Pre-experience of social exclusion suppresses cortisol response to psychosocial stress in women but not in men
Research Highlights
►Social exclusion pre-experience dampens subsequent cortisol responsiveness to stress. ►Effect in women only, no comparable effect in men observable. ►No gender differences in psychological stress responsiveness.
Introduction
Becoming involved in social relationships is a fundamental human motivation. Social support has several protective effects; it ameliorates the psychological impact of stressful situations and is associated with positive health outcomes (House et al., 1988). Lack of support and social exclusion, on the other hand, is often observed for instance in depression (Hawthorne, 2008), anxiety disorders (Torgrud et al., 2004), fibromyalgia (Montoya et al., 2004), chronic fatigue syndrome (Prins et al., 2004), cardiovascular disease (Sorkin et al., 2002), cancers and HIV/AIDS (Reynolds and Kaplan, 1990, Leserman et al., 2000). Gender differences are reported in this context, but findings remain inconclusive. Some studies indicate that the beneficial impact of support on health is more pronounced in men than in women (House et al., 1982), whereas others state the opposite (Denton et al., 2004, Berkman and Syme, 1979). However, women seem to be more vulnerable to social triggers of health disturbances (Denton et al., 2004, Troisi, 2001).
Mechanisms mediating between the degree of social integration and physical and mental health are only partially understood. Particularly with regard to physiological mediators, little is known to date. Remarkably, however, many of the aforementioned diseases are also characterized by dysregulation of the HPA axis (Leserman et al., 2000, Burke et al., 2005, Furlan et al., 2001, Wingenfeld et al., 2008, Van Den Eede et al., 2007, Van Den Eede et al., 2008, Koertge et al., 2002, Ehlert et al., 2001, McEwen, 1998). Thus, the question arises whether the degree of social integration interferes with HPA-axis regulation.
The HPA-axis is activated by psychosocial stress resulting in increased release of cortisol from the adrenal glands, with women tending to show a dampened cortisol response due to basal biological regulatory mechanisms (Kajantie and Phillips, 2006, Hellhammer et al., 2009). A few studies indicate that salivary cortisol responses to stress can be reduced by social support (Heinrichs et al., 2003, Ditzen et al., 2007, Ditzen et al., 2008, Kirschbaum et al., 1995). Support by their male partners enhances the cortisol release of women, while men, on the other hand, show a dampened cortisol response when supported by their female mates (Kirschbaum et al., 1995). Data on cardiovascular stress responses suggests that this effect might be attributed rather to the gender of the supporting person than to that of the person being supported. Social support provided by women but not by men reduces cardiovascular stress responses in both women and men (Glynn et al., 1999). Considerable research is still needed with respect to gender differences in the physiological response to social support. Even less is known about the effects of social exclusion or ostracism. In particular, effects of social exclusion on the HPA response to a subsequent stressor have not yet been analysed. Studies assessing direct effects of social exclusion on salivary cortisol (Zwolinski, 2008, Blackhart et al., 2007, Stroud et al., 2002) are rare as well. The results of these studies are equivocal, which, at least in part, might be due to the exclusion paradigm that includes a direct social interaction hardly to standardize.
Indeed, experimental research on exclusion faces the problem of how to induce a standardized exclusion condition. “Cyberball,” a virtual ball game, represents one possibility of inducing social exclusion in a highly standardized manner (Williams et al., 2000). In this paradigm, participants are made to believe that they are playing with three other participants (which in fact are computer generated). During the game the degree of social inclusion (i.e., how often they receive the ball from the other participants) is manipulated: “included” participants receive the ball regularly throughout the game while “excluded” participants receive no further ball after the first throws. Previous research on this paradigm indicates that “excluded” participants not only perceive themselves as being excluded but also suffer from lower self-esteem compared to the included participants (Williams et al., 2000). Furthermore, fMRI studies have shown that the dorsal anterior cingulate cortex, a region also activated while experiencing physical pain, is activated during exclusion (Eisenberger et al., 2003).
In a previous study (Zöller et al., 2010) we analysed the immediate effects of Cyberball exclusion on cortisol secretion and psychological parameters in women. While exclusion increased depression and anger no effects on cortisol were found. In the present study we used the Cyberball paradigm to assess the effects of a social exclusion pre-experience on HPA stress responsiveness to a standard laboratory stressor in men and in women.
Section snippets
Participants and ethics
Participants were healthy students between 18 and 35 years, recruited by advertisement on the University campus and received a monetary compensation (15 €) for participation. Exclusion criteria were acute or chronic infections, acute allergy, diseases of the adrenal gland, regular use of any medication, gravidity, and actual or past mental illness. Detailed flows of participants and final samples according to the CONSORT criteria are displayed in the Supplemental information. The final sample
Results
A CONSORT Flow diagram is provided in the Supplementary material.
Sixty-five subjects (n = 33 m and n = 32 f) came to analysis. Groups did not differ in any of the control variables besides a significant effect with respect to internal locus of control in men (see Supplemental material).
Discussion
We analysed the effect of social exclusion pre-experience on the cortisol response to a subsequent standard stressor. We did not find a main effect of social exclusion on cortisol secretion, instead, a significant gender by Cyberball effect was observed. While Cyberball pre-experience did not significantly affect cortisol responses to public speaking stress in men pre-experience of exclusion was followed by a blunted cortisol response to public speaking in women. Psychological responses to
References (45)
- et al.
Salivary cortisol in response to acute social rejection and acceptance by peers
Biol. Psychol.
(2007) - et al.
Depression and cortisol responses to psychological stress: a meta-analysis
Psychoneuroendocrinology
(2005) - et al.
Acute stress effects on Il-1 β responses to pathogens in a human in vivo model
Brain Behav. Immun.
(2004) - et al.
Gender differences in health: a Canadian study of the psychosocial, structural and behavioral determinants of health
Soc. Sci. Med.
(2004) - et al.
Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women
Psychoneuroendocrinology
(2007) - et al.
Adult attachment and social support interact to reduce psychological but not cortisol responses to stress
J. Psychosom. Res.
(2008) - et al.
Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus–pituitary–adrenal axis
Biol. Psychol.
(2001) - et al.
Abnormal salivary cortisol levels in social phobic patients in response to acute psychological but not physical stress
Biol. Psychiatry
(2001) - et al.
Oxytocin, vasopressin, and human social behaviour
Front. Neuroendocrinol.
(2009) - et al.
Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress
Biol. Psychiatry
(2003)
Salivary cortisol as a biomarker in stress research
Psychoneuroendocrinology
The effects of sex and hormonal status on the physiological response to acute psychosocial stress
Psychoneuroendocrinology
Cortisol and vital exhaustion in relation to significant coronary artery stenosis in middle-aged women with acute coronary syndrome
Psychoneuroendocrinology
Sex differences in stress responses: social rejection versus achievement stress
Biol. Psychiatry
Gender differences in vulnerability to social stress. A Darwinian perspective
Physiol. Behav.
No effect of social exclusion on salivary cortisol secretion in women in a randomized controlled study
Psychoneuroendocrinology
Biopsychosocial responses to social rejection in targets of relational aggression
Biol. Psychol.
Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents
Am. J. Epidemiol.
Das Profile of Mood States (POMS). Mannheim
Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research
Psychol. Bull.
Does rejection hurt? An fMRI study of social exclusion
Science
Fragebogen zur Sozialen Unterstützung (F-SozU)
Cited by (35)
Decreased salivary alpha-amylase reactivity for excluded young women after a speech task
2024, Physiology and BehaviorSocial Determinants of Intrinsic Capacity: A National Cohort Study
2024, American Journal of Preventive MedicineRescue doses of antenatal corticosteroids, children's neurodevelopment, and salivary cortisol after a threatened preterm labor: a 30-month follow-up study
2023, American Journal of Obstetrics and Gynecology MFMVirtual and real-life ostracism and its impact on a subsequent acute stressor
2021, Physiology and BehaviorCitation Excerpt :Furthermore, most studies have focused on acute stress reactions, and only little research exists on the prolonged impact of social exclusion experiences on subsequent stress coping. Among the small number of studies, Weik et al. [23–25] found that a prior ostracism experience is linked to a suppressed cortisol reactivity in excluded individuals during a public speaking task in front of a TV camera. Typically, socio-evaluative stressors like a public speaking scenario are assumed to provoke increased HPA- and SNS-activity [58].
Endocrine and psychological stress response in simulated doctor-patient interactions in medical education
2019, PsychoneuroendocrinologyCitation Excerpt :This is important as exclusion has been found to moderate the stress response (Weik et al., 2010, 2013, 2017).
Association between baseline pro-inflammatory cytokines and brain activation during social exclusion in patients with vulnerability to suicide and depressive disorder
2019, PsychoneuroendocrinologyCitation Excerpt :This allowed excluding a sex effect, but limits the generalization of our results. Indeed, women are more sensitive to social exclusion (Eisenberger et al., 2009; Weik et al., 2010). Third, we did not control the results for smoking status and body mass index.