Interaction Effects of Life Events and Hair Cortisol on Perceived Stress, Anxiety, and Depressive Symptoms Among Chinese Adolescents: Testing the Differential Susceptibility and Diathesis-Stress Models

Abstract

The differential susceptibility model and the diathesis-stress model on the interaction effect between the individuals’ traits and environmental factors will be conducive to understand in depth whether the psychophysiological traits are the risk factors of child development. However, there is no study focusing on the activity of the hypothalamic-pituitary-adrenal (HPA) axis. We examined whether the HPA activity serves as a physiological marker of the differential susceptibility model or the diathesis-stress model by exploring the interactive effect of life events and hair cortisol on perceived stress, anxiety, and depressive symptoms among Chinese adolescents. The participants were 324 students in senior high school. They reported their psychological states with questionnaires in their first semester after a 3-month adaptation period; 2 weeks later, they provided 1-cm hair segments closest to the scalp. We measured hair cortisol concentration as a biomarker of HPA activity using high-performance liquid chromatography–tandem mass spectrometry. There was a significant interaction effect of academic events and hair cortisol on adolescents’ perceived stress, anxiety, and depression symptoms. We also observed a significant interaction between interpersonal events and hair cortisol on adolescents’ anxiety symptoms. Looking at the region of significance, proportion of interaction index, and proportion affected index, we found that adolescents with higher cortisol levels had a tendency to experience higher perceived stress and anxiety symptoms when they had high academic events scores, but lower perceived stress and anxiety symptoms when they had lower academic events scores. By contrast, adolescents with higher cortisol levels had a greater risk of experiencing high depressive symptoms only when they had higher academic events scores. Adolescents with higher cortisol levels also tended to have lower anxiety symptoms when they had higher interpersonal events scores, but greater anxiety symptoms when they had lower interpersonal events scores. These results suggested that HPA activity might serve as a biomarker of the differential susceptibility model for perceived stress and anxiety symptoms, while for depressive symptoms, it might serve as a marker of the diathesis-stress model.

Stress Reactivity Influences the Relationship between Emotional Labor Strategies and Job Burnouts among Chinese Hospital Nurses

“…Nurses with low stress reactivity not only showed higher professional inefficacy than those with high stress reactivity under high job stress due to low expression of naturally felt emotions but also showed lower professional inefficacy under low job stress due to high expression of naturally felt emotions. These results together with the above-mentioned previous findings on the interaction between stress reactivity and stressful environmental factors in predicting adolescents' psychological adaptations [ 23 , 37 , 38 , 40 ] supported the differential susceptibility model. It implied that stress reactivity might be the plasticity factor for Chinese nurses' emotional exhaustion, depersonalization, and professional inefficacy in MBI burnouts.…”

“…In the present study, nurses with higher stress reactivity are also more susceptible to the context related to job demands and are more easily affected by job stress, such as stressful emotional labor demands in work environments. This explanation obtains the support from previous findings demonstrating that individuals with high stress reactivity are more likely to show more maladaptive outcomes (e.g., lower prosocial behaviors and more anxiety symptoms) under adverse environments but more adaptive outcomes under supportive environments [ 23 , 37 , 38 , 40 ]. However, the explanation is held for associations of surface acting and deep acting with emotional exhaustion and depersonalization, but not for the association between the expression of naturally felt emotions and professional inefficacy.…”

“…This theoretical hypothesis on stress reactivity possibly obtains additional support from recent empirical studies finding that stress reactivity can moderate the relationship between environmental factors and psychological adaptations [ 23 , 37 – 40 ]. It found that compared to those with lower cortisol levels (i.e., lower stress reactivity), adolescents with higher cortisol levels (i.e., higher stress reactivity) not only showed less prosocial behaviors and worse execute functions under more family adversities [ 23 , 37 ] and more internalizing problems under more stressful events [ 38 , 40 ] but also showed more prosocial behaviors and better execute functions under less family adversities and less internalizing problems under less stressful events, which was consistent with the differential susceptibility model recently developed by Belsky and collaborators [ 41 , 42 ]. These results implied that high stress reactivity is a plasticity factor (i.e., it is not only a risk factor under adverse environments but also a promoting factor under supportive environments) or that low stress reactivity is a protective factor under adverse environments.…”

“…The strengthening effect of high stress reactivity on the association of emotional labor and burnout is possibly attributed to the fact that individuals with higher stress reactivity are more sensitive to the context [ 5 ] and are more frequently in the allostasis upon the occurrence of stress [ 56 ], thereby being in a relatively higher stress-related arousal state. This might make them more easily influenced by external factors, for example, more easily suffer from adverse environments, thereby undergoing more stress experiences [ 40 , 57 ]. In the present study, nurses with higher stress reactivity are also more susceptible to the context related to job demands and are more easily affected by job stress, such as stressful emotional labor demands in work environments.…”

The Role of Personal Biological Resource in the Job Demands-Control-Support Model: Evidence From Stress Reactivity

“…Previous studies had demonstrated that stress reactivity could moderate the relationship between environmental factors and adolescents' psychological adaptations (Wiel et al, 2004;Obradovi et al, 2010Obradovi et al, , 2015Owens et al, 2018;Xu et al, 2019) and the relationship between emotional labor and job burnouts (Deng et al, 2020). Thus, we hypothesized that hair cortisol levels (or stress reactivity) could moderate the relationship between environmental factors and work-related outcomes among Chinese nurses.…”