Elsevier

Psychoneuroendocrinology

Volume 49, November 2014, Pages 54-61
Psychoneuroendocrinology

A non-linear association between self-reported negative emotional response to stress and subsequent allostatic load: Prospective results from the Whitehall II cohort study

https://doi.org/10.1016/j.psyneuen.2014.07.001Get rights and content

Summary

Previous research suggests that high levels of negative emotions may affect health. However, it is likely that the absence of an emotional response following stressful events may also be problematic. Accordingly, we investigated whether a non-linear association exists between negative emotional response to major life events and allostatic load, a multisystem indicator of physiological dysregulation. Study sample was 6764 British civil service workers from the Whitehall II cohort. Negative emotional response was assessed by self-report at baseline. Allostatic load was calculated using cardiovascular, metabolic and immune function biomarkers at three clinical follow-up examinations. A non-linear association between negative emotional response and allostatic load was observed: being at either extreme end of the distribution of negative emotional response increased the risk of physiological dysregulation. Allostatic load also increased with age, but the association between negative emotional response and allostatic load remained stable over time. These results provide evidence for a more nuanced understanding of the role of negative emotions in long-term physical health.

Section snippets

Method

The study used data from the Phases 1, 2, 3, 5 and 7 of the Whitehall II cohort. The original sample (Phase 1, recruited in 1985–1988) included 10,308 British civil service workers aged 35–55. At baseline, participants completed a questionnaire and were given a clinical health examination. Follow-up questionnaire data were collected at every subsequent phase, approximately two years apart, Phase 2 being in 1989. Follow-up medical examinations were conducted every five years at Phases 3

Results

Ninety percent reported at least one event either at Phase 1 or Phase 2, with the mean number of reported events being 2.9 (SD = 1.97). The proportion of people who experienced each event and the average rating of the event's emotional impact are presented in Table 1.

As expected, people who experienced more events tended to be on average more upset about them (zero-order correlation between number of events and NER r = .13, p < .0001). Baseline serious illness and lower socioeconomic position were

Discussion

The present study investigated the relationship between patterns of emotional response to stress, as measured by the average strength of self-reported negative emotional response to several major life events, and AL, a cumulative measure of physiological dysregulation assumed to result from stress. We found a prospective non-linear association between self-reported emotional response and AL, i.e. people with both stronger than average and weaker than average emotional response had higher AL

Conflict of interest statement

The authors have no conflict of interest to report.

Role of the funding source

This work was not supported by any grants.

Acknowledgement

The authors would like to thank the participants of the Whitehall II study and all the staff involved in data collection and maintenance. We also thank Theis Lange for his advice on statistical analyses.

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