The behavioural, cognitive and neural correlates of deficient biological reactions to acute psychological stress

Blunted or deficient cardiovascular and cortisol reactions to acute psychological stress are associated with a range of adverse behavioural and health outcomes: depression, obesity, bulimia, substance and non-substance addictions. What links these diverse outcomes is that they all reflect suboptimal functioning in the face of challenge of the fronto-limbic systems in the brain that regulate motivated behaviour. Available brain imaging data support this. Deficient stress reactivity is also associated with other manifestations of impaired motivation, including lower cognitive ability and poorer performance on motivation-dependent tests of lung function. In addition, deficient stress responding is typical of stable behavioural characteristics, such as neuroticism, impulsivity, and lack of perseverance, and is common in various behavioural disorders. We amend the reactivity hypothesis to include deficient stress reactivity, as well as sketching out research priorities for the future.