应激与心血管疾病：检验两种当代理论中的警觉性路径
应激与心血管疾病：检验两种当代理论中的警觉性路径
Stress and Cardiovascular Disease: Testing A Vigilance Pathway in Two Contemporary Theories
——《健康心理学》第45卷第10期，2026年10月——
【摘要】目的：尽管已有确凿证据表明心理应激与心血管疾病（CVD）之间存在关联，但由于缺乏具有生态效度的模型，关于这种风险如何传导的解释尚显不足。近期的概念性进展（包括应激的“普遍不安全感理论”和“社会安全理论”）提出，由环境暴露引发的持续生理激活以及代偿性的情境警觉是其中的一种作用路径。本研究首次对上述两种理论模型在临床前心血管疾病中的应用进行了综合检验。方法：研究对象为一个包含300名成人的多元化社区样本（平均年龄42.44岁；女性占50%；非拉美裔白人占60%，拉美裔/拉丁裔占19%，非拉美裔黑人占15%，其他非拉美裔族群占6%）。参与者完成了一项为期两年的纵向研究，内容包括问卷调查、生态瞬时评估（EMA）以及用于测量疾病进展的颈动脉扫描。研究利用地理编码技术处理居住地数据，以评估犯罪暴露风险。数据分别于2012年和2014年进行采集。结果：正如假设预期，较高的环境不安全感（基于地理编码的犯罪率；B = 0.02, p < .05）和较高的日常社会警觉（EMA自评；B = 0.09, p < .05）均与更严重的疾病进展相关。尽管较高的日常社会安全感（EMA自评；B = ?0.04, p < .001）与较低的社会警觉相关，但社会警觉并未在任一安全指标与疾病进展之间起到中介作用。结论：研究结果与应激导致持续生理激活的概念模型相一致，并为相关理论的具体主张提供了适度支持。这些发现提示，未来的应激与心血管疾病相关研究应考量多层面的安全影响因素及持续性的监测行为，以便更准确地捕捉日常压力体验。
【关键词】动脉粥样硬化；安全感；心理应激；心血管疾病；犯罪风险
[Abstract] Objective: Despite robust evidence linking psychological stress to cardiovascular disease (CVD), explanations for how risk is transmitted are limited by a lack of ecologically valid models. Recent conceptual advances including generalized unsafety theory of stress and social safety theory articulate persistent physiological activation driven by contextual exposure and compensatory situational vigilance as a pathway. This study provides an integrated first test of generalized unsafety theory of stress and social safety theory models on preclinical CVD. Method: A diverse community sample of 300 adults (Mage = 42.44 years; 50% women; 60% non-Hispanic (NH) Whites, 19% Hispanic/Latinos, 15% NH Blacks, 6% NH Others) completed a 2-year longitudinal study with surveys, ecological momentary assessment (EMA), and carotid artery scans measuring disease progression. Residential data were geo-coded to assess risk for crime exposure. Data collection occurred in 2012 and 2014. Results: As hypothesized, greater environmental unsafety (geo-coded crime rates; B = 0.02, p < .05) and greater daily social vigilance (EMA self-report; Bs = 0.09, ps < .05) were associated with greater disease progression. Although higher daily social safety (EMA self-report; B = ?0.04, p < .001) was associated with lower social vigilance, social vigilance did not mediate associations between either safety indicator and disease progression. Conclusions: Results align with a persistent activation conceptualization of stress and modestly support the specific theoretical assertions. These findings suggest future stress-CVD investigations should account for multilevel safety influences and continuous monitoring behavior to more accurately capture daily stress experiences.
[Key words] atherosclerosis; safety; psychological stress; cardiovascular disease; crime risk
论文原文：Riley M. O'Neill, George M. Slavich, Julian F. Thayer, et al. (2026). Stress and cardiovascular disease: Testing a vigilance pathway in two contemporary theories. Health Psychology, Volume 45, Issue 10, Pages 963–974. October 2026.
https://doi.org/10.1037/hea0001615
（翻译兼责任编辑：MARY）
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