This meta-analysis reviews 208 laboratory studies of acute psychological stressors and tests a theoretical model delineating conditions capable of eliciting cortisol responses. Psychological stressors increased cortisol levels; however, effects varied widely across tasks. Consistent with the theoretical model, motivated performance tasks elicited cortisol responses if they were uncontrollable or characterized by social-evaluative threat (task performance could be negatively judged by others), when methodological factors and other stressor characteristics were controlled for. Tasks containing both uncontrollable and social-evaluative elements were associated with the largest cortisol and adrenocorticotropin hormone changes and the longest times to recovery. These findings are consistent with the animal literature on the physiological effects of uncontrollable social threat and contradict the belief that cortisol is responsive to all types of stressors.

Our program of research focuses on shame as a key emotional response to "social self" threats (i.e., social evaluation or rejection). We propose that shame may orchestrate specific patterns of psychobiological changes under these conditions. A series of studies demonstrates that acute threats to the social self increase proinflammatory cytokine activity and cortisol and that these changes occur in concert with shame. Chronic social self threats and persistent experience of shame-related cognitive and affective states predict disease-relevant immunological and health outcomes in HIV. Across our laboratory and longitudinal studies, general or composite affective states (e.g., distress) are unrelated to these physiological and health outcomes. These findings support a stressor- and emotional response-specificity model for psychobiological and health research.

More Americans try to change their health behaviors through self-help than through all other forms of professionally designed programs. Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health, yet little is known about patterns of support group participation in health care. What kinds of illness experiences prompt patients to seek each other's company? In an effort to observe social comparison processes with real-world relevance, support group participation was measured for 20 disease categories in 4 metropolitan areas (New York, Chicago, Los Angeles, and Dallas) and on 2 on-line forums. Support seeking was highest for diseases viewed as stigmatizing (e.g., AIDS, alcoholism, breast and prostate cancer) and was lowest for less embarrassing but equally devastating disorders, such as heart disease. The authors discuss implications for social comparison theory and its applications in health care.

These data suggest that inducing self-related emotions can cause changes in inflammatory products, and that shame may have specific immunological correlates.

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These findings suggest that the mere social presence of others is not driving the changes in cortisol observed under social-evaluative threat; instead, explicit negative social evaluation may be responsible for increases in this health-relevant physiological parameter.

This study experimentally tested whether a stressor characterized by social-evaluative threat (SET), a context in which the self can be judged negatively by others, would elicit increases in proinflammatory cytokine activity and alter the regulation of this response. This hypothesis was derived in part from research on immunological responses to social threat in nonhuman animals. Healthy female participants were assigned to perform a speech and a math task in the presence or absence of an evaluative audience (SET or non-SET, respectively). As hypothesized, stimulated production of the proinflammatory cytokine tumor necrosis factor-α (TNF-α) increased from baseline to poststressor in the SET condition, but was unchanged in the non-SET condition. Further, the increases in TNF-α production correlated with participants' cognitive appraisals of being evaluated. Additionally, the ability of glucocorticoids to shut down the inflammatory response was decreased in the SET condition. These findings underscore the importance of social evaluation as a threat capable of eliciting proinflammatory cytokine activity and altering its regulation.Preserving a positive social self-maintaining one's social esteem, status, and acceptanceis central to well-being and survival (Baumeister & Leary, 1995). Therefore, conditions that threaten the social self may elicit psychological, physiological, and behavioral changes to coordinate an appropriate response to the situation (e.g., Dickerson, Gruenewald, & Kemeny, 2004). Acute social self threat, or social-evaluative threat (SET), occurs when an aspect of the self could be negatively judged by others . Previous work has demonstrated that SET triggers specific psychological and physiological changes. For example, social-evaluative stressors (e.g., delivering a speech in front of an audience) are more likely to elicit production of the hormone cortisol than are otherwiseequivalent stressors without social evaluation Dickerson, Mycek, & Zaldivar, 2008;Gruenewald, Kemeny, Aziz, & Fahey, 2004). Additionally, studies have shown that increases in cortisol correlate with the self-evaluative cognitions and emotions experienced under SET, demonstrating patterned psychobiological changes (Dickerson et al., 2008;Gruenewald et al., 2004 Other physiological responses may also be elicited by SET. Evidence from nonhumananimal models demonstrates that social threats can increase inflammatory markers; further, there may be specificity with regard to the nature of the threat and the immunological responses observed. Proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), are chemical communication molecules that orchestrate the inflammatory immune response, which is integral for fighting infection and healing from injury. Animals experiencing social threats, such as social subordination or defeat, show greater stimulated production of proinflammatory cytokines and increases in other inflammatory markers compared with animals exposed to either other types of stressors (e.g., physical res...

list of figures and tables to the continuous flow hypothesis of affect-laden information processing. Journal of Personality and Social Psychology, 54, 592-604. Adapted with permission.) 64 3.5 EMG activity recorded from the mylohyoid muscle region while typically-developing children and children with autism watched an experimenter grasp a piece of food to eat or a piece of paper to place in a container.