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The Role of Psychoneuroendocrinology in Health and Disease

If you have no idea what “psychoneuroendocrinology” means, no worries. It is not all that complicated and really just three words merged together.


Psychoneuroendocrinology is a combination of psychology, neurobiology and the study of hormones, endocrinology. The main goal of Psychoneuroendocrinology research is to understand how the mind (psychology/psychiatry) and body (neurobiology, endocrinology, immunology) work together in terms of health and disease.


I am a postdoctoral scholar at Iowa State University interested in the link between stress and health outcomes. Currently, I am the Social Media Editor for the International Society of Psychoneuroendocrinology and the associated journals, Psychoneuroendocrinology and Comprehensive Psychoneuroendocrinology. I studied medical psychology, which is a discipline that integrates medicine and things like psychotherapy, mental illness and other psychological topics, at Tilburg University in The Netherlands. I studied under Prof. Tessa Roseboom (Amsterdam) and Prof. Annemieke Hoek (Groningen) as a PhD student and wrote a dissertation in the field of Medical Sciences.


I became interested in psychoneuroendocrinology research as an undergraduate student, involved in a project about the stress response. Stress is a typical psychoneuroendocrinology topic since it really is all about the mind, the brain and the hormones working together.


Let me explain.


Think about the last time that you were driving a car or riding a bike and you were almost in an accident.


I remember a recent situation; the car in front of me was suddenly slowing down and I was about to crash into this car. I hit the brakes just in time. In a matter of seconds, my heart was pumping like crazy, my hands were sweaty and slightly shaking and my pupils were dilated. My mind was able to detect danger (almost crashing into the car in front of me) and activated my body. This type of mental and physical reaction is referred to as the acute stress response.


This acute response triggers, in case of danger, a fight-or-flight response. You need your body to become activated. See these Inspire the Mind blogs for more details about stress and the fight-or-flight response.


How does the response work? Well, for example, when you need to run away from or confront danger, your blood needs to be pumped around faster to make sure your body is getting the oxygen it needs, and so your heart rate picks up.

You may need to see your surroundings better, so your pupils become dilated.

You do not really have control over this bodily response, it is automatic.

This reflexive stress response makes a lot of sense from an evolutionary perspective too. You have a better chance at survival if the human body is equipped with an automatic fight-or-flight response when you run into a dangerous predator like a lion.

So why are psychoneuroendocrinology researchers interested in this acute stress response?

The way that your body responds to acute stress can provide a lot of information about your future health and disease.

Psychoneuroendocrinology researchers use what is called a “stress test” in a laboratory/research setting to test how people respond to acute stress. They measure different bodily responses, including heart rate, blood pressure, how sweaty your hands are, and stress hormones, while the participant is completing stressful tasks.


Of course, a lot of questions come to mind and need to be asked when we talk about stress tests.

First and foremost, are they ethical?


We obviously do not want to traumatize participants when they are subjected to a stress test. An ethical committee is always involved and evaluates how ethical a specific stress task is.


And so, decades of research in this field have led to a gold standard of stress testing; a task that involves social evaluative threat, which is just a fancy way of saying ‘a task where you are being judged by others’. A job interview is a good example of a situation that involves a social evaluative threat, which is why a mock job interview is often part of a stress test. Social evaluation is extremely important to many humans; almost everyone feels a strong urge to belong and cares to some degree about the judgement of others.


As it has done so for so much else around the world, COVID-19 has also changed the way psychoneuroendocrinology researchers conduct stress studies. In-person stress tests are not possible at the moment, which has halted the work of many researchers in this field. However, there are promising results that online stress testing works as well!


What is deemed ‘stressful’ varies from person to person.


Of course, we must keep in mind that not everyone shows the same bodily response pattern during a stress task. Some folks are pretty relaxed before the task starts and have a heart rate of 60 beats per minute (bpm). Others are already freaked out before the test even begins by the laboratory setting and the uncertainty of what is going to happen and start with a much higher 100 bpm heart rate.


Most people experience the classical acute stress response during the task, with increased heart rate and sweaty hands, but not everyone recovers — goes back to their ‘normal’ self — at the same pace.


As mentioned before, the stress response includes different bodily aspects.

Heart rate is one of those things you can usually feel (“my heart is pounding out of my chest!”) and measure with an EKG; those sticky pads on your chest. Sweaty hands are also not too difficult to detect yourself.


Researchers use special sensors on your hands to measure electrical conductance of the skin, and a cuff around your arm to measure changes in blood pressure.


However, you cannot “feel” changes in hormones. They need to be measured, in your blood or, more often, in saliva.


The most studied stress hormone is cortisol, and changes in cortisol levels can be detected in saliva. Other hormones that play a role include testosterone (a sex hormone), DHEA, which is an important puberty hormone, and a hormone involved in love and bonding, oxytocin.


To study these hormones, researchers often ask you to drool or spit in a tube when you participate in stress-related research. Saliva collection is not difficult and does not require expensive equipment to be collected, so it is also suitable for online stress testing where participants self-collect at home.


So, how can we use this information and actually help people and possibly prevent disease?


The cool thing about psychoneuroendocrinology research is that you can study the stress response at any age! The heel prick test or the vaccination jab are frequently used “stress tests” in babies, for example. That means that researchers can examine the stress response pattern very early in life, and help people through interventions to decrease the risk of future disease.


What is next? There is an exciting new line of research that looks at using virtual reality in stress research, which gives researchers a wealth of possibilities; anything is possible in virtual reality. You can be surrounded by zombies or participate in a virtual dance competition. My own team is currently summarizing existing evidence of how effective virtual reality stress tests are in evoking a stress response.


All of this information taken together tells researchers a lot about your stress response pattern, and in turn what it can mean for your health. For example, there is evidence that people who respond very strongly to a stress task, may be at increased risk for future disease (think heart disease, for example).


There is also increasing evidence that people with no bodily response to a stress task are at increased risk for future disease as well, including poor mental health outcomes.


This is how research in the field of psychoneuroendocrinology can help prevent disease and help develop future treatments.

I am deeply interested in this field and can hopefully contribute not only through research but through our social media outlets as well!


 

If you are interested in reading more about psychoneuroendocrinology and stress research: follow @ISPNE on Twitter and Facebook and the associated journals @PNECJournal@CPNECJournal.


 


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