Cultures under stress: A cross-national meta-analysis of cortisol responses to the Trier Social Stress Test and their association with anxiety-related value orientations and internalizing mental disorders
Cultures under stress: A cross-national meta-analysis of cortisol responses to the Trier Social Stress Test and their association with anxiety-related value orientations and internalizing mental disorders
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压力下的文化：对特里尔社会压力测试的皮质醇反应及其与焦虑相关价值取向和内化精神障碍的关系的跨国荟萃分析
DOI：
10.1016/j.psyneuen.2018.12.236
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发表时间：
2019
影响因子：
3.7
通讯作者：
C. Kirschbaum
中科院分区：
文献类型：
--
作者：
Robert Miller;C. Kirschbaum
急性皮质醇变化是生理指标（即，心理社会压力的生物标志物）已经使用标准化的实验室方案如特里尔社会压力测试（TSST）反复评估。尽管方法标准化，然而，皮质醇应激反应在不同的研究中差异很大。基于对237项TSST研究（n= 8487人）的多水平荟萃分析，我们证明了25%的变异性实际上归因于国家之间的系统性差异。特别是北美和欧洲的研究显示出显著的效果差异（d= 0.45 vs.d= 0.73，分别）。英国和爱尔兰）与皮质醇应激反应降低有关。这一发现进一步得到了与内化精神障碍（例如，世界卫生组织世界精神卫生调查报告指出，这些疾病（如严重抑郁症或创伤后应激障碍）的严重程度、家庭收入的不平等加剧、人口增长加快、卫生和军事开支增加以及税率降低。这些影响的大小与迄今为止已知的皮质醇应激反应的最重要的调节因素，即男性和更高的年龄相媲美，基于这些观察，我们认为皮质醇应激反应可能反映了一个人所习惯的社会文化环境中的持续威胁。高度竞争的文化强调个人对社会经济繁荣的责任，但同时增加了集体人口的压力，从而降低了可持续的个体发育和对意外环境逆境的适应力。
Acute cortisol changes are physiological indicators (i.e., biomarkers) of psychosocial stress that have been repeatedly assessed using standardized laboratory protocols like the Trier Social Stress Test (TSST). Despite this methodological standardization, however, cortisol stress responses vary considerably across different studies. Based on multilevel meta-analyses of 237 TSST studies (n= 8487 individuals), we demonstrate that ∼25% of this variability is actually attributable to systematic differences between countries. Particularly North American and European studies show a remarkable effect disparity (d= 0.45 vs.d= 0.73, respectively).Specifically, in-depth analyses suggested that the cultural orientation towards anxiety-related values in English-speaking countries (incl. the UK and Ireland) was associated with decreased cortisol stress responses. This finding was further supported by associations with the regionally varying prevalence of internalizing mental disorders (e.g., major depression or post-traumatic stress disorder) as reported by the WHO World Mental Health Surveys, a larger inequality of family incomes, larger population growth, larger expenses for health and the military, and lower tax rates. The size of these effects is comparable to the most important moderators of cortisol stress responses known to date, that is, male sex and higher age.Based on these observations, we argue that the cortisol stress response may reflect the persistent threats in the sociocultural environment an individual is accustomed too. Highly competitive cultures emphasize the individuals’ responsibility for socioeconomic prosperity, but simultaneously increase the collective population stress and thus lower sustainable ontogeny and resilience towards unexpected environmental adversity.