Stress and Health: A Review of Psychobiological Processes

• Published in: Annual review of psychology Vol. 72; no. 1; pp. 663 - 688
• Main Authors: O'Connor, Daryl B, Thayer, Julian F, Vedhara, Kavita
• Format: Journal Article
• Language: English
• Published: United States Annual Reviews 04.01.2021; Annual Reviews, Inc
• Subjects: Adversity; Allostatic load; Analysis; Autonomic nervous system; Behavior change; Central nervous system; Cortisol; Forecasts and trends; Gene expression; genomics; Health aspects; Health behavior; Health status; HPA axis; Hypothalamic-pituitary-adrenal axis; Infectious diseases; Nervous system; Neuroendocrine tumors; Occupational stress; Physiological aspects; Psychobiology; Psychological aspects; Psychophysiology; Risk factors; Stress; Stress (Psychology); United Kingdom; cortisol; genomics; HPA axis; autonomic nervous system; allostatic load
• ISSN: 0066-4308; 1545-2085
• DOI: 10.1146/annurev-psych-062520-122331

The cumulative science linking stress to negative health outcomes is vast. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in health behaviors. In this review, we present a brief overview of ( a ) why we should be interested in stress in the context of health; ( b ) the stress response and allostatic load; ( c ) some of the key biological mechanisms through which stress impacts health, such as by influencing hypothalamic-pituitary-adrenal axis regulation and cortisol dynamics, the autonomic nervous system, and gene expression; and ( d ) evidence of the clinical relevance of stress, exemplified through the risk of infectious diseases. The studies reviewed in this article confirm that stress has an impact on multiple biological systems. Future work ought to consider further the importance of early-life adversity and continue to explore how different biological systems interact in the context of stress and health processes.