific areas of conflict in their relationship. The couples then pinpoint a couple topics to discuss later on in the experiment (ex. finances, child-rearing). Couples are told to discuss the conflict(s) for 10 minutes while being videotaped.
Brouwer and Hogervorst (2014) designed the Sing-a-Song Stress Test (SSST) to induce stress in the laboratory setting. After viewing neutral images with subsequent 1-minute rest periods, the participant is instructed to sing a song after the next 1-minute rest period is complete. Researchers found that skin conductance and heart rate are significantly higher during the post-song message interval than the previous 1-minute intervals. The stress levels are comparable to that induced in the Trier Social Stress Task.
Statistical indicators of stress in large groups
A statistical indicator of stress, simultaneous increase of variance and correlations, was proposed for diagnosis of stress and successfully used in physiology and finance. Its applicability for early diagnosis of social stress in large groups was demonstrated by the analysis of crises. It was examined in the prolonged stress period preceding the 2014 Ukrainian economic and political crisis. There was a simultaneous increase in the total correlation between the 19 major public fears in the Ukrainian society (by about 64%) and also in their statistical dispersion (by 29%) during the pre-crisis years.
Research has consistently demonstrated that social stress increases risk for developing negative mental health outcomes. One prospective study asked over fifteen hundred Finnish employees whether they had "considerable difficulties with [their] coworkers/superiors/inferiors during the last 6 months, 5 years, earlier, or never". Information on suicides, hospitalizations due to psychosis, suicidal behavior, alcohol intoxication, depressive symptoms, and medication for chronic psychiatric disorders was then gathered from the national registries of mortality and morbidity. Those who had experienced conflict in the workplace with coworkers or supervisors in the last five years were more likely to be diagnosed with a psychiatric condition.
Research on the LGB population has suggested that people who identify as LGB suffer more from mental health disorders, such as substance abuse and mood disorders, compared to those who identify as heterosexual. Researchers deduce that the LGB people's higher risk of mental health issues derives from their stressful social environments. Minority groups can face high levels of stigma, prejudice, and discrimination on a regular basis, therefore leading to the development of various mental health disorders.
Risk for developing clinical depression significantly increases after experiencing social stress; depressed individuals often experience interpersonal loss before becoming depressed. One study found that depressed individuals who had been rejected by others had developed depression about three times more quickly than those who had experienced stress not involving social rejection. In non-clinically depressed populations, people with friends and family who make too many demands, criticize, and create tension and conflict tend to have more depressive symptoms.
Conflict between spouses also leads to more psychological distress and depressive symptoms, especially for wives. In particular, unhappy married couples are 10–25 times more at risk for developing clinical depression. Similarly, social stress arising from discrimination is related to greater depressive symptoms. In one study, African-Americans and non-Hispanic whites reported on their daily experiences of discrimination and depressive symptoms. Regardless of race, those who perceived more discrimination had higher depressive symptoms.
The biological basis for anxiety disorders is rooted in the consistent activation of the stress response. Fear, which is the defining emotion of an anxiety disorder, occurs when someone perceives a situation (a stressor) as threatening. This activates the stress response. If a person has difficulty regulating this stress response, it may activate inappropriately. Stress can therefore arise when a real stressor is not present or when something isn't actually threatening. This can lead to the development of an anxiety disorder (panic attacks, social anxiety, OCD, etc.). Social anxiety disorder is defined as the fear of being judged or evaluated by others, even if no such threat is actually present.
Research shows a connection between social stress, such as traumatic life events and chronic strains, and the development of anxiety disorders. A study that examined a subpopulation of adults, both young and middle-age, found that those who had diagnosed panic disorder in adulthood also experienced sexual abuse during childhood. Children who experience social stressors, such as physical and psychological abuse, as well as parental loss, are also more at risk for developing anxiety disorders during adulthood than children who did not experience such stressors.
Social stress occurring early in life can have psychopathological effects that develop or persist in adulthood. One longitudinal study found that children were more likely to have a psychiatric disorder (e.g. anxiety, depressive, disruptive, personality, and substance use disorders) in late adolescence and early adulthood when their parents showed more maladaptive child-rearing behaviors (e.g., loud arguments between parents, verbal abuse, difficulty controlling anger toward the child, lack of parental support or availability, and harsh punishment). Child temperament and parental psychiatric disorders did not explain this association. Other studies have documented the robust relationships between children’s social stress within the family environment and depression, aggression, antisocial behavior, anxiety, suicide, and hostile, oppositional, and delinquent behavior.
Relapse and recurrence
Social stress can also exacerbate current psychopathological conditions and compromise recovery. For instance, patients recovering from depression or bipolar disorder are two times more likely to relapse if there is familial tension. People with eating disorders are also more likely to relapse if their family members make more critical comments, are more hostile, or are over-involved. Similarly, outpatients with schizophrenia or schizoaffective disorder show greater psychotic symptoms if the most influential person in their life is critical and are more likely to relapse if their familial relationships are marked by tension.
In regard to substance abuse, cocaine-dependent individuals report greater cravings for cocaine following exposure to a social stressor. Traumatic life events and social stressors can also trigger the exacerbation of the symptoms of mental health disorders. Socially phobic children who experience a stressful event can become even more avoidant and socially inactive.
Research has also found a robust relationship between various social stressors and aspects of physical health.
Social status, a macro-social stressor, is a robust predictor of death. In a study of over 1700 British civil servants, socioeconomic status (SES) was inversely related to mortality. Those with the lowest SES have worse health outcomes and greater mortality rates than those with the greatest SES. Other studies have replicated this relationship between SES and mortality in a range of diseases, including infectious, digestive, and respiratory diseases. A study examining the link between SES and mortality in the elderly found that education level, household income, and occupational prestige were all related to lower mortality in men. In women, however, only household income was related to lower mortality.
Similarly, social stressors in the micro-environment are also linked to increased mortality. A seminal longitudinal study of nearly 7,000 people found that socially isolated people had greater risk of dying from any cause.
Social support, which is defined as "the comfort, assistance, and/or information one receives through formal or informal contacts with individuals or groups", has been linked to physical health outcomes. Research shows the three aspects of social support, available attachments, perceived social support, and frequency of social interactions, can predict mortality thirty months after assessment.
Social stress also makes people more sick. People who have fewer social contacts are at greater risk for developing illness, including cardiovascular disease. The lower one’s social status, the more likely he or she is to have a cardiovascular, gastrointestinal, musculoskeletal, neoplastic, pulmonary, renal, or other chronic diseases. These links are not explained by other, more traditional risk factors such as race, health behaviors, age, sex, or access to health care.
In one laboratory study, researchers interviewed participants to determine whether they had been experiencing social conflicts with spouses, close family members and friends. They then exposed the participants to the common cold virus and found that participants with conflict-ridden relationships were two times more likely to develop a cold than those without such social stress. Social support, especially in terms of support for socioeconomic stressors, is inversely related to physical morbidity. A study that investigated social determinants of health in an urban slum in India found that social exclusion, stress, and lack of social support are significantly related to illnesses, such as hypertension, coronary heart disease, and diabetes.
Exposure to social stress in childhood can also have long-term effects, increasing risk for developing diseases later in life. In particular, adults who were maltreated (emotionally, physically, sexually abused or neglected) as children report more disease outcomes, such as stroke, heart attack, diabetes, and hypertension or greater severity of those outcomes. The Adverse Childhood Experiences study (ACE), which includes over seventeen thousand adults, also found that there was a 20% increase in likelihood for experiencing heart disease for each kind of chronic familial social stressor experienced in childhood, and this was not due to typical risk factors for heart disease such as demographics, smoking, exercise, adiposity, diabetes, or hypertension.
Recovery and other disease
Social stress has also been tied to worse health outcomes among patients who already have a disease. Patients with end-stage renal disease faced a 46% increased risk for mortality when there was more relationship negativity with their spouse even when controlling for severity of disease and treatment. Similarly, women who had experienced an acute coronary event were three times more likely to experience another coronary event if they experienced moderate to severe marital strain. This finding remained even after controlling for demographics, health behaviors, and disease status.
With regard to HIV/AIDS, stress may affect the progression from the virus to the disease. Research shows the HIV-positive males who have more negative life events, social stress, and lack of social support progress to a clinical AIDS diagnosis more quickly than HIV-positive males who do not have as high levels of social stress. For HIV-positive females, who have also contracted the HSV virus, stress is a risk factor for genital herpes breakouts.
Social stress leads to a number of physiological changes that mediate its relationship to physical health. In the short term, the physiological changes outlined below are adaptive, as they enable the stressed organism to cope better. Dysregulation of these systems or repeated activation of them over the long-term can be detrimental to health.
Sympathetic nervous system
The sympathetic nervous system (SNS) becomes activated in response to stress. Sympathetic arousal stimulates the medulla of the medulla to secrete epinephrine and norepinephrine into the blood stream, which facilitates the fight-or-flight response. Blood pressure, heart rate, and sweating increase, veins constrict to allow the heart to beat with more force, arteries leading to muscles dilate, and blood flow to parts of the body not essential for the fight or flight response decreases. If stress persists in the long run, then blood pressure remains elevated, leading to hypertension and atherosclerosis, both precursors to cardiovascular disease.
A number of animal and human studies have confirmed that social stress increases risk for negative health outcomes by increasing SNS activity. Studies of rodents show that social stress causes hypertension and atherosclerosis. Studies of non-human primates also show that social stress clogs arteries. Although humans cannot be randomized to receive social stress due to ethical concerns, studies have nevertheless shown that negative social interactions characterized by conflict lead to increases in blood pressure and heart rate. Social stress stemming from perceived daily discrimination is also associated with elevated levels of blood pressure during the day and a lack of blood pressure dipping at night.
Hypothalamic-pituitary adrenocortical axis (HPA)
In response to stress, the hypothalamus releases corticotropin-releasing hormone (CRH), stimulating the anterior pituitary to release adrenocorticotropic hormone (ACTH). ACTH then stimulates the adrenal cortex to secrete glucocorticoids, including cortisol. Social stress can lead to adverse health outcomes by chronically activating the HPA axis or disrupting the HPA system. There are a number of studies that link social stress and indications of a disrupted HPA axis; for instance, monkey infants neglected by their mothers show prolonged cortisol responses following a challenging event.
In humans, abused women exhibit a prolonged elevation in cortisol following a standardized psychosocial laboratory stressor compared to those without an abuse history. Maltreated children show higher morning cortisol values than non-maltreated children. Their HPA systems also fail to recover after a stressful social interaction with their caregiver. Over time, low-SES children show progressively greater output of cortisol. Although these studies point to a disrupted HPA system accounting for the link between social stress and physical health, they did not include disease outcomes. Nevertheless, a dysfunctional HPA response to stress is thought to increase risk for developing or exacerbating diseases such as diabetes, cancer, cardiovascular disease, and hypertension.
Inflammation is an immune response that is critical to fighting infections and repairing injured tissue. Although acute inflammation is adaptive, chronic inflammatory activity can contribute to adverse health outcomes, such as hypertension, atherosclerosis, coronary heart disease, depression, diabetes, and some cancers.
Research has elucidated a relationship between different social stressors and cytokines (the markers of inflammation). Chronic social stressors, such as caring for a spouse with dementia, lead to greater circulating levels of cytokine interleukin-6 (IL-6), whereas acute social stress tasks in the laboratory have been shown to elicit increases in proinflammatory cytokines. Similarly, when faced with another type of social stress, namely social evaluative threat, participants showed increases in IL-6 and a soluble receptor for tumor necrosis factor-α. Increases in inflammation may persist over time, as studies have shown that chronic relationship stress has been tied to greater IL-6 production 6 months later and children reared in a stressful family environment marked by neglect and conflict tend to show elevated levels of C-reactive protein, a marker of IL-6, in adulthood.
Interactions of physiological systems
There is extensive evidence that the above physiological systems affect one another's functioning. For instance, cortisol tends to have a suppressive effect on inflammatory processes, and proinflammatory cytokines can also activate the HPA system. Sympathetic activity can also upregulate inflammatory activity. Given the relationships among these physiological systems, social stress may also influence health indirectly via affecting a particular physiological system that in turn affects a different physiological system.
- Smith, C. A., & Lazarus, R. S. (1990) Emotion and adaptation. In L. A. Pervin (Ed.), Handbook of Personality: Theory and Research (pp. 609-637). New York:Guilford.
- Levine, S., 2017. Social stress. New York: Routledge.
- Carr, Deborah; Umberson, Debra (2013-01-01). DeLamater, John; Ward, Amanda (eds.). The Social Psychology of Stress, Health, and Coping. Handbooks of Sociology and Social Research. Springer Netherlands. pp. 465–487. doi:10.1007/978-94-007-6772-0_16. ISBN 978-94-007-6771-3.
- Kreiger, Nancy (2001). "Theories for social epidemiology in the 21st century: an ecosocial perspective". International Journal of Epidemiology. 30 (4): 668–677. doi:10.1093/ije/30.4.668. PMID 11511581.
- Slavich, George M; O'Donovan, Aoife; Epel, Elissa S; Kemeny, Margaret E (September 2010). "Black sheep get the blues: a psychobiological model of social rejection and depression". Neuroscience and Biobehavioral Reviews. 35 (1): 39–45. doi:10.1016/j.neubiorev.2010.01.003. PMC 2926175. PMID 20083138.
- Baumeister, R F; Leary, M R (May 1995). "The need to belong: desire for interpersonal attachments as a fundamental human motivation". Psychological Bulletin. 117 (3): 497–529. doi:10.1037/0033-2909.117.3.497. PMID 7777651.
- Kessler, R. C. (1979). Stress, social status, and psychological distress.Journal of Health and Social behavior, 259-272.
- Taylor, J., & Turner, R. J. (2002). Perceived discrimination, social stress, and depression in the transition to adulthood: Racial contrasts. Social Psychology Quarterly, 213-225.
- Booth, A., & Amato, P. (1991). Divorce and psychological stress. Journal of health and social behavior, 396-407.
- Lazarus, R. S., & Launier, R. (1978). Stress-related transactions between person and environment. In Perspectives in interactional psychology (pp. 287-327). Springer US.
- Almeida, D.M. (2005). "Resilience and vulnerability to daily stressors assessed via diary methods" (PDF). Current Directions in Psychological Science. 14 (2): 64–68. doi:10.1111/j.0963-7214.2005.00336.x.
- Wadman, Ruth; Durkin, Kevin; Conti-Ramsden, Gina (2011-06-01). "Social stress in young people with specific language impairment" (PDF). Journal of Adolescence. 34 (3): 421–431. doi:10.1016/j.adolescence.2010.06.010.
- Ilfeld, F. W. (1977-02-01). "Current social stressors and symptoms of depression". The American Journal of Psychiatry. 134 (2): 161–166. doi:10.1176/ajp.134.2.161. ISSN 0002-953X. PMID 835737.
- Dormann, Christian; Zapf, Dieter (January 2004). "Customer-Related Social Stressors and Burnout". Journal of Occupational Health Psychology. 9 (1).
- Ruehlman, Linda S.; Karoly, Paul (1991). "With a little flak from my friends: Development and preliminary validation of the Test of Negative Social Exchange (TENSE)". Psychological Assessment. 3 (1): 97–104. doi:10.1037/1040-3522.214.171.124.
- Locke, Harvey J.; Wallace, Karl M. (August 1959). "Short Marital-Adjustment and Prediction Tests: Their Reliability and Validity". Marriage and Family Living. 21 (3): 251–255. doi:10.2307/348022. JSTOR 348022.
- Taylor, Shelley E; Lerner, Jennifer S; Sage, Rebecca M; Lehman, Barbara J; Seeman, Teresa E (December 2004). "Early environment, emotions, responses to stress, and health" (PDF). Journal of Personality. 72 (6): 1365–1393. CiteSeerX 10.1.1.324.5195. doi:10.1111/j.1467-6494.2004.00300.x. PMID 15509286.
- Holmes, Thomas H.; Rahe, Richard H. (August 1967). "The social readjustment rating scale". Journal of Psychosomatic Research. 11 (2): 213–218. doi:10.1016/0022-3999(67)90010-4. PMID 6059863.
- Schulz, Peter; Schlotz, Wolff (1999-01-01). "Trierer Inventar zur Erfassung von chronischem Streß (TICS): Skalenkonstruktion, teststatistische Überprüfung und Validierung der Skala Arbeitsüberlastung". Diagnostica. 45 (1): 8–19. doi:10.1026//0012-19126.96.36.199. ISSN 0012-1924.
- Brantley, Phillip J.; Waggoner, Craig D.; Jones, Glenn N.; Rappaport, Neil B. (1987-02-01). "A daily stress inventory: Development, reliability, and validity". Journal of Behavioral Medicine. 10 (1): 61–73. doi:10.1007/BF00845128. ISSN 0160-7715.
- Karasek, Robert; Brisson, Chantal; Kawakami, Norito; Houtman, Irene; Bongers, Paulien; Amick, Benjamin (1998). "The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics". Journal of Occupational Health Psychology. 3 (4): 322–355. doi:10.1037/1076-89188.8.131.522.
- Cohen, Sheldon; Kamarck, Tom; Mermelstein, Robin (1983-12-01). "A Global Measure of Perceived Stress". Journal of Health and Social Behavior. 24 (4): 385–396. doi:10.2307/2136404. JSTOR 2136404. PMID 6668417.
- Slavich, G. M., & Epel, E. S. (2010). The Stress and Adversity Inventory (STRAIN): An automated system for assessing cumulative stress exposure. Los Angeles: University of California, Los Angeles.
- Cohen, Sheldon; Kessler, Ronald C.; Gordon, Lynn Underwood (1997-11-17). Measuring Stress: A Guide for Health and Social Scientists. Oxford University Press. ISBN 9780190283889.
- Brown, George William; Harris, Tirril (1978). Social origins of depression: A study of psychiatric disorder in women. London: Tavistock. ISBN 978-0-422-76310-3.
- "Hammen Lab at UCLA". hammenlab.psych.ucla.edu. Retrieved 2015-12-10.
- Stark, Jennifer L.; Avitsur, Ronit; Padgett, David A.; Campbell, Kim A.; Beck, F. Michael; Sheridan, John F. (2001-06-01). "Social stress induces glucocorticoid resistance in macrophages". American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 280 (6): R1799–R1805. doi:10.1152/ajpregu.2001.280.6.R1799. ISSN 0363-6119. PMID 11353685.
- Berton, Olivier; McClung, Colleen A.; DiLeone, Ralph J.; Krishnan, Vaishnav; Renthal, William; Russo, Scott J.; Graham, Danielle; Tsankova, Nadia M.; Bolanos, Carlos A. (2006-02-10). "Essential Role of BDNF in the Mesolimbic Dopamine Pathway in Social Defeat Stress". Science. 311 (5762): 864–868. Bibcode:2006Sci...311..864B. doi:10.1126/science.1120972. ISSN 0036-8075. PMID 16469931.
- Kirschbaum, C; Pirke, K M; Hellhammer, D H (1993). "The 'Trier Social Stress Test'—a tool for investigating psychobiological stress responses in a laboratory setting" (PDF). Neuropsychobiology. 28 (1–2): 76–81. doi:10.1159/000119004. PMID 8255414.
- Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.
- Ditzen, B.; Schaer, M.; Gabriel, B.; Bodenmann, G.; Ehlert, U.; Heinrichs, M. (2009). "Intranasal oxytocin increases positive communication and reduces cortisol levels during couple conflict". Biological Psychiatry. 65 (9): 728–731. doi:10.1016/j.biopsych.2008.10.011. PMID 19027101.
- Brouwer, Anne-Marie; Hogervorst, Maarten A. (2014-07-29). "A new paradigm to induce mental stress: the Sing-a-Song Stress Test (SSST)". Frontiers in Neuroscience. 8: 224. doi:10.3389/fnins.2014.00224. ISSN 1662-4548. PMC 4114180. PMID 25120425.
- Gorban, A.N.; Smirnova, E.V.; Tyukina, T. A. (August 2010). "Correlations, risk and crisis: From physiology to finance". Physica A: Statistical Mechanics and Its Applications. 389 (16): 3193–3217. arXiv:0905.0129. Bibcode:2010PhyA..389.3193G. doi:10.1016/j.physa.2010.03.035.
- Mantegna, R.N.; Stanley, H.E. "Introduction to econophysics: correlations and complexity in finance."' Cambridge university press; 1999 Nov 13.
- Rybnikov, S.R.; Rybnikova, N.A.; Portnov, B.A. (March 2017). "Public fears in Ukrainian society: Are crises predictable?". Psychology & Developing Societies. 29 (1): 98–123. doi:10.1177/0971333616689398.
- Levine, S., 2017. Social stress. New York: Routledge
- Romanov, K; Appelberg, K; Honkasalo, M L; Koskenvuo, M (February 1996). "Recent interpersonal conflict at work and psychiatric morbidity: a prospective study of 15,530 employees aged 24-64". Journal of Psychosomatic Research. 40 (2): 169–176. doi:10.1016/0022-3999(95)00577-3. PMID 8778399.
- Meyer, Ilan H. (2003-09-01). "Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence". Psychological Bulletin. 129 (5): 674–697. doi:10.1037/0033-2909.129.5.674. ISSN 0033-2909. PMC 2072932. PMID 12956539.
- Monroe, S. M.; Slavich, G. M.; Georgiades, K. (2009). "The social environment and life stress in depression". Handbook of Depression. 2 (1): 340–60.
- Paykel, E. S. (2003). "Life events and affective disorders". Acta Psychiatrica Scandinavica. 108: 61–66. doi:10.1034/j.1600-0447.108.s418.13.x.
- Mazure, Carolyn M. (1998). "Life Stressors as Risk Factors in Depression". Clinical Psychology: Science and Practice. 5 (3): 291–313. doi:10.1111/j.1468-2850.1998.tb00151.x.
- Slavich, GEORGE M.; Thornton, Tiffany; Torres, Leandro D.; Monroe, Scott M.; Gotlib, Ian H. (1 February 2009). "Targeted Rejection Predicts Hastened Onset of Major Depression". Journal of Social and Clinical Psychology. 28 (2): 223–243. doi:10.1521/jscp.2009.28.2.223. PMC 2847269. PMID 20357895.
- Schuster, T L; Kessler, R C; Aseltine, R H, Jr (June 1990). "Supportive interactions, negative interactions, and depressed mood" (PDF). American Journal of Community Psychology. 18 (3): 423–438. doi:10.1007/bf00938116. hdl:2027.42/117085. PMID 2264558.CS1 maint: multiple names: authors list (link)
- Finch, J F; Okun, M A; Pool, G J; Ruehlman, L S (August 1999). "A comparison of the influence of conflictual and supportive social interactions on psychological distress". Journal of Personality. 67 (4): 581–621. doi:10.1111/1467-6494.00066. PMID 10444852.
- Pinquart, Martin; Sörensen, Silvia (March 2003). "Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis". The Journals of Gerontology: Series B. 58 (2): 112–128. doi:10.1093/geronb/58.2.p112. PMID 12646594.
- Horwitz, A V; McLaughlin, J; White, H R (June 1998). "How the negative and positive aspects of partner relationships affect the mental health of young married people". Journal of Health and Social Behavior. 39 (2): 124–136. doi:10.2307/2676395. JSTOR 2676395. PMID 9642903.
- Weissman, M M (April 1987). "Advances in psychiatric epidemiology: rates and risks for major depression". American Journal of Public Health. 77 (4): 445–451. doi:10.2105/ajph.77.4.445. PMC 1646931. PMID 3826462.
- Daniel, K.; Christian, Jennifer L.; Mendell, Nancy R. (1994). "A closer look at the link between marital discord and depressive symptomatology". Journal of Social and Clinical Psychology. 13 (1): 33–41. doi:10.1521/jscp.19184.108.40.206.
- Taylor, John; Jay, R. (2002). "Perceived discrimination, social stress and depression in the transition to adulthood: Racial contrasts". Social Psychology Quarterly. 65 (3): 213–225. doi:10.2307/3090120. JSTOR 3090120.
- Bear, Mark F.; Connors, Barry W.; Paradiso, Michael A. (2007-01-01). Neuroscience. Lippincott Williams & Wilkins. ISBN 9780781760034.
- Shin, L. M.; Liberzon, I. (2010). "The neurocircuitry of fear, stress, and anxiety disorders". Neuropsychopharmacology. 35 (1): 169–191. doi:10.1038/npp.2009.83. PMC 3055419. PMID 19625997.
- "Social Anxiety Disorder | Anxiety and Depression Association of America, ADAA". www.adaa.org. Retrieved 2015-12-06.
- Beehr, T. A.; McGrath, J. E. (1992). "Social support, occupational stress and anxiety". Anxiety, Stress, & Coping. 5 (1): 7–19. doi:10.1080/10615809208250484.
- Prigerson, H. G.; Shear, M. K.; Bierhals, A. J.; Zonarich, D. L.; Reynolds, C. F. (1996). "Childhood adversity, attachment and personality styles as predictors of anxiety among elderly caregivers". Anxiety. 2 (5): 234–241. doi:10.1002/(sici)1522-7154(1996)2:5<234::aid-anxi5>3.3.co;2-9.
- Stein, M.B.; Walker, J.R.; Anderson, G.; Hazen, Al; Ross, C.A.; Eldridge, G.; et al. (1996). "Childhood physical and sexual abuse in patients with anxiety disorders and in a community sample". Am J Psychiatry. 153 (2): 275–277. doi:10.1176/ajp.153.2.275. PMID 8561213.
- Johnson, J G; Cohen, P; Kasen, S; Smailes, E; Brook, J S (May 2001). "Association of maladaptive parental behavior with psychiatric disorder among parents and their offspring". Archives of General Psychiatry. 58 (5): 453–460. doi:10.1001/archpsyc.58.5.453. PMID 11343524.
- Repetti, Rena L; Taylor, Shelley E; Seeman, Teresa E (March 2002). "Risky families: family social environments and the mental and physical health of offspring" (PDF). Psychological Bulletin. 128 (2): 330–366. CiteSeerX 10.1.1.327.165. doi:10.1037/0033-2909.128.2.230. PMID 11931522.
- Miklowitz, D. J.; Goldstein, M. J.; Nuechterlein, K. H.; Snyder, K. S.; Mintz, J. (1988). "Family factors and the course of bipolar affective disorder". Archives of General Psychiatry. 45 (3): 225–231. doi:10.1001/archpsyc.1988.01800270033004. PMID 3341878.
- Butzlaff, R L; Hooley, J M (June 1998). "Expressed emotion and psychiatric relapse: a meta-analysis". Archives of General Psychiatry. 55 (6): 547–552. doi:10.1001/archpsyc.55.6.547. PMID 9633674.
- Docherty, Nancy M.; St-Hilaire, Annie; Aakre, Jennifer M.; Seghers, James P.; McCleery, Amanda; Divilbiss, Marielle (1 May 2011). "Anxiety Interacts With Expressed Emotion Criticism in the Prediction of Psychotic Symptom Exacerbation". Schizophrenia Bulletin. 37 (3): 611–618. doi:10.1093/schbul/sbp123. PMC 3080683. PMID 19892819.
- Back, Sudie E; Hartwell, Karen; DeSantis, Stacia M; Saladin, Michael; McRae-Clark, Aimee L; Price, Kimber L; Moran-Santa Maria, Megan M; Baker, Nathaniel L; Spratt, Eve; Kreek, Mary Jeanne; Brady, Kathleen T (1 January 2010). "Reactivity to laboratory stress provocation predicts relapse to cocaine". Drug and Alcohol Dependence. 106 (1): 21–27. doi:10.1016/j.drugalcdep.2009.07.016. PMC 2815094. PMID 19726138.CS1 maint: multiple names: authors list (link)
- Pynoos, Robert S; Steinberg, Alan M; Piacentini, John C (1999-12-01). "A developmental psychopathology model of childhood traumatic stress and intersection with anxiety disorders". Biological Psychiatry. 46 (11): 1542–1554. CiteSeerX 10.1.1.456.8902. doi:10.1016/S0006-3223(99)00262-0.
- Miller, G.; Chen, E.; Cole, S. W. (2009). "Health Psychology". Annual Review of Psychology. 60: 501–524. doi:10.1146/annurev.psych.60.110707.163551. PMID 19035829.
- Marmot, M G; Rose, G; Shipley, M; Hamilton, P J (December 1978). "Employment grade and coronary heart disease in British civil servants". Journal of Epidemiology and Community Health. 32 (4): 244–249. doi:10.1136/jech.32.4.244. PMC 1060958. PMID 744814.
- Adler, N E; Boyce, T; Chesney, M A; Cohen, S; Folkman, S; Kahn, R L; Syme, S L (January 1994). "Socioeconomic status and health. The challenge of the gradient" (PDF). The American Psychologist. 49 (1): 15–24. CiteSeerX 10.1.1.336.6204. doi:10.1037/0003-066x.49.1.15. PMID 8122813.
- Kaplan, G A; Keil, J E (October 1993). "Socioeconomic factors and cardiovascular disease: a review of the literature". Circulation. 88 (4, part 1): 1973–1998. doi:10.1161/01.cir.88.4.1973. PMID 8403348.
- Bassuk, Shari S.; Berkman, Lisa F.; Amick, Benjamin C. (2002-03-15). "Socioeconomic status and mortality among the elderly: findings from four US communities". American Journal of Epidemiology. 155 (6): 520–533. doi:10.1093/aje/155.6.520. ISSN 0002-9262. PMID 11882526.
- Berkman, L F; Syme, S L (February 1979). "Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents". American Journal of Epidemiology. 109 (2): 186–204. doi:10.1093/oxfordjournals.aje.a112674. PMID 425958.
- Wallston, B. S.; Alagna, S. W.; DeVellis, B. M.; DeVellis, R. F. (1983). "Social support and physical health". Health Psychology. 2 (4): 367–391. doi:10.1037/0278-6220.127.116.117.
- Blazer, Dan G. (1982-05-01). "Social Support and Mortality in an Elderly Community Population". American Journal of Epidemiology. 115 (5): 684–694. doi:10.1093/oxfordjournals.aje.a113351. ISSN 0002-9262. PMID 7081200.
- Seeman, T E (August 2000). "Health promoting effects of friends and family on health outcomes in older adults". American Journal of Health Promotion. 14 (6): 362–370. doi:10.4278/0890-1171-14.6.362. PMID 11067571.
- Pincus, T; Callahan, L F; Burkhauser, R V (1987). "Most chronic diseases are reported more frequently by individuals with fewer than 12 years of formal education in the age 18-64 United States population". Journal of Chronic Diseases. 40 (9): 865–874. doi:10.1016/0021-9681(87)90186-x. PMID 3597688.
- Cohen, S; Frank, E; Doyle, W J; Skoner, D P; Rabin, B S; Gwaltney, J M, Jr (May 1998). "Types of stressors that increase susceptibility to the common cold in healthy adults" (PDF). Health Psychology. 17 (3): 214–223. doi:10.1037/0278-618.104.22.168. PMID 9619470.CS1 maint: multiple names: authors list (link)
- Aneshensel, Carol S. (1992-01-01). "Social Stress: Theory and Research". Annual Review of Sociology. 18: 15–38. doi:10.1146/annurev.soc.18.1.15. JSTOR 2083444.
- Pawar, A. B.; Mohan, P. V. T. K.; Bansal, R. K. (2008). "Social determinants, suboptimal health behavior, and morbidity in urban slum population: an Indian perspective". Journal of Urban Health. 85 (4): 607–618. doi:10.1007/s11524-008-9261-3. PMC 2443249. PMID 18404392.
- Rich-Edwards, Janet W; Spiegelman, Donna; Lividoti Hibert, Eileen N; Jun, Hee-Jin; Todd, Tamarra James; Kawachi, Ichiro; Wright, Rosalind J (December 2010). "Abuse in childhood and adolescence as a predictor of type 2 diabetes in adult women". American Journal of Preventive Medicine. 39 (6): 529–536. doi:10.1016/j.amepre.2010.09.007. PMC 3003936. PMID 21084073.CS1 maint: multiple names: authors list (link)
- Wegman, Holly L; Stetler, Cinnamon (October 2009). "A meta-analytic review of the effects of childhood abuse on medical outcomes in adulthood". Psychosomatic Medicine. 71 (8): 805–812. doi:10.1097/PSY.0b013e3181bb2b46. PMID 19779142.
- Dong, Maxia; Giles, Wayne H; Felitti, Vincent J; Dube, Shanta R; Williams, Janice E; Chapman, Daniel P; Anda, Robert F (28 September 2004). "Insights Into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study". Circulation. 110 (13): 1761–1766. doi:10.1161/01.CIR.0000143074.54995.7F. PMID 15381652.
- Kimmel, P L; Peterson, R A; Weihs, K L; Shidler, N; Simmens, S J; Alleyne, S; Cruz, I; Yanovski, J A; Veis, J H; Phillips, T M (August 2000). "Dyadic relationship conflict, gender, and mortality in urban hemodialysis patients". Journal of the American Society of Nephrology. 11 (8): 1518–1525. PMID 10906166.
- Orth-Gomér, K; Wamala, S P; Horsten, M; Schenck-Gustafsson, K; Schneiderman, N; Mittleman, M A (20 December 2000). "Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study" (PDF). The Journal of the American Medical Association. 284 (23): 3008–3014. doi:10.1001/jama.284.23.3008. PMID 11122587.
- Cohen, S; Janicki-Deverts, D; Miller, GE (2007-10-10). "Psychological stress and disease". JAMA. 298 (14): 1685–1687. doi:10.1001/jama.298.14.1685. ISSN 0098-7484. PMID 17925521.
- Leserman, J.; Petitto, J. M.; Gu, H.; Gaynes, B. N.; Barroso, J.; Golden, R. N.; Perkins, D. O.; Folds, J. D.; Evans, D. L. (2002-08-01). "Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors". Psychological Medicine. 32 (6): 1059–1073. doi:10.1017/S0033291702005949. ISSN 1469-8978.
- Pereira, D. B.; Antoni, M. H.; Danielson, A.; Simon, T.; Efantis-Potter, J.; Carver, C. S.; O'Sullivan, M. J. (2003). "Stress as a predictor of symptomatic genital herpes virus recurrence in women with human immunodeficiency virus". Journal of Psychosomatic Research. 54 (3): 237–244. doi:10.1016/s0022-3999(02)00494-4.
- Sapolsky, R. M. (1994). Why zebras don't get ulcers: A guide to stress, stress related diseases, and coping. New York: W.H. Freeman.
- McEwen, B S; Stellar, E (27 September 1993). "Stress and the individual: Mechanisms leading to disease" (PDF). Archives of Internal Medicine. 153 (18): 2093–2101. doi:10.1001/archinte.153.18.2093. PMID 8379800.
- Sgoifo, A; Koolhaas, J; De Boer, S; Musso, E; Stilli, D; Buwalda, B; Meerlo, P (November 1999). "Social stress, autonomic neural activation, and cardiac activity in rats". Neuroscience and Biobehavioral Reviews. 23 (7): 915–923. CiteSeerX 10.1.1.473.9291. doi:10.1016/s0149-7634(99)00025-1. PMID 10580306.CS1 maint: multiple names: authors list (link)
- Manuck, S B; Marsland, A L; Kaplan, J R; Williams, J K (June 1995). "The pathogenicity of behavior and its neuroendocrine mediation: an example from coronary artery disease" (PDF). Psychosomatic Medicine. 57 (3): 275–283. doi:10.1097/00006842-199505000-00009. PMID 7652128.
- Shively, Carol A.; Register, Thomas C.; Clarkson, Thomas B. (2009-09-01). "Social stress, visceral obesity, and coronary artery atherosclerosis: product of a primate adaptation". American Journal of Primatology. 71 (9): 742–751. doi:10.1002/ajp.20706. ISSN 1098-2345. PMC 3970187. PMID 19452515.
- Gerin, W; Pieper, C; Levy, R; Pickering, T G (June 1992). "Social support in social interaction: a moderator of cardiovascular reactivity" (PDF). Psychosomatic Medicine. 54 (3): 324–336. CiteSeerX 10.1.1.514.1178. doi:10.1097/00006842-199205000-00008. PMID 1620808.
- Tomfohr, Lianne; Cooper, Denise C; Mills, Paul J; Nelesen, Richard A; Dimsdale, Joel E (April 2010). "Everyday discrimination and nocturnal blood pressure dipping in black and white americans". Psychosomatic Medicine. 72 (3): 266–272. doi:10.1097/PSY.0b013e3181d0d8b2. PMC 2894630. PMID 20124424.
- Smart Richman, Laura; Pek, Jolynn; Pascoe, Elizabeth; Bauer, Daniel J (July 2010). "The effects of perceived discrimination on ambulatory blood pressure and affective responses to interpersonal stress modeled over 24 hours". Health Psychology. 29 (4): 403–411. doi:10.1037/a0019045. hdl:10161/11806. PMID 20658828.
- Dettling, A; Pryce, C R; Martin, R D; Döbeli, M (July 1998). "Physiological Responses to parental separation and a strange situation are related to parental care received in juvenile Goeldi's monkeys (Callimico goeldii)". Developmental Psychobiology. 33 (1): 21–31. doi:10.1002/(sici)1098-2302(199807)33:1<21::aid-dev3>3.0.co;2-u. PMID 9664169.
- Heim, C; Newport, D J; Heit, S; Graham, Y P; Wilcox, M; Bonsall, R; Miller, A H; Nemeroff, C B (2 August 2000). "Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood" (PDF). Journal of the American Medical Association. 284 (5): 592–597. doi:10.1001/jama.284.5.592. PMID 10918705.
- Cicchetti, D; Rogosch, F A (2001). "The impact of child maltreatment and psychopathology on neuroendocrine functioning". Development and Psychopathology. 13 (4): 783–804. PMID 11771908.
- Wismer Fries, Alison B.; Shirtcliff, Elizabeth A.; Pollak, Seth D. (September 2008). "Neuroendocrine dysregulation following early social deprivation in children". Developmental Psychobiology. 50 (6): 588–599. doi:10.1002/dev.20319. PMC 2673795. PMID 18683181.
- Chen, Edith; Cohen, Sheldon; Miller, Gregory E. (1 January 2010). "How Low Socioeconomic Status Affects 2-Year Hormonal Trajectories in Children". Psychological Science. 21 (1): 31–37. doi:10.1177/0956797609355566. PMID 20424019.
- Evans, Gary W; Kim, Pilyoung (November 2007). "Childhood poverty and health: cumulative risk exposure and stress dysregulation". Psychological Science. 18 (11): 953–957. doi:10.1111/j.1467-9280.2007.02008.x. PMID 17958708.
- McEwen, B S; Underhill, Lisa H.; McEwen, Bruce S. (15 January 1998). "Protective and damaging effects of stress mediators". The New England Journal of Medicine. 338 (3): 171–179. CiteSeerX 10.1.1.357.2785. doi:10.1056/NEJM199801153380307. PMID 9428819.
- Niskanen, Leo; Laaksonen, David E; Nyyssönen, Kristiina; Punnonen, Kari; Valkonen, Veli-Pekka; Fuentes, Ricardo; Tuomainen, Tomi-Pekka; Salonen, Riitta; Salonen, Jukka T (December 2004). "Inflammation, abdominal obesity, and smoking as predictors of hypertension". Hypertension. 44 (6): 859–865. doi:10.1161/01.HYP.0000146691.51307.84. PMID 15492131.
- Amar, Jacques; Fauvel, Josette; Drouet, Ludovic; Ruidavets, Jean Bernard; Perret, Bertrand; Chamontin, Bernard; Boccalon, Henri; Ferrieres, Jean (June 2006). "Interleukin 6 is associated with subclinical atherosclerosis: a link with soluble intercellular adhesion molecule 1". Journal of Hypertension. 24 (6): 1083–1088. doi:10.1097/01.hjh.0000226198.44181.0c. PMID 16685208.
- Cesari, Matteo; Penninx, Brenda W J H; Newman, Anne B; Kritchevsky, Stephen B; Nicklas, Barbara J; Sutton-Tyrrell, Kim; Rubin, Susan M; Ding, Jingzhong; Simonsick, Eleanor M; Harris, Tamara B; Pahor, Marco (11 November 2003). "Inflammatory markers and onset of cardiovascular events: results from the Health ABC study". Circulation. 108 (19): 2317–2322. doi:10.1161/01.CIR.0000097109.90783.FC. PMID 14568895.CS1 maint: multiple names: authors list (link)
- Ridker, P M; Rifai, N; Stampfer, M J; Hennekens, C H (18 April 2000). "Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men". Circulation. 101 (15): 1767–1772. doi:10.1161/01.cir.101.15.1767. PMID 10769275.
- Raison, Charles L; Capuron, Lucile; Miller, Andrew H (January 2006). "Cytokines sing the blues: inflammation and the pathogenesis of depression". Trends in Immunology. 27 (1): 24–31. doi:10.1016/j.it.2005.11.006. PMC 3392963. PMID 16316783.
- Wellen, Kathryn E; Hotamisligil, Gökhan S (May 2005). "Inflammation, stress, and diabetes". The Journal of Clinical Investigation. 115 (5): 1111–1119. doi:10.1172/JCI25102. PMC 1087185. PMID 15864338.
- Coussens, Lisa M; Werb, Zena (19 December 2002). "Inflammation and cancer". Nature. 420 (6917): 860–867. Bibcode:2002Natur.420..860C. doi:10.1038/nature01322. PMC 2803035. PMID 12490959.
- Rakoff-Nahoum, Seth (December 2006). "Why Cancer and Inflammation?". The Yale Journal of Biology and Medicine. 79 (3–4): 123–130. PMC 1994795. PMID 17940622.
- Kiecolt-Glaser, Janice K; Preacher, Kristopher J; MacCallum, Robert C; Atkinson, Cathie; Malarkey, William B; Glaser, Ronald (22 July 2003). "Chronic stress and age-related increases in the proinflammatory cytokine IL-6". Proceedings of the National Academy of Sciences of the United States of America. 100 (15): 9090–9095. Bibcode:2003PNAS..100.9090K. doi:10.1073/pnas.1531903100. PMC 166443. PMID 12840146.
- Steptoe, Andrew; Hamer, Mark; Chida, Yoichi (October 2007). "The effects of acute psychological stress on circulating inflammatory factors in humans: a review and meta-analysis". Brain, Behavior, and Immunity. 21 (7): 901–912. doi:10.1016/j.bbi.2007.03.011. PMID 17475444.
- Slavich, George M.; Way, Baldwin M.; Eisenberger, Naomi I.; Taylor, Shelley E. (17 August 2010). "Neural sensitivity to social rejection is associated with inflammatory responses to social stress". Proceedings of the National Academy of Sciences of the United States of America. 107 (33): 14817–14822. Bibcode:2010PNAS..10714817S. doi:10.1073/pnas.1009164107. PMC 2930449. PMID 20679216.
- Dickerson, Sally S; Gable, Shelly L; Irwin, Michael R; Aziz, Najib; Kemeny, Margaret E (October 2009). "Social-evaluative threat and proinflammatory cytokine regulation: an experimental laboratory investigation". Psychological Science. 20 (10): 1237–1244. doi:10.1111/j.1467-9280.2009.02437.x. PMC 2761517. PMID 19754527.
- Miller, Gregory E; Rohleder, Nicolas; Stetler, Cinnamon; Kirschbaum, Clemens (October 2005). "Clinical depression and regulation of the inflammatory response during acute stress". Psychosomatic Medicine. 67 (5): 679–687. doi:10.1097/01.psy.0000174172.82428.ce. PMID 16204423.
- Miller, Gregory E; Rohleder, Nicolas; Cole, Steve W (January 2009). "Chronic interpersonal stress predicts activation of pro- and anti-inflammatory signaling pathways 6 months later". Psychosomatic Medicine. 71 (1): 57–62. doi:10.1097/PSY.0b013e318190d7de. PMC 2720615. PMID 19073750.
- Taylor, Shelley E; Lehman, Barbara J; Kiefe, Catarina I; Seeman, Teresa E (15 October 2006). "Relationship of early life stress and psychological functioning to adult C-reactive protein in the coronary artery risk development in young adults study". Biological Psychiatry. 60 (8): 819–824. doi:10.1016/j.biopsych.2006.03.016. PMID 16712805.
- Wilder, R L (1995). "Neuroendocrine-immune system interactions and autoimmunity". Annual Review of Immunology. 13: 307–338. doi:10.1146/annurev.iy.13.040195.001515. PMID 7612226.
- Jan, Badar U; Coyle, Susette M; Macor, Marie A; Reddell, Michael; Calvano, Steve E; Lowry, Stephen F (April 2010). "Relationship of basal heart rate variability to in vivo cytokine responses after endotoxin exposure". Shock. 33 (4): 363–368. doi:10.1097/SHK.0b013e3181b66bf4. PMC 2980578. PMID 20407404.
- Marsland, Anna L; Gianaros, Peter J; Prather, Aric A; Jennings, J Richard; Neumann, Serina A; Manuck, Stephen B (November 2007). "Stimulated production of proinflammatory cytokines covaries inversely with heart rate variability". Psychosomatic Medicine. 69 (8): 709–716. doi:10.1097/PSY.0b013e3181576118. PMID 17942840.