The association between self-reported stress and cardiovascular measures in daily life: A systematic review

Abstract

Background Stress plays an important role in the development of mental illness, and an increasing number of studies is trying to detect moments of perceived stress in everyday life based on physiological data gathered using ambulatory devices. However, based on laboratory studies, there is only modest evidence for a relationship between self-reported stress and physiological ambulatory measures. This descriptive systematic review evaluates the evidence for studies investigating an association between self-reported stress and physiological measures under daily life conditions. Methods Three databases were searched for articles assessing an association between self-reported stress and cardiovascular and skin conductance measures simultaneously over the course of at least a day. Results We reviewed findings of 36 studies investigating an association between self-reported stress and cardiovascular measures with overall 135 analyses of associations between self-reported stress and cardiovascular measures. Overall, 35% of all analyses showed a significant or marginally significant association in the expected direction. The most consistent results were found for perceived stress, high-arousal negative affect scales, and event-related self-reported stress measures, and for frequency-domain heart rate variability physiological measures. There was much heterogeneity in measures and methods. Conclusion These findings confirm that daily-life stress-dynamics are complex and require a better understanding. Choices in design and measurement seem to play a role. We provide some guidance for future studies.

Does anxiety explain why math-anxious people underperform in math?

“…Prior work, however, has shown inconsistent correlations between traditional (trait) math anxiety and various measures of in-the-moment ('state') anxiety about math 49 . Additionally, there is debate about the utility of self-report vs physiological arousal as measures state anxiety [61][62][63][64] , and there is evidence that people tend to have fairly poor introspection into how much they are physiologically reacting to stressors 65 . Therefore, rather than deciding a priori on a single 'best' way to measure math-related state anxiety (i.e., in-the-moment anxiety associated with math), we instead measured multiple indices, including subjective self-report measures and several biological measures related to anxiety: heart rate (HR), skin conductance levels (SCL), and pre-ejection period (PEP).…”

Physiological reactions to acute stressors and subjective stress during daily life: A systematic review on ecological momentary assessment (EMA) studies

“…For example, previous laboratory studies showed that associations between subjective stress and heart rate peak during occurrence of stressors and that heart rate levels recover after five minutes [ 53 , 190 ]. This goes along with the recommendation of not using time frames of more than 30 minutes when examining cardiovascular outcomes [ 64 ].…”

“…For instance, there are few exceptions with narrowed scope including a recent review targeting specific psychophysiological outcomes in psychiatric populations [ 63 ] and a review solely targeting cortisol reactions but missing a systematic literature search [ 15 ]. Furthermore, a very recent systematic review found mixed evidence regarding associations of perceived stress and cardiovascular reactions [ 64 ]. The authors of this study noted that blood pressure, heart rate and HRV were most often investigated and that perceived stress was operationalized in very different ways potentially explaining disparate findings [ 64 ].…”

“…Furthermore, a very recent systematic review found mixed evidence regarding associations of perceived stress and cardiovascular reactions [ 64 ]. The authors of this study noted that blood pressure, heart rate and HRV were most often investigated and that perceived stress was operationalized in very different ways potentially explaining disparate findings [ 64 ]. It might therefore be useful to discuss those results by differentiating for outcome and operationalization of stress.…”

“…global subjective stress or momentary perceived distress). We also include subjective feelings of being stressed as exposure due the inconsistent definition, distinction and measurement of psychological stress and stressors in the EMA research literature [ 64 ]. This definition will exclude cognitive, emotional or behavioral responses to stress (e.g.…”