Table 3:
Abridgment of representative stress models
| Origin | Duration | Cause | Validity | Comments | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Acute | Chronic | Natural | Man-made | Construct (measure) | Convergent | Discriminant | Criterion | ||||
| HPA axis | Sympat hoadrenal | ||||||||||
| Mental | — | PTSD (e.g., torture motor vehicle accident) | X | X | Reliving traumatic event(s) measured via Clinician-Administered PTSD Scale, the PTSD Checklist (Mueser et al., 2001), Civilian (Green et al., 2017) and Combat (Beresford et al., 2021) Mississippi Scale etc... | Horror, anger guilt, or shame; diminished value of natural reinforcers and unhappiness (American Psychiatric, 2022) | Pathophysiological model of chronic stress (Elman and Borsook, 2019) | ↓ (Fischer et al., 2021; Gola et al., 2012) | ↑ (Fu, 2022; Pervanidou et al. 2007), but see (Videlock et al., 2008); sympat hetic hyperarousal is the key feature (American Psychiatric, 2022) | Laboratory animals’ models may not properly capture the complexity of the syndrome (Videlock et al., 2008) | |
| — | Social defeat | — | X | The Social Defeat Scale, (Gilbert and Allan, 1998) | Bullying, subordin ation (Bjorkqvist, 2001), burnout, work-related stress (van der Molen et al., 2020), aggression and humiliation (Bjorkqvist, 2001; Rohde, 2001); debating with a member of the opposite gender (Bjorkqvist, 2001; Rejeski et al., 1989)“ residentintruder“ procedure in animals (Koolhaas et al., 2013) | Neuropsyc hiatric disorders e.g., major depression, generalized anxiety disorder and schizophre nia (Bjorkqvist, 2001; Laviola et al., 2004; Rohde, 2001) | ↑ (Cannizzaro et al., 2020; Iob et al., 2021; Laceulle et al., 2017) | ↑ (Ghaddar et al., 2014; Nakatake et al., 2020; Rajalingam et al., 2021) | More studies on concordance between human and animal research are needed (Bjorkqvist, 2001) as human studies are usually retrospective or cross-sectional | ||
| Trier social stress test | — | — | X | Self-reported acute stress (Hellham mer and Schubert, 2012; Mohiyeddini et al., 2013) | interview preparation, public speech and mental arithmetic task (Frisch et al., 2015); ↑ anxiety and insecurity (Hellhammer and Schubert, 2012) | Robust and reliable neurobiological effects notwithstanding the psychosocial nature of the task (Allen et al., 2017) | ↑ (Gabrys et al., 2019; Hellhammer and Schubert, 2012) | ↑ (Bremner et al., 1996) | Ecological validity is good for Western cultures, external validity for non-Western remains to be examined | ||
| Maastricht acute stress test | — | — | X | Self-reported acute stress (Smeets et al., 2012; van Ruitenbeek et al., 2021); the State-Trait Anxiety Inventory (Shilton et al., 2017) | Elements of the Trier Social Stress Test, the Cold Pressor Test, stress of social evaluation (Smeets et al., 2012) | Combination of the Trier social stress test and the Cold Pressor Test is unique | ↑ (Bali and Jaggi, 2015) | ↑ (Bali and Jaggi, 2015; van Ruitenbeek et al., 2021) | Limited ecological validity of the Cold Pressor Test | ||
| Stroop test | — | — | X | Self-reported acute stress (Renaud and Blondin, 1997) | Self-reported anxiety (Tulen et al., 1989); working memory (Tulen et al., 1989); information processing e.g., attention (Parris et al., 2022), speed (Perianez et al., 2021) and parallel disturbance (Herd et al., 2006) | Consistent engagement of the anterior cingulate- and dorsolateral prefrontal cortices (Milham et al., 2003) | ↑ (Compton et al., 2013; Young Kuchenbecker et al., 2021) | ↑ (Huang et al., 2021; Renaud and Blondin, 1997; Vazan et al., 2017) | Multiple trials are required in order to elicit stress responses (Renaud and Blondin, 1997) | ||
| Physical | Infection | X | X | X | “Post-COVID Stress Disorder” ≅ PTSD (Tucker, 2021); Holeboard open field apparatus for anxiety-like behavior (Lyte et al., 2006) | Generalizable across various types of pathogens (Gareau et al., 2011) | Memory dysfunction (Gareau et al., 2011) | ↑ (Dunn, 1993a, b) | ↑ (Dunn, 1993a, b; Dunn et al., 1989) | Paucity of human studies; the construct validity of the COVID-induced stress is questiona ble given potential environmental impacts | |
| Hypovolemia (e.g., dehydration or blood loss) | — | X | X | Anxiety (self-reported or observed) ((Medline Plus, 2021) | Agitation, confusion and fatigue (Medline Plus, 2021) | Initially specific stress response (activation of the sympathon eural system), which becomes generalized following deterioratio n (Goldstein, 1995) | ↑ (Gann, 1979; Lilly et al., 1983) | ↑ (Bond and Johnson, 1985) | Poor construct validity | ||
| Glucoprivation (hypoglycemia) | — | — | X | Self-reported distress (Breier, 1989; Elman et al., 2004) | Whole body level hormonal response (Kerr et al., 1989; Schwartz et al., 1987) | Hunger, counterreg ulatory hormones (Breier, 1989; Muneer, 2021) | ↑ (Breier, 1989; Elman et al., 1998) | ↑ (Breier, 1989; Elman et al., 2004) | Acccomp anied by hunger and tiredness | ||
| Heat | X | X | X | Subjective heat stress question naire (Beckmann, 2021 #738; 26411664}. Objective quantification of the environmental stress-, personal stress- and heat strain indices factoring in ambient and core temperature, relative humidity, solar radiation and heart rate (Garzon-Villalba et al., 2017; Ramphal-Naley, 2012). | Heat-induced pain (Elman et al., 2018) | Heat exhaustion (Gauer and Meyers, 2019), hyperventilation (Tsuji et al., 2016), syncope, edema, rash (Howe and Boden, 2007), (Wilson et al., 2014) and stroke (Morris and Patel, 2023) | ↑ (Brenner et al., 1998; Follenius et al., 1982; Wang et al., 2015) | ↑ (Boonruksa et al., 2020; Cheshire, 2016; Cramer and Jay, 2016) | Good ecologic validity as heat is part of everyday life (Kunz-Plapp, 2018) external validity is questionable given cross-cultural temperature preference variability (Havenith, 2020) | ||
| Sleep deprivation | X | X | X | Various stress questionnaires (Gardani et al., 2022) e.g., a global measure of perceived stress (Cohen et al., 1983); Depressi on Anxiety Stress Subscale (Lovibond and Lovibond, 1995) and Undergra duate Stress Question naire (Schlarb et al., 2017), the stress component of the Patient Health Questionnaire (Schlarb et al., 2017) | Hypertension, glucoregulatory abnormalities, cardiovascular events, depression and anxiety (Hanson and Huecker, 2023) | Diminished alertness, excessive sleepiness, accidents (Colten et al., 2006) | ↑ (Nollet et al., 2020; Tsai et al., 1989) | Inconsistent findings; both ↑ (Lusardi et al., 1999; Tochikubo et al., 1996) and no change reported (Kato et al., 2000) | Good ecologic and external validity in the face of questionable criterion validity | ||
| Pain | ≅ PTSD due to persistent relieving of stress (26748087) | X | X | Various stress questionnaires e.g., Cohen’s Perceived Stress Scale (Vinstrup et al., 2020) | Neurobiological and clinical overlap with emotional pain e.g., depression, anxiety and PTSD (Borsook et al., 2016; Elman et al., 2013; Elman et al., 2011) | The involvement of the neural sensory apparatus (Elman and Borsook, 2016); pain-induced pleasure or algophilia (Elman and Borsook, 2016) | Initially analgesic (Hannibal and Bishop, 2014); chronically enhances pain (Griep et al., 1998; Tennant and Hermann, 2002) | Initially analgesic; later evolves to enhance pain (Taylor and Westlund, 2017; Tsigos et al., 1993) | Limited criterion validity; limited external validity e.g., cross cultural variability in perceived childbirth pain; offset of pain from daggers and hooks deeply penetrating the body from being a participant in a sacred ceremony (Elman and Borsook, 2016) | ||
| Pharmacological agents | Adenosine | — | — | X | Indirect evidence cardiac effects are similar to those of mental stress (Gottlieb et al., 2014) | — | An alternative for cardiac stress test (O’Keefe et al., 1992); causes transient AV block; reduces blood flow to ischemic areas i.e., coronary steal (Aetesam-Ur-Rahman et al., 2021) in the face of increased cardiac perfusion (Yimcharoen et al., 2020) | ↓ (Chamey et al., 1985) | ↓ (Richardt et al., 1989) | Poor validity as a stress model | |
| Dobutamine | — | — | X | Has not been methodically assessed for self-reported physical and mental stress (Wagner et al., 1996) | — | Utility for treatment of heart failure (Pickworth, 1992); may be used as cardiac stress test (Elhendy et al., 2002) | ↑ (Taylor, 1998) | ↓ (Velez-Roa et al., 2003) | Question able validity as a stress model | ||
| Yohimbine | — | — | X | Self-reported stress (Elman et al., 2012) and psychom etric ratings (Umhau et al., 2011) | Anxiety (Tam et al., 2001; Vasa et al., 2009), fear (Kausche et al., 2021) and pain (Ji et al., 2022) | FDA approved for the treatment of the Erectile Dysfunction (Tam et al., 2001) | ↑ (Fricke et al., 2023; Grunhaus et al., 1989; Price et al., 1986) | ↑ (Biaggioni et al., 1994; Petrie et al., 2000; Swann et al., 2013; Tanaka et al., 2000) | Requires safety monitoring for potential hypertension, tachycardia, tachypnea, arrhythmia, bronchos pasm and nausea (Landis and Shore, 1989; Lefton, 2023; Linden et al., 1985; WebMD, 2023) | ||