Skip to main content

ETHNOS_APP

Home • Search • Journals • List 0

Stress Measurement in Primary Care

Conceptual Issues, Barriers, Resources, and Recommendations for Study

Bibliographic Data

ID19301593
AuthorsLawson R Wulsin (0000-0002-2809-3507, Irvine Valley College, corresponding author), Sara J Sagui‐Henson (0000-0001-5410-2684, Irvine Valley College), Sara J Sagui-Henson, Lydia G Roos (0000-0003-4688-5687, Irvine Valley College), Diana Wang (0000-0002-5474-7287, Irvine Valley College), Brooke N Jenkins (0000-0001-9829-4550, Irvine Valley College), Brooke Jenkins, Beth E Cohen (0000-0002-6166-0761, Irvine Valley College), Amit Shah (0000-0001-9099-9687, Irvine Valley College), Amit J Shah, George M Slavich (0000-0001-5710-3818, Irvine Valley College)
Year2022
Volume84
Issue3
Pages267-275
Publication date2022-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000001051
PMID35067657
OpenAlexW4206991777
LanguageEN
Citations received1
References cited85

OBJECTIVE: Exposure to stressors in daily life and dysregulated stress responses are associated with increased risk for a variety of chronic mental and physical health problems, including anxiety disorders, depression, asthma, heart disease, certain cancers, and autoimmune and neurodegenerative disorders. Despite this fact, stress exposure and responses are rarely assessed in the primary care setting and infrequently targeted for disease prevention or treatment. METHOD: In this narrative review, we describe the primary reasons for this striking disjoint between the centrality of stress for promoting disease and how rarely it is assessed by summarizing the main conceptual, measurement, practical, and reimbursement issues that have made stress difficult to routinely measure in primary care. The following issues will be reviewed: a) assessment of stress in primary care, b) biobehavioral pathways linking stress and illness, c) the value of stress measurements for improving outcomes in primary care, d) barriers to measuring and managing stress, and e) key research questions relevant to stress assessment and intervention in primary care. RESULTS: On the basis of our synthesis, we suggest several approaches that can be pursued to advance this work, including feasibility and acceptability studies, cost-benefit studies, and clinical improvement studies. CONCLUSIONS: Although stress is recognized as a key contributor to chronic disease risk and mortality, additional research is needed to determine how and when instruments for assessing life stress might be useful in the primary care setting, and how stress-related data could be integrated into disease prevention and treatment strategies to reduce chronic disease burden and improve human health and well-being.

Anxiety · Disease · Health care · Mental health · Pathology · Psychiatry · Reimbursement · Stressor · Cardiac Health and Mental Health · Clinical Psychology · Healthcare professionals’ stress and burnout · Medicine · Psychology · Stress Responses and Cortisol

  • Machine-learning detection of stress severity expressed on a continuous scale using acoustic, verbal, visual, and physiological data

    Open Access•Marketa Ciharova, Khadicha Amarti et al.•Frontiers in Psychiatry•2025

  • Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

    Aram V Chobanian, George L Bakris et al.•Hypertension•2003

  • Screening for Depression in Adults

    Albert L Siu, and the US Preventive Services Task Force et al.•JAMA•2016

  • Psychological Stress and Disease

    Sheldon Cohen, Denise Janicki-Deverts et al.•JAMA•2007

  • European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)

    Authors/Task Force Members, Joep Perk et al.•European Heart Journal•2012

  • Modern Approaches to Conceptualizing and Measuring Human Life Stress

    Scott M Monroe•Annual Review of Clinical…•2008

  • Separate and cumulative effects of adverse childhood experiences in predicting adult health and health care utilization

    Open Access•Mariette Chartier, Mariette J Chartier et al.•Child Abuse & Neglect•2010

  • Claude Bernard and the heart–brain connection

    Open Access•Julian F Thayer, Richard D Lane•Neuroscience & Biobehavioral…•2009

  • Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk

    Open Access•Sheldon Cohen, Denise Janicki-Deverts et al.•Proceedings of the National…•2012

  • The role of vagal function in the risk for cardiovascular disease and mortality

    Open Access•Julian F Thayer, Richard D Lane•Biological Psychology•2007

  • More than a feeling

    Open Access•Elissa S Epel, Alexandra D Crosswell et al.•Frontiers in Neuroendocrinology•2018

  • Resilience in the Context of Chronic Stress and Health in Adults

    Open Access•Christine Dunkel Schetter, Christyn Dolbier et al.•Social and Personality Psychology…•2011

  • The Emerging Field of Human Social Genomics

    Open Access•George M Slavich, Steven W Cole•Clinical Psychological Science•2013

  • Child abuse

    Open Access•Donna Della Femina, Catherine A Yeager et al.•Child Abuse & Neglect•1990

  • Mindfulness-based stress reduction and health benefits

    Open Access•Paul Grossman, Ludger Niemann et al.•Journal of Psychosomatic Research•2004

  • Job strain as a risk factor for coronary heart disease

    Open Access•Mika Kivimäki, Solja T Nyberg et al.•The Lancet•2012

  • Life Expectancy and Mortality Rates in the United States, 1959-2017

    Steven H Woolf, Heidi Schoomaker•JAMA•2019

  • Association of Psychosocial Risk Factors With Risk of Acute Myocardial Infarction in 11 119 Cases and 13 648 Controls From 52 Countries (The Interheart Study)

    Open Access•Annika Rosengren, Steven Hawken et al.•The Lancet•2004

  • Effects of stress on the development and progression of cardiovascular disease

    Open Access•Mika Kivimäki, Andrew Steptoe•Nature Reviews Cardiology•2018

  • Improving diabetes self-management through acceptance, mindfulness, and values

    Jennifer Gregg, Jennifer A Gregg et al.•Journal of Consulting and…•2007

  • Self-management approaches for people with chronic conditions

    Open Access•Julie Barlow, Josep Maria Nadal et al.•Patient Education and Counseling•2002

  • Neurobiological and Systemic Effects of Chronic Stress

    Open Access•Bruce S Mcewen•Chronic Stress•2017

  • Chronic inflammation in the etiology of disease across the life span

    Open Access•David Furman, Judith Campisi et al.•Nature Medicine•2019

  • Stress and Cardiovascular Disease

    Andrew Steptoe, Mika Kivimäki•Annual Review of Public Health•2013

  • Collaborative Care for Patients with Depression and Chronic Illnesses

    Wayne J Katon, Wayne Katon et al.•New England Journal of Medicine•2010

  • Protective and Damaging Effects of Stress Mediators

    Bruce S Mcewen, Jeffrey S Flier et al.•New England Journal of Medicine•1998

  • Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults

    Open Access•Vincent J Felitti, Robert F Anda et al.•American Journal of Preventive…•1998

  • Stress, Adaptation, and Disease

    Open Access•Bruce S Mcewen•Annals of the New York Academy of…•1998

  • Race and Resting-State Heart Rate Variability in Brazilian Civil Servants and the Mediating Effects of Discrimination

    Andrew H Kemp, Julian Koenig et al.•Psychosomatic Medicine•2016

  • Assessing Lifetime Stress Exposure Using the Stress and Adversity Inventory for Adults (Adult STRAIN)

    Open Access•George M Slavich, Grant S Shields•Psychosomatic Medicine•2018

  • Relationships Matter

    Timothy W Smith•Psychosomatic Medicine•2019

  • Chronic and Acute Psychological Risk Factors for Clinical Manifestations of Coronary Artery Disease

    Willem Johan Kop, Mohammad Iqbal Hossain et al.•Psychosomatic Medicine•1999

  • Unpacking the impact of adverse childhood experiences on adult mental health

    Open Access•Melissa T Merrick, Katie A Ports et al.•Child Abuse & Neglect•2017

Unique citing works1
Citations per year1
Citation span2025 - 2025 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 1

Tools

Open DOIOpen Access
Ethnos_APP • Open Source Project • MIT License • Frontend v2.0.0 • Privacy and Cookies • API Documentation: api.ethnos.app/docs • API Source Code: GitHub • DOI: 10.5281/zenodo.17049435 • Frontend Source Code: GitHub • DOI: 10.5281/zenodo.17050053 • cruz.rio.br • Expectantes Misericordiae