This review discusses selected neurobiologic and genetic factors—including noradrenergic and hypothalamic-pituitary-adrenal axis markers, oxytocin pathways, and serotonin transporter and brain-derived neurotrophic factor gene polymorphisms—in the context of resilience to stress, with an emphasis on social support. Social support’s impact on medical and psychiatric health outcomes is reviewed, and putative mediators are discussed. The reviewed literature indicates that social support is exceptionally important to maintaining good physical and psychological health in the presence of genetic, developmental, and other environmental risks. Future studies should continue to explore the neurobiologic factors associated with social support’s contribution to stress resilience.
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References and Recommended Reading
Southwick SM, Ozbay F, Charney DS, McEwen BS: Adaptation to stress and psychobiological mechanisms of resilience. In Biobehavioral Resilience to Stress. Edited by Lukey BJ, Tepe V. Boca Raton, FL: Taylor & Francis; 2008:91–116.
Charney DS: Psychobiological mechanism of resilience and vulnerability: implications for successful adaptation to extreme stress. Am J Psychiatry 2004, 161:195–216.
Southwick SM, Bremner JD, Rasmusson A, et al.: Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder. Biol Psychiatry 1999, 46:1192–1204.
Southwick SM, Vythilingam M, Charney DS: The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annu Rev Clin Psychol 2005, 1:255–291.
Morgan CA III, Rasmusson AM, Wang S, et al.: Neuropeptide-Y, cortisol, and subjective distress in humans exposed to acute stress: replication and extension of previous report. Biol Psychiatry 2002, 52:136–142.
Heilig M, Koob GF, Ekman R, et al.: Corticotropin-releasing factor and neuropeptide Y: role in emotional integration. Trends Neurosci 1994, 17:80–85.
Husum H, Mathe AA: Early life stress changes concentrations of neuropeptide Y and corticotropin-releasing hormone in adult rat brain. Lithium treatment modifies these changes. Neuropsychopharmacology 2002, 27:756–764.
Morgan CA 3rd, Wang S, Southwick SM, et al.: Plasma neuropeptide-Y concentrations in humans exposed to military survival training. Biol Psychiatry 2000, 47:902–909.
Rasmusson AM, Hauger RL, Morgan CA, et al.: Low baseline and yohimbine-stimulated plasma neuropeptide Y (NPY) levels in combat-related PTSD. Biol Psychiatry 2000, 47:526–539.
Bing O, Moller C, Engel JA, et al.: Anxiolytic-like action of centrally administered galanin. Neurosci Lett 1993, 164:17–20.
Moller C, Sommer W, Thorsell A, et al.: Anxiogenic-like action of galanin after intra-amygdala administration in the rat. Neuropsychopharmacology 1999, 21:507–512.
Yehuda R: Current status of cortisol findings in posttraumatic stress disorder. Psychiatr Clin North Am 2002, 25:341–368.
Bremner JD: Does stress damage the brain? Biol Psychiatry 1999, 45:797–805.
Kimonides VG, Khatibi NH, Svendsen CN, et al.: Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS) protect hippocampal neurons against excitatory amino acid-induced neurotoxicity. Proc Natl Acad Sci U S A 1998, 95:1852–1857.
Bale TL, Contarino A, Smith GW, et al.: Mice deficient for corticotropin-releasing hormone receptor-2 display anxiety-like behaviour and are hypersensitive to stress. Nat Genet 2000, 24:410–414.
Bale TL, Picetti R, Contarino A, et al.: Mice deficient for both corticotropin-releasing factor receptor 1 (CRFR1) and CRFR2 have an impaired stress response and display sexually dichotomous anxiety-like behavior. J Neurosci 2002, 22:193–199.
Friedman MJ: Future pharmacotherapy for post-traumatic stress disorder: prevention and treatment. Psychiatr Clin North Am 2002, 25:427–441.
Komesaroff PA, Sudhir K, Esler MD: Effects of estrogen on stress responses in women. J Clin Endocrinol Metab 1999, 84:4292–4293.
Masten AS: Ordinary magic. Resilience processes in development. Am Psychol 2001, 56:227–238.
LeDoux JE, Gorman JM: A call to action: overcoming anxiety through active coping. Am J Psychiatry 2001, 158:1953–1955.
Caspi A, Sugden K, Moffitt TE, et al.: Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 2003, 301:386–389.
Grabe HJ, Lange M, Wolff B, et al.: Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden. Mol Psychiatry 2005, 10:220–224.
Kaufman J, Yang BZ, Douglas-Palumberi H, et al.: Brain-derived neurotrophic factor-5-HTTLPR gene interactions and environmental modifiers of depression in children. Biol Psychiatry 2006, 59:673–680.
Lin N, Simeone RS, Ensel WM, et al.: Social support, stressful life events, and illness: a model and an empirical test. J Health Soc Behav 1979, 20:108–119.
Shively CA, Clarkson TB, Kaplan JR: Social deprivation and coronary artery atherosclerosis in female cynomolgus monkeys. Atherosclerosis 1989, 77:69–76.
Stanton ME, Patterson JM, Levine S: Social influences on conditioned cortisol secretion in the squirrel monkey. Psychoneuroendocrinology 1985, 10:125–134.
Sapolsky RM, Alberts SC, Altmann J: Hypercortisolism associated with social subordinance or social isolation among wild baboons. Arch Gen Psychiatry 1997, 54:1137–1143.
Ratcliffe HL, Luginbuhl H, Schnarr WR, et al.: Coronary arteriosclerosis in swine: evidence of a relation to behavior. J Comp Physiol Psychol 1969, 68:385–392.
Sapolsky RM: Why Zebras Don’t Get Ulcers, edn 3. New York: Times Books; 2004.
Insel TR, Shapiro LE: Oxytocin receptor distribution reflects social organization in monogamous and polygamous voles. Proc Natl Acad Sci U S A 1992, 89:5981–5985.
Winslow JT, Noble PL, Lyons CK, et al.: Rearing effects on cerebrospinal fluid oxytocin concentration and social buffering in rhesus monkeys. Neuropsychopharmacology 2003, 28:910–918.
Heinrichs M, Baumgartner T, Kirschbaum C, et al.: Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress. Biol Psychiatry 2003, 54:1389–1398.
Coan JA, Schaefer HS, Davidson RJ: Lending a hand: social regulation of the neural response to threat. Psychol Sci 2006, 17:1032–1039.
Bartz JA, Hollander E: The neuroscience of affiliation: forging links between basic and clinical research on neuropeptides and social behavior. Horm Behav 2006, 50:518–528.
Elsenbruch S, Benson S, Rucke M, et al.: Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome. Hum Reprod 2007, 22:869–877.
Slykerman RF, Thompson JM, Pryor JE, et al.: Maternal stress, social support and preschool children’s intelligence. Early Hum Dev 2005, 81:815–821.
Herwig JE, Wirtz M, Bengel J: Depression, partnership, social support, and parenting: interaction of maternal factors with behavioral problems of the child. J Affect Disord 2004, 80:199–208.
Bishop SJ, Leadbeater BJ: Maternal social support patterns and child maltreatment: comparison of maltreating and nonmaltreating mothers. Am J Orthopsychiatry 1999, 69:172–181.
Jacobson SW, Frye KF: Effect of maternal social support on attachment: experimental evidence. Child Dev 1991, 62:572–582.
Ladd CO, Thrivikraman KV, Huot RL, et al.: Differential neuroendocrine responses to chronic variable stress in adult Long Evans rats exposed to handling-maternal separation as neonates. Psychoneuroendocrinology 2005, 30:520–533.
Kraemer GW, Ebert MH, Schmidt DE, et al.: A longitudinal study of the effect of different social rearing conditions on cerebrospinal fluid norepinephrine and biogenic amine metabolites in rhesus monkeys. Neuropsychopharmacology 1989, 2:175–189.
Caldji C, Tannenbaum B, Sharma S, et al.: Maternal care during infancy regulates the development of neural systems mediating the expression of fearfulness in the rat. Proc Natl Acad Sci U S A 1998, 95:5335–5340.
Sanchez MM, Hearn EF, Do D, et al.: Differential rearing affects corpus callosum size and cognitive function of rhesus monkeys. Brain Res 1998, 812:38–49.
Kuhn CM, Schanberg SM: Responses to maternal separation: mechanisms and mediators. Int J Dev Neurosci 1998, 16:261–270.
Kaufman J, Plotsky PM, Nemeroff CB, et al.: Effects of early adverse experiences on brain structure and function: clinical implications. Biol Psychiatry 2000, 48:778–790.
Parker KJ, Buckmaster CL, Schatzberg AF, et al.: Prospective investigation of stress inoculation in young monkeys. Arch Gen Psychiatry 2004, 61:933–941.
Parker KJ, Buckmaster CL, Justus KR, et al.: Mild early life stress enhances prefrontal-dependent response inhibition in monkeys. Biol Psychiatry 2005, 57:848–855.
Boyce WT, Chesterman E: Life events, social support, and cardiovascular reactivity in adolescence. J Dev Behav Pediatr 1990, 11:105–111.
Stacey M: Hospitals, Children and Their Families: The Report of a Pilot Study. London: Routledge & K. Paul; 1970.
Kaufman J, Yang BZ, Douglas-Palumberi H, et al.: Social supports and serotonin transporter gene moderate depression in maltreated children. Proc Natl Acad Sci U S A 2004, 101:17316–17321.
Ozbay F, Johnson DC, Dimoulas E, et al.: Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry 2007, 4:35.
Berkman LF: The role of social relations in health promotion. Psychosom Med 1995, 57:245–254.
Mitchinson AR, Kim HM, Geisser M, et al.: Social connectedness and patient recovery after major operations. J Am Coll Surg 2008, 206:292–300.
Mohr DC, Classen C, Barrera M Jr: The relationship between social support, depression and treatment for depression in people with multiple sclerosis. Psychol Med 2004, 34:533–541.
Manne SL, Pape SJ, Taylor KL, et al.: Spouse support, coping, and mood among individuals with cancer. Ann Behav Med 1999, 21:111–121.
Revenson TA, Schiaffino KM, Majerovitz SD, et al.: Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients. Soc Sci Med 1991, 33:807–813.
Travis LA, Lyness JM, Shields CG, et al.: Social support, depression, and functional disability in older adult primarycare patients. Am J Geriatr Psychiatry 2004, 12:265–271.
Sayal K, Checkley S, Rees M, et al.: Effects of social support during weekend leave on cortisol and depression ratings: a pilot study. J Affect Disord 2002, 71:153–157.
Boscarino JA: Post-traumatic stress and associated disorders among Vietnam veterans: the significance of combat exposure and social support. J Trauma Stress 1995, 8:317–336.
Johnson DR, Lubin H, Rosenheck R, et al.: The impact of the homecoming reception on the development of posttraumatic stress disorder. The West Haven Homecoming Stress Scale (WHHSS). J Trauma Stress 1997, 10:259–277.
Paykel ES: Life events, social support and depression. Acta Psychiatr Scand Suppl 1994, 377:50–58.
Oxman TE, Hull JG: Social support and treatment response in older depressed primary care patients. J Gerontol B Psychol Sci Soc Sci 2001, 56:P35–P45.
Rozanski A, Blumenthal JA, Kaplan J: Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999, 99:2192–2217.
Fontana AF, Kerns RD, Rosenberg RL, et al.: Support, stress, and recovery from coronary heart disease: a longitudinal causal model. Health Psychol 1989, 8:175–193.
Holahan CJ, Moos RH, Holahan CK, et al.: Social support, coping, and depressive symptoms in a late-middle-aged sample of patients reporting cardiac illness. Health Psychol 1995, 14:152–163.
Stice E, Ragan J, Randall P: Prospective relations between social support and depression: differential direction of effects for parent and peer support? J Abnorm Psychol 2004, 113:155–159.
Lynch TR, Mendelson T, Robins CJ, et al.: Perceived social support among depressed elderly, middle-aged, and young-adult samples: cross-sectional and longitudinal analyses. J Affect Disord 1999, 55:159–170.
Hyman SM, Gold SN, Cott MA: Forms of social support that moderate PTSD in childhood sexual abuse survivors. J Fam Violence 2003, 18:295–300.
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Ozbay, F., Fitterling, H., Charney, D. et al. Social support and resilience to stress across the life span: A neurobiologic framework. Curr Psychiatry Rep 10, 304 (2008). https://doi.org/10.1007/s11920-008-0049-7
- Social Support
- Active Coping
- Biol Psychiatry