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Do low levels of stress reactivity signal poor states of health?
Open accessAbstract
Studies of cardiovascular disease risk have explored the idea that exaggerated physiological responses to stress may signal increased risk of cardiovascular disease. We describe a neurophysiological model of brain structures and peripheral structures that may contribute to exaggerated reactivity. Level I in this model includes the limbic system and its interactions with the prefrontal cortex that determine stress appraisals and coping responses. Level II addresses the hypothalamus and brainstem that contribute outputs to the body and which also includes brainstem nuclei that feed back to Level I to modulate its functioning. Level III includes the peripheral tissues themselves. We then suggest that stress reactivity ranging from very low to very high has a normative midrange of intensity and present evidence that negative health outcomes may be associated with both exaggerated and diminished stress reactivity since both tendencies imply a loss of homeostatic regulation. In particular, dysregulation at Levels I and II in our heuristic model signify altered motivational function and an attendant alteration in outflow to the periphery and poor behavioral homeostasis. In consequence, poor affective and behavioral regulation would be expected to contribute to poor health behaviors therefore additionally impairing health. In conclusion, diminished as well as exaggerated physiological reactivity should be seen as nonoptimal functioning that can contribute to poor health outcomes. This conceptualization places physical health into the context of behavioral and physiological processes that contribute to homeostasis.
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“Altered stress reactivity appears to play an important role in the development of psychiatric disorders (Ehlert et al., 2001) as well as cardiovascular disease (Phillips et al., 2013; Lovallo, 2011; Treiber et al., 2003).”
From More than a feeling: A unified view of stress measurement for population science (2018) · cites this paper as Lovallo, 2011
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Bakkum, L., Oosterman, M., Verhage, M. L., Kunseler, F. C., Fearon, P. R. M., Schuengel, C., & Duschinsky, R. (2020) · Development and Psychopathology · doi:10.1017/s0954579420001492 · Cited by 13
Ruiz‐Robledillo, N., Bellosta‐Batalla, M., & Moya‐Albiol, L. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.07.011 · Cited by 17
Metadata
- Authors
- Lovallo, W. R.
- Affiliations
- Oklahoma City VA Medical Center (US)
- Corresponding author
- Lovallo, William R.
- ORCID
- Lovallo, William R.
- Venue
- Biological Psychology
- Publisher
- Elsevier BV
- Published
- 2011-02
- Volume
- 86
- Issue
- 2
- Pages
- 121-128
- ISSN
- 0301-0511 (ISSN-L)
- PMC
- PMC2888887
- OpenAlex
- W2130101970
- Cited by
- 208
- References
- 102
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 8 · 2023: 4 · 2022: 14 · 2021: 13 · 2020: 34 · 2019: 11 · 2018: 12 · 2017: 11 · 2016: 13 · 2015: 20 · 2014: 19 · 2013: 17 · 2012: 11
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Biological Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA019691, R01AA012207)
- National Heart, Lung, and Blood Institute (R01HL032050)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- stress reactivity, cardiovascular risk, homeostatic regulation, limbic system, prefrontal cortex, hypothalamus, brainstem, stress appraisal, coping, motivational function, health behavior, emotion regulation, neurophysiological model
- MeSH terms
- Brain, Cardiovascular System, Health Status, Humans, Models, Biological, Neural Pathways, Peripheral Nerves, Stress, Psychological
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