Depression and anxiety: associations with biological and perceived stress reactivity to a psychological stress protocol in a middle-aged population
Abstract
Background Depression and anxiety have been linked to higher as well as lower reactivity to stressful circumstances. Large, population-based studies investigating the association between depression and anxiety, perceived and physiological stress responses are lacking.Methods We studied 725 men and women, aged 55-60 years, from a population-based cohort, who filled out the Hospital Anxiety and Depression Scale (HADS). We performed a standardized interview on medical history and lifestyle. We measured continuous blood pressure (BP) and heart rate (HR) reactivity, saliva cortisol reactivity and perceived stress during a psychological stress protocol.Results Albeit not statistically significant in all groups, systolic BP (SBP), diastolic BP (DBP), HR and cortisol reactivity to the psychological stress protocol were lower in those with mild-to-severe depression or anxiety symptoms and those ever clinically diagnosed with depression or anxiety, while perceived levels of stress were higher compared to those without depression or anxiety symptomatology. Maximum SBP, HR and cortisol stress responses significantly decreased and perceived stress scores significantly increased with increasing scores on the HADS depression subscale (HADS-D) and HADS anxiety subscale (HADS-A) (all P<0.05). The same held for stress responses in relation to the total HADS score (all P<0.05) and, in this case, the maximum DBP stress response was also significantly lower with an increasing HADS score (P=0.05). In addition, the maximum DBP stress response was significantly lower for those ever clinically diagnosed with depression (P=0.04). Adjusting for sex, use of anti-hypertensive medication, anti-depressant and anxiolytic medication, smoking, alcohol consumption, socio-economic status (SES) and body mass index (BMI) did not attenuate the results.Conclusion The present study results suggest that the biological stress response of middle-aged men and women who experienced depressed and anxious feelings does not completely correspond with how stressed they feel at that moment. Although differences were not substantial in all cases, response to a psychological stress protocol seemed to be decreased in the groups with experience of depressed and anxious feelings, while the perception of stress seemed to be increased.
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Compared to non-depressed controls, depressed individuals show more negative facial expressions to unpleasant images, greater perceived stress to laboratory stressors, and greater increases in negative affect to daily stressors.
“For example, compared to non-depressed controls, individuals with depression exhibit more negative facial expressions in response to unpleasant images (Sloan et al., 1997), report greater perceived stress in response to a laboratory stress tasks (de Rooij et al., 2010), and display greater increases in negative affect in response to daily stressors (Myin-Germeys et al., 2003).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as de Rooij et al., 2010
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“This differs from the results of de Rooij et al. (2010) who found that with increased self-reported anxiety symptoms, SBP and heart rate reactivity decreased.”
BackgroundMethodResultInfluentialDepression and anxiety predict sex-specific cortisol responses to interpersonal stress
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“[5] Mental health problems during adolescence include stress, depression, anxiety,[6] concerning about the Address for correspondence: Dr.”
Background
- Authors
- de Rooij, S. R., Schene, A. H., Phillips, D. I., & Roseboom, T. J.
- Affiliations
- Amsterdam UMC Location University of Amsterdam (NL)
- Southampton General Hospital (GB)
- Venue
- Psychoneuroendocrinology
- Publisher
- Elsevier BV
- Published
- 2010-07
- Volume
- 35
- Issue
- 6
- Pages
- 866-877
- ISSN
- 0306-4530 (ISSN-L)
- OpenAlex
- W2161577136
- Cited by
- 164
- References
- 32
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 13 · 2023: 9 · 2022: 12 · 2021: 10 · 2020: 15 · 2019: 10 · 2018: 8 · 2017: 7 · 2016: 11 · 2015: 10 · 2014: 10 · 2013: 13 · 2012: 12
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychoneuroendocrinology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- depression, anxiety, psychological stress response, perceived stress, blood pressure reactivity, heart rate reactivity, cortisol response, middle-aged adults, physiological stress response, Hospital Anxiety and Depression Scale
- MeSH terms
- Anxiety, Blood Pressure, Depression, Female, Heart Rate, Humans, Hydrocortisone, Male, Middle Aged, Saliva, Stress, Psychological
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