Project abstract.

Stress-in-Action has a unique approach to modern day stress. Using innovative technological and scientific methods we aim to gain insight into the causes and consequences of daily-life stress, and to provide a path towards more stress-resilient citizens.

 

Urgency

Stress is the ‘buzzword’ of modern life. It impacts all aspects of daily life and most individuals deal with some form of stress on a daily basis. When stress occurs frequently and remains high for sustained periods of time, it can cause mental (e.g. depression, anxiety, burnout) and cardiometabolic (e.g. cardiovascular disease, diabetes, obesity) disease. According to the World Health Organization, these stress-related conditions constitute the largest disease burden and form a major threat to well-being and economic competitiveness. Reducing the impact of stress and stress-related disease is crucial to improve public health and population well-being.

Problem definition

Despite its relevance, our understanding of stress remains very limited, and conceptualizations are heterogeneous. The slew of laboratory studies and animal models dominating current stress concepts have poor ecological and predictive validity. They do not teach us about person-specific patterns of stress responses in the ‘real world’. Static, one-time assessments of stressful events and experiences do not capture the actual daily-life context in which stress arises, let alone the full set of emotional, physiological, cognitive and behavioural stress responses. Consequently, there remains a huge gap in our understanding of what determines stress in our daily life, how we can quantify it, what the temporal dynamics of the various stress responses are, how they are moderated by person-specific characteristics, and how stress responses drive the onset and course of stress-related disease.

Aim and promise

Stress-in-Action capitalizes on the fast advances in technology and big data analytics to move stress research from the lab to daily life. A theoretical framework of daily-life stress will be developed using the novel insights from ambulatory assessments in large, long-running Dutch cohorts and from experimental validation studies. This generates novel, mechanistic understanding of 1) how responses to daily-life stress arise from the temporal, dynamic interplay between context and person-specific factors, 2) how daily-life stress can be reliably measured in a specific individual in real-time, and 3) how and when potential beneficial stress-response mechanisms turn into detrimental effects on mental and cardiometabolic health. This will enable the development of novel monitoring and intervention strategies to track and reduce daily-life stress and its health impact.

Approach

In the first developmental phase, we will use existing daily-life stress data from our studies to establish which contextual and person-specific factors play a key role in daily-life stress, and which aspects of daily-life stress responses should be prioritized for prolonged monitoring and for evaluation of (stress-)interventions. In parallel, starting from our existing arsenal of tools, we will develop methods to quantify daily-life stress context and responses using smartphone-based ecological momentary assessments, accelerometer or other passive sensor-based tracking of behaviours, and physiological monitoring through wearables and non-invasive biomaterial sampling. Human values and user-centred design take centre stage in the development of these new daily-life stress assessment tools. Selection and validation pipelines in our design field labs establish their ethical and legal feasibility, user-acceptance, reliability and validity, and potential application in just-in-time adaptive stress interventions. In the second cohort enrichment phase, an increasingly better set of these tools will be applied to generate the most comprehensive dataset on daily-life stress exposures and multicomponent stress responses to date. We enrich ongoing large-scale epidemiological cohorts with daily-life stress assessments in at least 3000 participants across extended time periods and in multiple waves across years. These daily-life stress assessments are linked to long-term follow-up of health outcomes. For the ‘big data’ generated, improved data analytic strategies are developed combining a dynamic multilevel framework for prolonged and autocorrelated within-subject data with machine learning (ML)-based prediction strategies. In the model validation phase, our unique longitudinal dataset will allow rigorous testing of the growing theoretical framework for daily-life stress and clinical utility of the stress-assessment toolkit. Through iterative experimental validation of theory and tools in ongoing and new interventions, we evaluate their potential to improve stress management and mental and cardiometabolic health.

Consortium

The Netherlands possesses internationally renowned scientific leaders in the fields of ambulatory assessment of stress responses and stress-related diseases and harbours unique, large research infrastructures and a solid tradition of methodological and statistical innovation. The Stress-in-Action consortium combines these strengths in a highly interdisciplinary collaboration that puts Dutch stress research at the forefront of science. Its 25 members (52% female, 52% ≤45 years) from five universities combine expertise from the humanities and social sciences, technical sciences, and biomedical and life sciences. An extensive training and mentoring programme within a focussed consortium ensures that the paradigm shift accomplished by Stress-in-Action is transferred into the next generation.