Cited by 508Stress Responses and CortisolDeath Anxiety and Social ExclusionHealth disparities and outcomes

Social Safety Theory: A Biologically Based Evolutionary Perspective on Life Stress, Health, and Behavior

Open access
Slavich, George M.·2020·Annual Review of Clinical Psychology

Abstract

Social Safety Theory hypothesizes that developing and maintaining friendly social bonds is a fundamental organizing principle of human behavior and that threats to social safety are a critical feature of psychological stressors that increase risk for disease. Central to this formulation is the fact that the human brain and immune system are principally designed to keep the body biologically safe, which they do by continually monitoring and responding to social, physical, and microbial threats in the environment. Because situations involving social conflict, isolation, devaluation, rejection, and exclusion historically increased risk for physical injury and infection, anticipatory neural–immune reactivity to social threat was likely highly conserved. This neurocognitive and immunologic ability for humans to symbolically represent and respond to potentially dangerous social situations is ultimately critical for survival. When sustained, however, this multilevel biological threat response can increase individuals’ risk for viral infections and several inflammation-related disease conditions that dominate present-day morbidity and mortality.

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Written from the paper’s full text.

TL;DR

Social Safety Theory proposes that forming and maintaining friendly social bonds is a fundamental organizing principle of human behavior, and that threats to social safety are key psychological stressors that increase disease risk. It integrates immune, neural, and neuroimmune evidence to argue that social threat engages conserved inflammatory responses that, when sustained, contribute to viral infections and inflammation-related disease.

Key findings

  • Social safety and social integration are linked to better health: a meta-analysis of 148 studies and 308,849 participants followed for an average of 7.5 years found being socially well integrated was associated with a 91% increase in odds of survival (OR = 1.91; 95% CI [1.63, 2.23]); another meta-analysis of 41 studies and 73,037 participants found lower inflammatory markers TNF-α, IL-6, CRP, and fibrinogen (Zr = −0.076; 95% CI [−0.11, −0.04]).
  • Social threat predicts mortality and morbidity: adjusted mortality odds were 1.26 for low socioeconomic status (95% CI [1.21, 1.32]), 1.26 for perceived loneliness (95% CI [1.04, 1.53]), 1.29 for social isolation (95% CI [1.06, 1.56]), and 1.32 for living alone (95% CI [1.14, 1.53]), translating to roughly 2.1 years of reduced life expectancy by age 40. Targeted rejection stressors hasten depression onset, promote suicidal ideation, alter inflammatory signaling, and accelerate biological aging as indexed by telomere length.
  • Proposed mechanisms involve four neural networks (amygdala, mentalizing, empathy, mirror neuron) and four neural–immune pathways (sympathetic nervous system, HPA axis, vagus nerve, meningeal lymphatic vessels) that enable “social signal transduction”; cytokines are described as critical mediators affecting physiology, cognition, and behavior.
  • Several moderators are proposed: genetics (e.g., OPRM1 rs1799971, IL6 −174G>C), sleep, childhood microbial environment, diet/adiposity, birth cohort, air pollution, and self-harm. For example, parental absence predicted 47% higher CRP in young adulthood for those with low infancy animal-feces exposure versus 17% lower CRP for those with high exposure; PM2.5 <12 μg/m3 was associated with a 13.6% increase in all-cause mortality (HR = 1.136; 95% CI [1.131, 1.141]).

Methods

  • Design: conceptual/theoretical review and theory-building paper; it proposes Social Safety Theory and reviews evidence for its three main tenets.
  • Data or sample: no primary sample or new empirical data are reported; it synthesizes existing literature from anthropology, psychology, sociology, epidemiology, and public health, including cited meta-analyses, cohort studies, and experimental studies.
  • Main analysis: narrative integration of prior stress theories, immune system function, social brain networks, neural–immune communication, and evidence for social safety and threat effects; no systematic review search or quality-appraisal methods are stated.

Limitations

  • Stated in the paper: stress research lacks consensus on definitions and on which social-environmental adversities are most deleterious; epidemiologic studies are not designed to discern what about social threat is most harmful; no studies have examined within-person associations between nonsuicidal self-injury, inflammation, and social safety/threat; acetaminophen is the only biologically informed strategy listed and is far from accepted; future longitudinal studies are needed.
  • Evident from the text: as a narrative review, it does not systematically search or appraise evidence or directly test the theory as a whole; causal and mechanistic claims rely on cited studies, and several proposed moderators (e.g., birth cohort, air pollution, self-harm) are presented as needing future research.

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Integrity signals

Registry

Crossref · 10.1146/annurev-clinpsy-032816-045159

Cites

157 of 157 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

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  • Findingcitation

    Sustained social threat heightens inflammatory reactivity to social stress.

    “being exposed to sustained social threat characterized by verbal attacks, social exclusion, devaluation, and aggression heightens inflammatory reactivity to social stress (Giletta et al. 2018)”
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  • Findingcitation

    Sleep disturbance is a strong predictor of inflammation-related disease risk and all-cause mortality.

    “Sleep disturbance (e.g., difficulty falling or staying asleep, nonrestorative sleep, early-morning awakening) is a strong predictor of both inflammation-related disease risk and all-cause mortality (Irwin 2019).”
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  • Findingcitation

    Social threat can promote anger, procrastination, aggression, withdrawal, and externalizing behaviors such as fighting, cursing, cheating, rule breaking, and stealing.

    “it can promote anger, procrastination, aggression, and withdrawal as well as a variety of externalizing behaviors, such as fighting, cursing, cheating, rule breaking, and stealing (Leary 2001).”
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  • Findingcitation

    Socioeconomic status and subjective social status are strong predictors of all-cause mortality.

    “socioeconomic status and subjective social status, which are strong predictors of all-cause mortality (see Adler & Rehkopf 2008, Muscatell et al. 2018).”
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  • Findingcitation

    Social isolation is associated with about 29% increased likelihood of mortality over time (OR 1.29, 95% CI 1.06-1.56).

    “29% for social isolation (OR = 1.29; 95% CI [1.06, 1.56])”
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    Findingcitation

    Greater social safety is associated with better outcomes in acute myocardial infarction, amputation, acquired brain injury, substance dependence treatment, HIV/AIDS, stroke, heart disease, and cancer.

    “individuals with greater social safety exhibit better outcomes in the context of acute myocardial infarction (Mookadam & Arthur 2004), amputation (Hawkins et al. 2016), acquired brain injury (Jones et al. 2011), substance dependence treatment (Haslam et al. 2019), HIV/AIDS (van Luenen et al. 2018), stroke (Haslam et al. 2008), and heart disease and cancer (Valtorta et al. 2016).”
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    Findingcitation

    In 420 adolescents, OPRM1 rs1799971 moderated likelihood of developing depression after a severe targeted rejection event; G allele carriers were twice as likely to meet MDD criteria, while A/A homozygotes were unaffected.

    “Whereas G allele carriers were twice as likely to meet criteria for major depressive disorder following a recent severe targeted rejection life event (e.g., because they exhibit less opioid receptor expression and signaling efficiency), A/A homozygotes were completely unaffected by such stress.”
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    Findingcitation

    Sleep disturbance is relatively common, with up to 48% of adults reporting some sleep complaints, and is especially prevalent among persons exposed to social safety stressors such as interpersonal violence and aggression.

    “with up to 48% of adults reporting at least some sleep complaints, it is especially prevalent among persons exposed to stressors that threaten social safety, such as interpersonal violence and aggression (Gallegos et al. 2019).”
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    Findingcitation

    Social safety is associated with greater occupational and scholastic achievement, perseverance, productivity, more volunteering, and fewer sick days.

    “social safety is associated with greater occupational and scholastic achievement, perseverance, and productivity (Holt-Lunstad 2018, Strayhorn 2018) as well as with more volunteering and fewer sick days (Babey et al. 2019).”
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    Findingcitation

    In 87 adolescents, greater daily social threat interacted with shorter sleep duration to predict reduced expression of 511 genes and increased expression of 1,894 genes, including inflammatory genes, with changes structured by increased NF-κB activity.

    “greater daily experiences of social threat (e.g., arguments with parents, family members, teachers, or friends; punishment; being insulted or threatened) interacted with shorter sleep duration to predict reduced expression of 511 genes and increased expression of 1,894 genes including several that promote inflammatory activity, such as TNF, IL1RAP, IL2RB, and IL15RA.”
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    • cites Chiang et al. 2019

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    Findingcitation

    Social-environmental effects translate into reduced life expectancy of about 2.1 years by age 40, exceeding mortality risk of high alcohol intake, obesity, and hypertension.

    “These social-environmental effects translate into a rather striking reduced life expectancy of around 2.1 years by age 40, thus exceeding the mortality risk associated with high alcohol intake, obesity, and hypertension (Stringhini et al. 2017).”
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    Findingcitation

    Social safety is related to better health behaviors, which predict outcomes including longevity.

    “Social safety is also related to practicing better health behaviors, which in turn predicts numerous behavioral and health-related outcomes including longevity (Umberson et al. 2010).”
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    Findingcitation

    In 1,622 young adults in the Philippines, parental absence during childhood was associated with 47% higher CRP in young adulthood for those with low infant animal feces exposure, and 17% lower CRP for those with high feces exposure; social threat predicted greater inflammation only in hygienic microbial environments.

    “For individuals exposed to low levels of animal feces during infancy, those who experienced a core threat to social safety in the form of prolonged parental absence during childhood (e.g., resulting from divorce, separation, or death) exhibited 47% higher CRP levels in young adulthood relative to their no-stress counterparts.”
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    • cites McDade et al. 2013

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    Findingcitation

    Social threat can increase gut permeability, enabling bacteria to cross the epithelial barrier and activate a mucosal immune response that changes the microbiome, upregulates HPA axis and inflammatory activity, and heightens social threat.

    “experiences of social threat can increase gut permeability, which enables bacteria to cross the epithelial barrier and activate a mucosal immune response that changes the microbiome, upregulates HPA axis and inflammatory activity, and heightens experiences of social threat”
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    • cites Dinan & Cryan 2012

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    Findingcitation

    High-fat diets cause microbiome changes that heighten neuroendocrine reactivity and inflammatory activity, inducing anxiety, hypervigilance, and social threat experiences.

    “high-fat diets cause compositional changes in the microbiome that heighten neuroendocrine reactivity and inflammatory activity, which in turn induce anxiety, hypervigilance, and experiences of social threat.”
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    Findingcitation

    Approximately 33% of women report lifetime partner or nonpartner physical violence, or nonpartner sexual violence.

    “approximately 33% of women report having experienced lifetime partner or nonpartner physical violence, or nonpartner sexual violence (OECD 2011).”
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    • cites OECD 2011

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    Findingcitation

    NSSI is more common in people who have experienced major threats to social safety, such as emotional, physical, or sexual abuse, making social threat a key risk factor for NSSI.

    “NSSI is more common in people who have experienced major threats to social safety, such as emotional, physical, or sexual abuse, thus making social threat a key risk factor for NSSI (Nock 2009, Stewart et al. 2019).”
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    • cites Stewart et al. 2019

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    Findingcitation

    Diet affects bacterial composition of microbiota, which shapes social safety and threat via the brain-gut-microbiome axis.

    “Diet strongly affects the bacterial composition of the microbiota that can in turn shape experiences of social safety and threat by influencing the brain–gut–microbiome axis, which includes the CNS, neuroendocrine and neuroimmune systems, autonomic nervous system, enteric nervous system, and intestinal microbiota (Dinan & Cryan 2012).”
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    Findingcitation

    In 40 young adults, urban upbringing was associated with greater TSST-induced IL-6 increases and poorer anti-inflammatory capability compared to rural upbringing.

    “it was the participants who grew up in an urban environment who exhibited the greatest TSST-induced increases in IL-6.”
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    • cites Böbel et al. 2018

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    Findingcitation

    Exposure to PM2.5 is especially harmful because particles can be inhaled, enter circulation, reach the brain, influence serotonergic and dopaminergic activity, and affect brain structure, function, and plasticity.

    “Exposure to fine PM ≤2.5 μm in aerodynamic diameter (i.e., PM2.5) is especially harmful because these particles can be inhaled, enter the circulation, and reach the brain, where they influence serotonergic and dopaminergic activity and affect brain structure, function, and plasticity.”
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    • cites Olvera Alvarez et al. 2018

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    Findingcitation

    Across 35 countries, total fertility rates dropped from 2.7 children/woman in 1970 to 1.7 in 2009, leading to declines in average household size and fewer available familial bonds.

    “Across 35 countries, total fertility rates have dropped from an average of 2.7 children/woman in 1970 to 1.7 children/woman in 2009, leading to a corresponding decline in average household size and fewer available familial bonds.”
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    • cites OECD 2011

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    Findingcitation

    Obesity shifts adipose immunologic stance from type 2/T helper 2 to type 1/T helper 1, with proinflammatory M1 macrophages accumulating and secreting IL-1β and TNF-α under psychological stress.

    “obesity shifts this immunologic stance toward a type 1 or T helper 1 state in which proinflammatory (i.e., M1-polarized) macrophages accumulate and secrete large amounts of different cytokines, including IL-1β and TNF-α, under conditions of psychological stress (Reilly & Saltiel 2017).”
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    Findingcitation

    NSSI has lifetime prevalence up to 23% in adolescents and 4% in adults.

    “NSSI has a lifetime prevalence of up to 23% in adolescents and 4% in adults”
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    Findingcitation

    Across 62 countries, approximately 70% of children 2-14 have experienced psychological threats to social safety, and approximately 60% have experienced physical threats.

    “UNICEF (2014) estimated that across 62 countries, approximately 70% of children 2–14 years old have experienced psychological threats to social safety, such as verbal aggression, intimidation, humiliation, or ridicule.”
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    Findingcitation

    Birth month independently predicts longevity in several studies, attributed to seasonal differences in healthy food availability during pregnancy and infant exposure to inflammation-promoting pathogens.

    “birth month has been found to independently predict longevity in several studies, with such effects being attributed to seasonal differences in the availability of healthy foods during pregnancy (which is generally better during spring and summer months) and to differences in infants’ likelihood of exposure to inflammation-promoting pathogens (which is generally worse in autumn and winter months)”
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    Interpretationreasoning

    Threats to social safety are a key feature of psychological stressors that most strongly affect health and behavior.

    “threats to social safety are a critical feature of psychological stressors that increase risk for disease”
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    Interpretationcitation

    DAMPs are key promoters of systemic chronic inflammation and may be relevant for how life stress exerts persistent effects on health, behavior, and age-related disease risk.

    “DAMPs are now recognized as a key promoter of systemic chronic inflammation, meaning that they may be especially relevant for understanding how life stress exerts persistent effects on human health, behavior, and age-related disease risk (i.e., in the absence of infection) (see Furman et al. 2019)”
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    Premisecitation

    Antigen-presenting cells differentiate self from nonself, migrate to lymph nodes, present antigen to T helper cells, and cause release of cytokines.

    “APCs migrate from the infection site to local lymph nodes where they present antigen peptides to T helper cells, resulting in the release of several cytokines including IL-2, IL-4, IL-5, and interferon gamma (IFN-γ) (Slavich 2020)”
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    Premisecitation

    Sterile inflammation occurs without infection and helps recovery from tissue damage.

    “This type of innate immune response can occur in the absence of a pathogenic infection, which is why some have called it sterile inflammation, and it plays a critical role in helping individuals recover from tissue damage sustained during physical injury or bodily trauma (Crişan et al. 2016)”
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    Premisecitation

    There is little agreement about which social-environmental adversities are most deleterious and no consensus about what makes stressors stressful.

    “there is little agreement about the types of social-environmental adversity that are most deleterious and no consensus regarding the social-psychological characteristics that make particular stressors stressful (Cohen et al. 2019, Epel et al. 2018)”
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    Premisecitation

    The primary goal of the immune system is to keep the body biologically safe and protected from foreign invaders and physical injuries.

    “The primary goal of the immune system, in turn, is to keep the body biologically safe and protected from these foreign invaders and from physical injuries that could cause illness or death if left unaddressed (Slavich & Irwin 2014)”
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    • cites Slavich & Irwin 2014

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    Interpretationnone given

    Social Safety Theory proposes that forming and maintaining friendly social bonds is a fundamental organizing principle of human behavior.

    “Social Safety Theory hypothesizes that developing and maintaining friendly social bonds is a fundamental organizing principle of human behavior”
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    Premisecitation

    DAMPs activate PRRs, especially TLR2 and TLR4, causing rapid NF-κB-mediated inflammation.

    “DAMPs can bind to and activate PRRs, especially TLR2 and TLR4, and in turn initiate a very rapid inflammatory response that is characterized by NF-κB-mediated increases in several inflammatory cytokines, especially IL-1β (Schaefer 2014)”
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    • cites Schaefer 2014

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    Premisecitation

    The adaptive immune system is evolutionarily younger and develops over several days via microbial-specific lymphocytes and immunological memory.

    “the body engages the evolutionarily younger, 450-million-year-old adaptive immune system (Travis 2009). Compared with the innate immune response, which is nonspecific and occurs quickly, adaptive immunity develops over several days and involves the proliferation of microbial-specific lymphocytes that neutralize or eliminate microbes based on an immunological memory”
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    Premisereasoning

    These stress theories are largely based on behavioral and clinical data, with researchers assuming how stressors affect underlying biological processes.

    “these theories are largely based on behavioral and clinical data, with researchers in turn assuming how different stressors might affect underlying biological processes”
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    Existing alternative stress theories provide very different, largely nonoverlapping explanations for why certain stressors are most impactful.

    “these formulations provide very different, largely nonoverlapping explanations for why certain stressors are most impactful”
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    Premisecitation

    Intracellular pathogen detection via TLRs activates antiviral type I interferon genes.

    “if the immunologic threat involves an intracellular pathogen (e.g., virus), then TLRs activate the transcription factors NF-κB, ATF2–c-Jun, interferon-regulatory factor 3, and interferon-regulatory factor 7, which induce antiviral immune response genes, particularly type I interferon genes”
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    Premisecitation

    The innate immune system provides a rapid, highly conserved defense response activated under microbial infection and tissue damage.

    “The innate immune system dates back to the origin of multicellularity and provides humans with an extremely rapid, highly conserved immunologic defense response that gets activated under conditions of microbial infection and tissue damage (Travis 2009)”
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    Premisecitation

    Meningeal lymphatic vessels drain macromolecules and excess fluid from the CNS and provide a path for immune cells to travel from the CNS to the periphery.

    “These vessels help drain macromolecules and excess fluid from the central nervous system (CNS). However, they also represent a physical path along which immune cells can travel from the CNS to the periphery”
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    Premisenone given

    Multiple bidirectional pathways-SNS, HPA axis, vagus nerve, and meningeal lymphatic vessels-enable the brain to signal the peripheral immune system and vice versa during social threat.

    “Multiple bidirectional pathways enable the brain to signal the peripheral immune system and vice versa during times of social threat. These pathways include the sympathetic nervous system (SNS), hypothalamic–pituitary–adrenal (HPA) axis, vagus nerve, and meningeal lymphatic vessels”
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    Interpretationcitation

    Adversity can trigger increased arborization of SNS fibers in the lymph node, expanding the neural-immune regulatory pipeline and potentially promoting neuro-inflammatory sensitization that sustains perceptions of social threat for months or years after a triggering event.

    “adversity can trigger increased arborization of SNS fibers in the lymph node, which expands the neural–immune regulatory pipeline and may promote neuro-inflammatory sensitization to adversity that sustains perceptions of social threat for months or years after an initial triggering event has passed (see Slavich & Irwin 2014)”
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    Premisecitation

    Cytokines can affect threat and pain sensitivity, exploratory and pleasure-seeking behavior, ingestive behavior, sleep, learning, attention, memory, impulsivity, temporal focus, emotion regulation, executive function, and cognitive control.

    “cytokines can affect threat and pain sensitivity, exploratory and pleasure-seeking behavior, ingestive behavior, sleep, learning, attention, memory, impulsivity, temporal focus, emotion regulation, executive function, and cognitive control (Larson & Dunn 2001, Shields et al. 2017)”
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    Premisecitation

    Adversity can lead to epigenetic reprogramming of innate immune cells and alter hematopoietic output from the bone marrow, skewing them toward a more proinflammatory state.

    “adversity can lead to epigenetic reprogramming of innate immune cells (Crişan et al. 2016) and alter the hematopoietic output of these cells from the bone marrow (Hanke et al. 2012), skewing them toward a more proinflammatory state”
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    Premisecitation

    Cortisol can also increase inflammatory activity by priming heightened inflammatory reactivity, stimulating immune cell trafficking, and promoting glucocorticoid insensitivity or resistance.

    “cortisol can also lead to increased inflammatory activity by priming heightened inflammatory reactivity, stimulating immune cell trafficking, and promoting glucocorticoid insensitivity/resistance (Sorrells et al. 2009)”
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    Interpretationreasoning

    Each of these experiences threatens social safety differently and can engage social signal transduction pathways, leading to changes in disease risk, cognition, and behavior.

    “Each of these experiences threatens social safety in a different way and can therefore engage the social signal transduction pathways described above, leading to substantial changes in disease risk, cognition, and behavior”
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    Interpretationcitation

    Actual physical danger is at the top of the severity gradient, while social conflict, aggression, devaluation, discrimination, isolation, rejection, and exclusion are lower but relevant.

    “Atop this list would be actual physical danger, such as being physically attacked, abused, or neglected. However, there are many other social circumstances a bit lower on the severity gradient that are also relevant, including social conflict, aggression, devaluation, discrimination, isolation, rejection, and exclusion (Slavich & Irwin 2014, Slavich et al. 2010a)”
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    • cites Slavich & Irwin 2014

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    • cites Slavich et al. 2010a

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    Interpretationcitation

    Mounting an anticipatory inflammatory response to potential physical danger requires continually monitoring whether the body is in a socially safe environment, supported by four neural networks.

    “Mounting an anticipatory inflammatory response to potential physical danger requires continually monitoring the extent to which the body is in a socially safe environment, and four neural networks support this capacity: the amygdala network, mentalizing network, empathy network, and mirror neuron system (Kennedy & Adolphs 2012)”
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    • cites Kennedy & Adolphs 2012

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    Interpretationnone given

    Social threat is harmful for human health and behavior.

    “Social threat is harmful for human health and behavior”
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    Premisenone given

    Current broad support for Social Safety Theory comes from anthropology, psychology, sociology, epidemiology, and public health.

    “Current broad support for Social Safety Theory comes from several fields, including anthropology, psychology, sociology, epidemiology, and public health”
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    Premisenone given

    Humans have long inhabited a world filled with physical and microbial threats that can cause death and reduce reproductive success if not avoided or dealt with effectively.

    “humans have long inhabited a world filled with physical and microbial threats—including dangerous conspecifics, viruses, and bacteria—that can cause death and reduce reproductive success if not avoided or dealt with effectively”
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    Premisereasoning

    Physical wounding threatens survival directly through injury-induced bleeding and indirectly by enabling pathogens to enter through wounds created during social conflict.

    “Physical wounding threatens survival directly (e.g., through injury-induced bleeding) but also indirectly by enabling pathogens to enter the body through wounds created during social conflict”
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  • May combine two claims.

    Interpretationreasoning

    The immune system cannot directly detect social circumstances that may increase risk for physical conflict or injury, so it relies on the brain.

    “Because the immune system cannot directly detect social circumstances that may increase risk for physical conflict or injury, it relies on the brain”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    These activations can occur intermittently or become prolonged, mediated by social safety schemas about the self, social world, and future.

    “These activations can occur intermittently—for example, when engaged by occasional negative automatic thoughts about a potential threat in the environment—but they can also become prolonged, mediated by one’s social safety schemas about the self, social world, and future”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    Immune cells care about physical and social safety, not about a person's financial resources or the size of his or her social network.

    “immune cells care about physical and social safety, not about a person’s financial resources or the size of his or her social network”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    A fundamental drive to develop friendly social bonds, and to mount a systemic inflammatory response to social cues historically associated with increased physical danger, was likely highly conserved.

    “a fundamental drive to develop friendly social bonds, and to mount a systemic inflammatory response to social cues historically associated with increased physical danger, was likely highly conserved”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Humans have an affinity for similar others and hostility toward strangers, which historically increased reproductive success and survival.

    “humans have a well-known affinity for those most like themselves and a tendency to be hostile toward strangers (Bloom 2013), which historically enhanced their reproductive success and helped ensure their survival (Silk 2007).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bloom 2013

      Not checked in the free run.

    • cites Silk 2007

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Release of IL-1β, IL-6, and TNF-α heightens threat sensitivity, degrading experiences of social safety and increasing perceptions of social threat.

    “The resulting release of IL-1β, IL-6, and TNF-α heightens threat sensitivity that can degrade experiences of social safety and increase perceptions of social threat.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationcitation

    The survival benefit of social integration is similar in magnitude to quitting smoking and exceeds that of obesity and physical inactivity.

    “These beneficial effects are similar in magnitude to quitting smoking and exceed those associated with traditional risk factors for mortality, such as obesity and physical inactivity.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Evidence of natural selection for prosociality first emerged about 2.6 million years ago in the Paleolithic period and drove human self-domestication, enabling people to live, hunt, and gather together in small bands.

    “Evidence of natural selection for prosociality first emerged about 2.6 million years ago in the Paleolithic period and it drove human self-domestication, enabling people to live, hunt, and gather together in small bands (Henrich 2015)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Henrich 2015

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Social safety confers numerous benefits, while social threat can degrade mental and physical health, lead to negative behaviors, and increase risk for biological aging and early mortality.

    “whereas social safety confers numerous benefits, social threat can degrade mental and physical health, lead to a variety of negative behaviors, and increase risk for biological aging and early mortality”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationcitation

    Relative to rural upbringing, urban upbringing is associated with greater inflammatory responses to acute social threat and poorer immunoregulatory/anti-inflammatory capability following such threat.

    “Together, these data provide strong converging evidence that relative to individuals who are raised in rural environments, those who grow up in urban environments exhibit greater inflammatory responses to acute social threat in addition to poorer immunoregulatory/anti-inflammatory capability following such threat”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Historically, social threats raised the risk of isolation, conflict, or wounding.

    “Physical threats are the most impactful types of stressors from this evolutionary perspective, but such experiences are followed closely by social threats that historically increased risk for possible isolation, conflict, or wounding.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Over millennia, the cellular self evolved to monitor its surroundings, detect threats, and produce anticipatory biobehavioral responses that gave the greatest adaptive advantage.
  • May combine two claims.

    Interpretationreasoning

    NSSI may induce neuroinflammation that exacerbates perceptions of social conflict, criticism, or exclusion, leading to emotional distress and greater propensity for NSSI.

    “NSSI may thus represent a behavioral trigger that induces neuroinflammation, which exacerbates a person’s perceptions of social conflict, criticism, or exclusion, in turn leading to heightened emotional distress and an even greater propensity to engage in NSSI”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationcitation

    Bodily injury releases mitochondrial DAMPs, which initiate immune responses and produce inflammatory cytokines that increase neural threat sensitivity and degrade social safety.

    “The resulting production of inflammatory cytokines increases neural threat sensitivity that can degrade perceptions of social safety and promote experiences of social threat (Zhang et al. 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Zhang et al. 2010

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The construct of life stress has been notoriously messy, with little consensus on what actually matters.

    “Life stress has been a notoriously messy construct with little agreement about what actually matters (Cohen et al. 2019, Malat et al. 2017, Monroe & Slavich 2020).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Cohen et al. 2019

      Not checked in the free run.

    • cites Malat et al. 2017

      Not checked in the free run.

    • cites Monroe & Slavich 2020

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Social safety and social threat are central to life's most impactful experiences.

    “If we ask the human brain and immune system, though, they will tell us that social safety and social threat lie at the heart of life’s most impactful experiences.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Over millennia, the cellular self evolved to monitor its surroundings, detect threats, and produce anticipatory biobehavioral responses that gave the greatest adaptive advantage.
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Understanding the true underlying structure of life stress requires examining the cellular self.

    “To address these problems and begin to understand the true underlying structure of life stress, I propose that we need only look to our cellular selves, which evolved over millennia to monitor the surrounding environment, detect potential threats, and mount anticipatory biobehavioral responses that conferred the greatest adaptive advantage.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Over millennia, the cellular self evolved to monitor its surroundings, detect threats, and produce anticipatory biobehavioral responses that gave the greatest adaptive advantage.
62 of 62
  • The paper relies on this without support.

    Sleep plays a central role in regulating biological processes that affect social cognition, health, and behavior.

    “Sleep is a critical human behavior that plays a central role not just in everyday life but in regulating biological processes that affect social cognition, health, and behavior.”
  • The paper relies on this without support.

    The benefit-to-cost ratio of the inflammatory response is greatest when it upregulates quickly and downregulates shortly after a threat has passed.

    “Like other neural and physiological systems, the benefit-to-cost ratio of the inflammatory response is greatest when it upregulates quickly and then downregulates shortly after a threat has passed.”
  • The paper relies on this without support.

    Objective characteristics of the social environment influence the extent to which people regard their surroundings as socially safe versus threatening.

    “Because objective characteristics of the social environment influence the extent to which people generally regard their surroundings as socially safe versus threatening”
  • The paper relies on this without support.

    Humans are embedded in a series of social safety circles that independently and interactively shape experiences of social safety and threat.

    “humans are embedded in a series of social safety circles that independently and interactively shape moment-to-moment and lifelong experiences of social safety and threat (see Figure 2).”
  • The paper relies on this without support.

    Over millennia, the cellular self evolved to monitor its surroundings, detect threats, and produce anticipatory biobehavioral responses that gave the greatest adaptive advantage.

    “which evolved over millennia to monitor the surrounding environment, detect potential threats, and mount anticipatory biobehavioral responses that conferred the greatest adaptive advantage.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Threats to social safety can undermine health.

    “The collective evidence linking systemic inflammation to the quality of social relationships and interactions is consistent with theory that threats to social safety (e.g., social conflict, isolation, rejection, exclusion) can undermine health (Slavich, 2020; also see Cole et al., 2015 for a related perspective on perceived social isolation and gene expression).”

Cites

Flagged first, then by citations

2 of the 159 references couldn’t be matched to a known paper.

Research works printed but not linked: 14

  1. Allbutt C., 1895, Contemp. Rev., 67, 210
  2. Babey SH, 2019, School Discipline Practices Associated with Adolescent School Connectedness and Engagement
  3. Bernard C., 1865, Introduction à L'étude de la Médecine Expérimentale
  4. Carver CS, 1999, Handbook of Personality, 553
  5. Clark DA, 1999, Scientific Foundations of Cognitive Theory of Depression
  6. Darwin CR., 1859, On the Origin of Species
  7. 10.2307/j.ctvc77f0d · DOI
  8. OECD (Organ. Econ. Co-operation Dev.), 2011, Doing Better for Families
  9. Reid BM, 2019, Brain Behav. Immun
  10. Selye H., 1976, The Stress of Life
  11. Slavich GM., 2020, The Oxford Handbook of Stress and Mental Health, 519
  12. UNICEF, 2014, Hidden in Plain Sight: A Statistical Analysis of Violence Against Children
  13. Weiss JM, 1985, Stress and Coping, 93
  14. Zaki J., 2019, The War for Kindness: Building Empathy in a Fractured World

Cited by

Sorted by citations

Authors
Slavich, G. M.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Slavich, George M.
Venue
Annual Review of Clinical Psychology
Published
2020-05-07
Volume
16
Issue
1
Pages
265-295
ISSN
  • 1548-5943 (ISSN-L)
  • 1548-5951
OpenAlex
W3010515129
Cited by
502
References
159
Citations by year
2026: 130 · 2025: 90 · 2024: 81 · 2023: 71 · 2022: 57 · 2021: 49 · 2020: 19 · 2019: 2 · 2018: 1 · 2017: 1 · 2015: 1
FWCI
5.10
Type
journal article
Language
en
Open access
Locations
  • Annual Review of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Alliance for Research on Schizophrenia and Depression (K08 MH103443, 23958)
  • National Institutes of Health (23958)
  • National Institute of Mental Health (K08MH103443)
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
  • Social Sciences › Health › Health disparities and outcomes
Keywords
social bonds, social danger, psychological stress, neuroimmune interactions, inflammation, viral infection, social rejection, social isolation, evolutionary psychology, disease risk, threat response
MeSH terms
Biological Evolution, Humans, Inflammation, Psychological Theory, Safety, Social Behavior, Stress, Psychological

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

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