Why stress is more than a psychological experience—and how biological regulation, personal interpretation, social relationships, and environmental conditions interact to shape health, coping, and resilience.
Stress is often described as something we need to manage.
We are encouraged to relax, practice mindfulness, exercise regularly, improve our sleep, and develop healthier coping strategies. These recommendations can be valuable. Yet for many individuals, they overlook a fundamental question:
What actually creates the experience of stress, and why do similar circumstances affect different people in profoundly different ways?
Consider two individuals facing comparable responsibilities at work.
One experiences the situation as a manageable challenge. They feel prepared, supported, and capable of responding effectively.
The other experiences the same responsibilities as overwhelming. Their sleep deteriorates, concentration declines, emotional reactivity increases, and they begin withdrawing from activities they previously enjoyed.
The external demands may appear similar, but the individuals' internal states, available resources, previous experiences, relationships, and environments may be considerably different.
This distinction reveals why stress cannot be adequately explained through the presence of external demands alone.
Stress emerges through complex interactions among biological, psychological, and social processes—and these relationships evolve over time.
The biopsychosocial model of stress provides a framework for understanding these interactions.
Rather than attributing stress exclusively to psychological weakness, environmental hardship, or hormonal dysfunction, the model recognizes that these dimensions continuously influence one another.
Research in neuroscience, psychophysiology, systems biology, psychology, and social epidemiology increasingly supports this integrated perspective.
A 2018 paper by Bennett, Rohleder, and Sturmberg, Biopsychosocial Approach to Understanding Resilience: Stress Habituation and Where to Intervene, examined how physiological responsiveness, emotion regulation, coping strategies, social resources, and environmental conditions contribute to resilience.
A 2021 study in BMC Medicine extended this understanding by examining how adverse socioeconomic conditions can initiate reinforcing feedback loops that perpetuate chronic stress.
More recently, a 2025 Nature Communications study demonstrated that patterns of stress appraisal can predict subsequent psychological resilience, reinforcing the importance of how individuals interpret and respond to challenges.
Together, these findings suggest that effective stress management should involve more than reducing stress symptoms.
It should help individuals recognize the interacting causes and consequences of stress, strengthen adaptive capacities, and address the conditions that make sustained recovery possible.
1. What Is the Biopsychosocial Model of Stress?
The biopsychosocial model is an approach to understanding health that considers biological, psychological, and social influences as interacting components rather than independent causes.
Applied to stress, this framework recognizes that a stress response involves multiple levels of organization.
The biological dimension includes nervous system activity, endocrine regulation, immune signaling, sleep, energy metabolism, and other physiological processes.
The psychological dimension includes emotional responses, cognitive appraisal, beliefs, perceived control, coping strategies, previous experiences, and expectations.
The social dimension includes relationships, family circumstances, work demands, cultural norms, financial stability, community resources, and access to healthcare.
These dimensions are not isolated.
For example, inadequate sleep can increase emotional reactivity and impair attention. Heightened emotional reactivity may intensify interpersonal conflict. Persistent conflict may then disrupt sleep and reinforce physiological arousal.
Similarly, supportive relationships may improve perceived coping resources, encourage health-supporting behaviors, and reduce the burden of difficult circumstances.
The essential insight is that stress emerges through interactions.
Consequently, understanding stress requires examining both the individual and the circumstances in which that individual lives.
Extending the Model: An Ecobiopsychosocial Perspective
Contemporary research increasingly emphasizes that biological, psychological, and social systems are embedded within broader ecological environments.
These include the physical environment, built spaces, neighborhood conditions, environmental exposures, access to nature, and sociocultural settings.
In 2023, Gómez-Carrillo and Kirmayer published A Cultural-Ecosocial Systems View for Psychiatry, arguing that human experiences cannot be adequately understood without considering the larger systems in which individuals participate.
Their framework emphasizes that biological processes, psychological experiences, cultural meaning, and environmental conditions influence one another.
For stress management, this provides an important extension.
A person's physiological stress response may be influenced by sleep and nutritional status, but also by housing insecurity, occupational demands, unsafe environments, discrimination, or limited social support.
No single variable explains the entire experience.
2. Stress Begins With an Interaction Between Demands and Resources
A stressor is an event, circumstance, or condition that creates demands on an individual.
Stressors may be physical, psychological, interpersonal, environmental, or physiological.
Examples include illness, intense exercise, work deadlines, financial concerns, interpersonal conflict, inadequate sleep, or exposure to threatening conditions.
However, the presence of a stressor does not automatically determine the intensity or consequences of the stress response.
Psychological research has long emphasized the importance of cognitive appraisal.
Appraisal refers to the process through which individuals interpret the significance of a situation and evaluate their capacity to respond.
Primary Appraisal: What Does This Situation Mean?
Primary appraisal concerns whether a situation is experienced as threatening, challenging, harmful, or relatively unimportant.
For example, a difficult professional assignment might be interpreted as an opportunity for growth or as a threat to financial security and professional identity.
Both interpretations can involve physiological activation, but they may produce different emotional and behavioral responses.
Secondary Appraisal: Do I Have the Resources to Respond?
Secondary appraisal concerns perceived coping resources.
Individuals evaluate whether they possess sufficient knowledge, skills, time, emotional capacity, financial resources, social support, or other means of responding.
When demands are perceived as exceeding available resources, stress may intensify.
Importantly, these perceptions can change.
Learning new skills, receiving social support, improving physical health, or gaining greater control over circumstances may alter how subsequent stressors are interpreted.
The experience of stress is shaped not only by what happens to us, but also by what those events mean to us and the resources we believe are available.
However, appraisal is not the same as freely choosing an emotional reaction. Many responses occur rapidly and automatically, and some threats are objectively dangerous or unavoidable.
Improving appraisal should never require denying legitimate hardship.
3. The Biological Stress Response: How the Body Mobilizes Resources
When the brain detects a challenge or potential threat, multiple physiological systems can respond.
Two important components are the autonomic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis.
The Autonomic Nervous System
The autonomic nervous system helps regulate cardiovascular, respiratory, digestive, and other involuntary physiological processes.
During many acute stress responses, sympathetic activity increases.
This can contribute to changes in heart rate, vascular tone, respiration, and the mobilization of energy substrates.
These responses prepare the body to meet immediate demands.
However, autonomic regulation is more complex than a simple switch between sympathetic activation and parasympathetic relaxation.
Both divisions participate in dynamic physiological regulation, and their activity varies across organs and circumstances.
The HPA Axis
The HPA axis coordinates important endocrine responses to stress.
Signals from the hypothalamus stimulate the pituitary gland, which influences adrenal cortisol secretion.
Cortisol helps regulate metabolic activity, immune signaling, and other processes involved in responding to physiological demands.
Its secretion follows a circadian rhythm and responds to numerous factors beyond psychological stress.
Therefore, a single cortisol measurement cannot reliably establish whether an individual experiences excessive chronic stress.
Likewise, fatigue does not automatically indicate cortisol deficiency or a condition sometimes marketed as adrenal fatigue.
Immune and Metabolic Responses
Stress-related signaling also interacts with inflammatory and metabolic pathways.
Acute responses may help support adaptation, but repeated or prolonged activation can contribute to dysregulation in susceptible individuals.
The effects depend on stressor characteristics, timing, duration, existing health conditions, and other biological and environmental factors.
These relationships demonstrate why stress can influence physical health.
However, they do not justify treating stress as the sole explanation for autoimmune disease, cancer, neurological conditions, or other complex illnesses.
4. Acute Stress Is Not Necessarily Harmful
Stress is frequently portrayed as something inherently negative.
Yet the ability to respond to challenges is essential for survival, learning, and adaptation.
Physical exercise provides a useful example.
An appropriately prescribed training session temporarily increases metabolic demand and activates physiological stress-response pathways.
When the stimulus is matched to the individual's capacity and followed by adequate recovery, adaptation may occur.
Psychological challenges can also provide opportunities for learning, mastery, and increased confidence.
The important distinction is not simply whether stress occurs.
It is whether the individual can respond effectively, recover appropriately, and maintain functioning over time.
A challenge that is manageable under one set of circumstances may become overwhelming when sleep is inadequate, resources are limited, or additional demands accumulate.
This helps explain why stress tolerance is not a fixed characteristic.
It changes according to the condition of the person and the surrounding environment.
5. Chronic Stress and Allostatic Load
The body maintains stability through continuous physiological adjustment.
This process is often described as allostasis.
Allostasis allows physiological systems to adapt to changing demands rather than maintaining every variable at one unchanging level.
However, adaptation has costs.
When stress-response systems are repeatedly activated, recovery is inadequate, or physiological regulation becomes persistently disrupted, cumulative strain may develop.
The concept of allostatic load describes the cumulative burden associated with repeated or prolonged physiological adaptation.
Researchers have investigated allostatic load through combinations of cardiovascular, metabolic, endocrine, and inflammatory measurements.
However, no single universally accepted biomarker panel can comprehensively quantify the total burden of stress for every individual.
The concept remains useful for understanding why long-term exposure to difficult circumstances can be associated with poorer health.
Repeated stress may also influence behavior.
An individual experiencing overwhelming demands may sleep less, exercise less frequently, eat differently, withdraw socially, or have greater difficulty following medical recommendations.
These changes can create additional physiological and psychological demands.
Chronic stress is therefore best understood as a dynamic process rather than a single elevated hormone or isolated symptom.
6. Stress Can Reduce the Cognitive Resources Needed to Manage Stress
One of the most important findings from systems-based stress research concerns cognitive bandwidth.
Cognitive bandwidth refers to the limited attentional and working-memory resources available for processing information, making decisions, and solving problems.
When individuals face multiple unresolved demands, substantial cognitive resources may be directed toward monitoring threats or managing immediate difficulties.
This can leave fewer resources available for planning, emotional regulation, and long-term decision-making.
The 2021 BMC Medicine paper by Crielaard and colleagues examined these relationships through a causal-loop framework.
The researchers identified several potential mechanisms through which recurring stressors can reinforce chronic stress.
One involves the cognitive burden created by accumulating demands.
As demands increase, individuals may have less capacity to address their underlying causes.
Unresolved problems may subsequently generate additional stress.
For example, financial insecurity may increase worry and interfere with sleep.
Reduced sleep and persistent worry may impair concentration and planning.
These difficulties can make financial problems harder to resolve, producing additional pressure.
The result is a reinforcing cycle.
This is why simply advising someone to improve their time management or develop greater discipline may be insufficient.
Effective intervention may require reducing demands, increasing access to resources, and improving the circumstances contributing to cognitive overload.
7. Avoidance and Stress: Why Short-Term Relief Can Create Long-Term Problems
Avoidance is a common response to stress.
When an activity, conversation, or responsibility produces substantial anxiety, postponing it may provide immediate relief.
In some circumstances, avoidance is protective and appropriate, particularly when a situation is unsafe.
However, persistent avoidance of manageable problems can sometimes maintain or increase stress over time.
Consider someone experiencing anxiety about an important financial conversation.
Avoiding the conversation temporarily reduces discomfort.
Yet the underlying issue remains unresolved.
As deadlines approach and consequences accumulate, anxiety may intensify.
The individual may then become even more reluctant to engage with the problem.
This creates another feedback loop.
The BMC Medicine paper identifies avoidance as one mechanism through which chronic stress may become self-reinforcing.
However, avoidance should not automatically be interpreted as a character flaw.
It may reflect limited resources, overwhelming circumstances, previous adverse experiences, or insufficient access to support.
Effective coping involves distinguishing situations requiring direct action from those requiring acceptance, protection, assistance, or changes to the surrounding environment.
8. The Role of Early-Life Experiences, Attachment, and Learned Patterns
The ways individuals interpret and respond to stress develop over time.
Childhood experiences, family relationships, social learning, and previous exposure to adversity can influence expectations about safety, control, and interpersonal relationships.
Some individuals develop effective coping strategies through consistent support and opportunities to practice managing challenges.
Others experience environments characterized by unpredictability, chronic conflict, neglect, or limited access to safety and support.
These experiences may influence stress reactivity, emotional regulation, and beliefs about personal control.
A 2025 review titled Expression of Hidden Stress: Shaping the Biopsychosocial Triads discusses themes such as emotional suppression, childhood adversity, parentification, and difficulty establishing interpersonal boundaries.
The article is primarily a critical discussion of Gabor Maté's book When the Body Says No, interpreted through cultural and psychological perspectives.
Its discussion raises important questions about the relationship between social experiences, emotional expression, and health.
However, case narratives and retrospective interpretations cannot establish that a particular psychological pattern directly causes an autoimmune disorder, cancer, or neurodegenerative disease.
The clinically useful insight is more measured:
Long-standing relational patterns and adverse experiences may shape how individuals perceive threats, express emotions, seek support, and respond to future stressors.
These patterns can become targets for appropriate psychological and behavioral interventions without assuming that individuals are responsible for developing medical illnesses.
9. Social Relationships and the Environment: Stress Is Not Experienced in Isolation
Social relationships are important components of the biopsychosocial model.
Supportive connections can provide emotional reassurance, practical assistance, information, and additional coping resources.
Conversely, isolation, interpersonal conflict, unsafe relationships, and unstable living conditions can contribute to stress exposure.
These influences operate through several pathways.
Social support may alter the perceived severity of a stressor.
Practical assistance can reduce the actual demands imposed by a difficult circumstance.
A sense of belonging may improve emotional well-being and encourage adaptive coping.
The broader environment also matters.
Individuals facing financial hardship, insecure housing, discrimination, unsafe working conditions, or inadequate access to care may experience recurring stressors that cannot be resolved through individual coping strategies alone.
The 2021 BMC Medicine analysis emphasizes that psychological interventions may be insufficient when the underlying socioeconomic conditions continue generating stress.
This is an important limitation of approaches that place the entire responsibility for stress management on the individual.
Sometimes, improving stress outcomes requires changing the environment—not merely changing how someone thinks about it.
10. Stress and the Brain: Threat Detection, Safety Learning, and Cognitive Control
Resilience research increasingly examines how brain networks contribute to adaptive responses under stressful conditions.
A major review by Kalisch, Russo, and Müller, Neurobiology and Systems Biology of Stress Resilience, integrates findings from behavioral neuroscience, neuroimaging, and biological research.
The authors identify several neural systems that may contribute to resilience.
The Prefrontal Cortex
The prefrontal cortex participates in executive functions such as attention, cognitive control, decision-making, and aspects of emotional regulation. These functions can help individuals evaluate circumstances and select appropriate behavioral responses.
The Hippocampus
The hippocampus participates in memory and contextual processing.
Some research suggests that hippocampal functions involved in distinguishing similar experiences may help individuals discriminate between threatening and safe contexts. This can be important when previous adverse experiences influence the interpretation of current situations.
Reward-Related Networks
Reward-related systems participate in motivation, reinforcement learning, pleasure, and goal-directed behavior.
The capacity to engage with meaningful activities and rewarding experiences may help protect against some stress-related psychological difficulties.
However, resilience cannot be localized to a single brain region.
It emerges through interactions among neural networks, behavior, physiological regulation, and environmental conditions.
These mechanisms remain active areas of research, and many proposed biomarkers of resilience are not yet validated for routine clinical assessment.
11. Resilience Is Dynamic: It Is Not Simply “Being Mentally Tough”
Resilience is sometimes described as the ability to endure pressure without showing distress. This definition is incomplete.
In 2018, Bennett and colleagues described resilience as an adaptive capacity that emerges through interactions among the individual, their environment, and available coping resources.
Their paper distinguishes trajectories involving relatively little disruption from those involving adaptation after prolonged adversity.
Similarly, a 2019 review in Translational Psychiatry, Psychobiological Factors of Resilience and Depression in Late Life, describes resilience as a dynamic, multidimensional capacity shaped by lifelong interactions between internal and external resources.
Resilience may therefore involve maintaining functioning during adversity, recovering after temporary impairment, or adapting successfully to changed circumstances.
These outcomes are not identical. A person can be resilient while experiencing distress. They can require support, experience setbacks, or take time to recover. Resilience is not proof that an individual is unaffected by adversity. Nor should it be used as a standard for judging those whose circumstances exceed their available resources.
12. Cognitive Appraisal and Psychological Flexibility: Learning to Respond More Adaptively
One potentially modifiable component of resilience involves how individuals interpret and respond to stressful situations.
A 2025 study published in Nature Communications, Positive Appraisal Style Predicts Long-Term Stress Resilience and Mediates the Effect of a Pro-Resilience Intervention, examined the relationship between appraisal patterns and subsequent stress-related mental health.
The study supports the importance of appraisal as one factor contributing to resilience.
However, the concept of positive appraisal does not mean pretending that a dangerous situation is harmless.
It involves evaluating circumstances in a realistic and appropriately constructive manner.
For example, an individual may recognize that an upcoming challenge is difficult while also accurately identifying available resources and potential solutions.
Psychological flexibility adds another dimension.
It involves adapting behavioral and emotional responses according to the situation.
When a stressor is controllable, direct problem-solving may be useful.
When circumstances cannot readily be changed, acceptance, emotional regulation, meaning-making, and support-seeking may be more appropriate.
The ability to select different strategies according to context may be more beneficial than relying rigidly on one preferred coping method.
Effective coping is not always about controlling circumstances. Sometimes it involves changing circumstances, sometimes changing our relationship to them, and sometimes obtaining the resources necessary to respond safely and effectively.
13. Understanding Stress Through Feedback Loops
A major advantage of the biopsychosocial model is its compatibility with systems thinking.
Rather than viewing stress as a linear sequence in which a stressor produces a response and then an outcome, systems thinking examines how those responses can influence future conditions.
Consider a recurring cycle involving occupational stress.
High demands may disrupt sleep.
Inadequate sleep may reduce attention, patience, and emotional regulation.
These changes may impair performance and increase interpersonal conflict.
Declining performance and additional conflict may create even greater occupational stress.
The process reinforces itself.
Another individual may experience a different cycle.
Financial insecurity may increase perceived threat and limit available resources.
Persistent worry may reduce cognitive bandwidth.
Reduced cognitive bandwidth may interfere with planning and problem-solving.
Difficulty resolving financial problems may perpetuate insecurity.
These cycles illustrate why stress frequently persists even when someone recognizes that their situation is harmful.
They also suggest that interventions can potentially occur at different points.
Improving sleep may reduce one source of vulnerability.
Strengthening coping skills may alter responses to manageable challenges.
Changing work demands may reduce the number or severity of stressors.
Increasing access to social or financial resources may improve actual coping capacity.
No single intervention necessarily resolves the entire system.
The objective is to identify which changes are most feasible, relevant, and likely to improve the individual's situation.
14. Barriers and Facilitators: Why Stress Management Is Not Equally Accessible
Stress management recommendations are often presented as universally available choices.
However, individuals differ substantially in their capacity to implement them.
A person working multiple jobs may have limited control over their schedule.
A caregiver may have difficulty obtaining uninterrupted sleep.
Someone facing financial hardship may have restricted access to nutritious foods, safe recreation, counseling, or transportation.
An individual managing chronic pain may face additional barriers to physical activity.
These circumstances matter because many recommended stress-management strategies require time, resources, or environmental support.
The biopsychosocial model encourages clinicians to distinguish internal and external barriers.
Internal barriers may include psychological symptoms, reduced confidence, limited coping skills, or health-related limitations.
External barriers may include unsafe environments, difficult relationships, limited access to resources, or occupational demands.
Likewise, facilitators may include supportive relationships, practical assistance, appropriate treatment, physical safety, accessible healthcare, and opportunities for meaningful activity.
Effective intervention should therefore consider not only what might help but also whether the individual can realistically implement it.
15. Translating the Model Into Personalized Stress Management
The biopsychosocial model provides a framework for identifying appropriate opportunities for intervention.
A comprehensive approach begins with understanding the person's stressors, physiological health, psychological experiences, available resources, and surrounding environment.
Physiological Regulation
Sleep, nutrition, physical activity, medical conditions, and relevant physiological limitations can influence stress responses and recovery.
Addressing these factors may improve overall health and provide a stronger foundation for coping.
When appropriate, clinical assessment should also consider whether symptoms attributed to stress might reflect an underlying medical condition.
Psychological and Behavioral Strategies
Interventions such as cognitive behavioral therapy, acceptance and commitment therapy, mindfulness-based approaches, and other evidence-based psychological treatments may help selected individuals develop more adaptive responses.
Different treatments are appropriate for different conditions and individual needs.
Strategies may include recognizing unhelpful thinking patterns, improving problem-solving, developing emotional regulation skills, and reducing maladaptive avoidance.
Social and Environmental Support
Identifying practical barriers and available resources can be equally important.
This may involve improving interpersonal communication, seeking social support, adjusting occupational demands, or accessing community resources.
For some individuals, reducing exposure to harmful conditions is more important than increasing tolerance of those conditions.
Meaning, Values, and Purpose
Stress is also influenced by what individuals consider important. Responsibilities connected to personal values may be experienced differently from demands perceived as meaningless or imposed without autonomy.
Clarifying priorities, boundaries, and meaningful goals may help individuals make decisions about where to direct limited resources. However, meaning-making should complement rather than replace practical changes or necessary medical and psychological treatment.
16. Our Approach to Stress Well
We recognize that stress is not simply a psychological problem or a physiological response that can be explained by one biomarker.
It is a dynamic process emerging through interactions among the individual, their biology, experiences, behaviors, relationships, and environment.
Our Stress Well approach emphasizes education, individualized assessment, practical skills, and sustainable strategies for improving stress management and recovery.
Depending on the individual, this may involve exploring current stressors, perceived control, coping resources, sleep quality, nutritional adequacy, physical activity, health concerns, and relevant social or environmental circumstances.
We also recognize that experiences of stress are shaped by prior learning, beliefs, values, and individual expectations.
Rather than assuming every patient needs the same relaxation technique, our objective is to identify the factors most relevant to their circumstances.
For one individual, improving sleep regularity and workload boundaries may be important.
For another, developing more effective problem-solving skills or accessing psychological care may be a priority.
Someone experiencing persistent financial or family stress may need practical resources and environmental support alongside individual coping strategies.
We view these possibilities as complementary rather than competing explanations.
When appropriate, coordinated care with mental health professionals, primary care clinicians, and other qualified providers is essential.
Our aim is not to eliminate all stress from life.
It is to help individuals better understand their stress responses, expand appropriate coping resources, support recovery, and develop a greater capacity to navigate the demands of everyday life.
Conclusion: Stress Is a Whole-Person Experience
The biopsychosocial model offers a more complete understanding of stress by recognizing that biological, psychological, social, and environmental influences are interconnected.
Our physiological responses influence our thoughts and behavior.
Our appraisals and coping strategies influence how we respond to challenges.
Relationships and environments influence the demands we encounter and the resources available to manage them.
These interactions evolve throughout life and can generate either reinforcing cycles of strain or opportunities for adaptation and recovery.
The growing research on stress resilience, cognitive appraisal, social adversity, and systems biology reinforces the value of moving beyond approaches that treat stress as an isolated symptom.
Effective stress management requires asking better questions.
What is creating the demand? How is it being interpreted? What resources are available? Which physiological and behavioral processes are contributing? What barriers are preventing recovery? And which changes are both meaningful and realistically achievable?
The answers will differ among individuals.
Stress management is not simply the practice of becoming calmer in difficult circumstances. It is the ongoing process of developing the physiological, psychological, social, and environmental conditions that support effective adaptation, recovery, and meaningful participation in life.
We believe understanding these interactions is essential to building a more comprehensive, personalized, and sustainable approach to stress and long-term well-being.
Research References
Bennett JM, Rohleder N, Sturmberg JP. Biopsychosocial approach to understanding resilience: Stress habituation and where to intervene. Journal of Evaluation in Clinical Practice. 2018. https://doi.org/10.1111/jep.13052
Crielaard L, Nicolaou M, Sawyer A, Quax R, Stronks K. Understanding the impact of exposure to adverse socioeconomic conditions on chronic stress from a complexity science perspective. BMC Medicine. 2021;19:242. https://doi.org/10.1186/s12916-021-02106-1
Gómez-Carrillo A, Kirmayer LJ. A cultural-ecosocial systems view for psychiatry. Frontiers in Psychiatry. 2023;14:1031390. https://doi.org/10.3389/fpsyt.2023.1031390
Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiological Reviews. https://doi.org/10.1152/physrev.00042.2023
Laird KT, Krause B, Funes C, Lavretsky H. Psychobiological factors of resilience and depression in late life. Translational Psychiatry. 2019;9:88. https://doi.org/10.1038/s41398-019-0424-7
Chaudhuri A, Seema N. Expression of hidden stress: Shaping the biopsychosocial triads. Annals of Neurosciences. 2025. https://doi.org/10.1177/09727531251379694
Positive appraisal style predicts long-term stress resilience and mediates the effect of a pro-resilience intervention. Nature Communications. 2025. https://doi.org/10.1038/s41467-025-65147-7
Resilience and brain health in global populations. Nature Medicine. 2025. https://doi.org/10.1038/s41591-025-03846-w
Lee SY, et al. Multilevel and multimodal biobehavioral methods in the study of stress, trauma, and resilience: A systems approach. Journal of Neural Transmission. 2025;132:1379–1398. https://doi.org/10.1007/s00702-025-02962-8
The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology. Stress. 2024;27. https://doi.org/10.1080/10253890.2024.2327333