Dr. George Slavich points to an “aha!” moment from one of his lab’s studies, a finding that when people hear negative things said about them, even for 10 minutes, a body-wide stress response can occur, continuing 65 minutes later. There’s also an effect on gene expression, generating inflammatory responses that may be linked to falling physically ill.
“We have a neural signature in the brain that can predict individual differences in peripheral inflammatory response to social stress,” says the Professor, Psychiatry & Biobehavioral Sciences at the University of California, Los Angeles.
Teaching people how to develop psychosocial resilience is crucial, believes Dr. Slavich, which might help them mitigate acute social pain and reduce stressors to improve their overall health.
You can hear Dr. Slavich talk more about his findings during the DOC 2025 session “Sex, Stress and Social Nutrition: Get Your Groove On,” in the video or read our lightly edited transcript below.
TRANSCRIPT:
Dr. George Slavich
I was told this was on stress, drugs and rock and roll, so I may be on the wrong side. Thank you so much. So I fully realized that I just have the privilege to spend eight minutes on the stage here with you and any one of you could be up here doing the same thing. So thank you for your time. I’m a clinical psychologist by training, and I’m primarily interested in how it is that experiences of stress get represented in the brain and how the brain then regulates peripheral physiology.
And I want to just share a few main messages about that. In the short time that I have here, there’s good news and bad news about why you’re going to die. The good news is that about 120 years ago, you’re much more likely to die from communicable diseases such as pneumonia and influenza. Those have gone down as environments around us have become more sanitary, as you all know.
But the downside is that we’re all much more likely to die of chronic diseases of aging that are driven by stress and stress related lifestyle factors that increase inflammation throughout the body, cause oxidative stress, and cause cells in our body and our organs to break down. Now, of course, it’s the case that a lot of lifestyle factors are contributing to these chronic diseases of aging, sleep, diet, physical activity, etc. but what I want to make the argument here is that stress is one of the biggest killers in the room, and unfortunately, the one that we wear is a badge of honor the most and therefore, pay the least attention to in clinical care. So adverse childhood experiences which you may have heard of are things like early life abuse, neglect, maltreatment in early life, divorce, unpredictable households. The data here are showing the association between experiencing four or more adverse childhood experiences relative to zero adverse childhood experiences, being implicated in the nine of the ten top leading causes of death in the United States today.
Just so you know, about 20% of individuals in the United States have four or more Aces, and about 62% of individuals in the United States have at least one ace. These are, very common experiences that we’re talking about. Increasing risk for heart disease, 2.1 fold, increase Alzheimer’s disease and memory impairment, 4.9. Kidney disease, 1.7. Chronic liver disease 2.4. So very strong associations between stress and nine of the ten leading causes of death in the United States today, if you look at stress, related proportional attributable fractions, namely the proportion of that, of those health problems attributable to stress, you see a very similar picture of 40% of cases of depression attributable to stress aces, 20% of cardiovascular disease.
The economic costs in California alone top $110 billion per year. In a recent health care, economic analysis, there are lots of different, types of stress, food insecurity, caregiving, stress, which Alissa studied for many years. Incarceration, isolation. I’m here to tell you just a few data points about the impact of social stressors like social evaluation, rejection and exclusion on the brain and the immune system to make the point that we should really, as a society, be focused on reducing sources of social stress and promoting so sources of social safety, belonging, connection and inclusion.
So how have we studied this in the lab? Well, all kinds of interesting ways. I’ll just give you one example of a study. Although we’ve done this with very different methods in this particular study we had 40 to 52 well-characterized adolescent females, 12 to 16 years old. Psychiatrically healthy. They come in for a first session where we interviewed them about their goals, plans and aspirations for the future, what they want to be when they bring up what their household is like, etc. we video record them and audio record them. We have that on video. Then we bring them into the next session, which is about one week later, which is an fMRI session. We introduce them to somebody else who they think is part of the study, but who’s actually a Confederate. We flipped the proverbial coin, and the participant is always the person who goes into the fMRI scanner.
Okay, what do they think is happening in that fMRI scanner? They believe they are led to believe that the person, the other person is part of the study is watching the video that we recorded of them, and judging how the participant is coming across and seeing in real time the evaluation of the other person, what they think the person is coming across in the interview.
If you’re the participant in this study, you put on fMRI safe goggles, you go into the fMRI scanner, and this is what you see through the fMRI safe goggles a matrix of words, all personal attributes, one third positive, one third negative and one third neutral, ostensibly relating to how the other person feels like you’re coming across.
One word is clicked on about every 10s so the other person thinks that you’re interesting. That’s great. But then of course, the other shoe always drops and the other person now thinks that you’re coming across as insecure. So they think that these, assessments are being done in real time. Actually, what we did was just pre-record a PowerPoint video.
Every participant has seen this video that is very believable. And it induces, a stress response, which I’ll show in a minute. Okay. What is that stress response. So we found that fMRI safe needles. We installed an in-dwelling catheter in the non-dominant arm and enables us to get, blood samples before, immediately after and 65 minutes after the stressor.
So this, for me, is one of the biggest AHA’s. Think for a moment in the past day or week or month, the number of times that you’ve been stressed out for only ten minutes, a ten minute stressor of social evaluation, laying flat on the scanner where you can’t run or go anywhere significantly induces a systemic inflammatory response, shown here, by three key inflammatory cytokines that initiate the inflammatory cascade interleukin one beta, interleukin six, and tumor necrosis factor alpha.
That’s the first ten minute stressor inducing a systemic inflammatory response. What’s the second one? 65 minute, 65 minutes after the stressor, the group average is still increasing. So in inducing a group wide inflammatory response that does not come down to baseline for most people, even 65 minutes after the onset of the stressor. If you look at the level of the human genome, you see very compelling results as well.
So we applied, a transcriptional wide, profiling. So this is looking at gene expression across 30,000 transcripts and a result of this ten minute social evaluation stressor leads that, greater than two fold change in more than 1500 genes. The main finding been significant increase in genes that support the inflammatory pathway and significant down regulation in gene sets that are involved in antiviral immunity.
So if you’ve ever been stressed out and you feel like you have pain sensitivity, and then 2 or 3 days later you get sick, this is the mechanistic basis for what’s happening, shift toward greater inflammation that happens quickly and against reduction and antiviral immunity. All these are all a result of a ten minute stressor. If you look into the brain, what are the sites, the primary brain sites of neural activity, you see this social pain, social evaluation, social rejection, stressor activity in the same neural regions in the human brain that would be activated if you expose somebody to physical pain.
If you put somebody in that fMRI scanner with a heat pad on their leg, you engage those in the anterior cingulate cortex, amygdala, bilateral and teller insula. If you socially reject them in the scanner, you get the same primary sites of neural activation and in fact, activity in those brain regions, when people are being rejected versus included strongly is a strong neural predictor of the extent to which they mount an inflammatory response to acute social stress.
We have a neural signature in the brain that can predict individual differences in peripheral inflammatory response to social stress. What’s the pivot here? Is any of this science being taught in medical schools. So we sought to do an analysis of that question. We asked U.S. News and World Report tell us the top 50 primary care-focused medical schools in the United States today.
We downloaded all course descriptions and course syllabi, and we looked for these keywords social determinants of health, health disparities, health equity, resilience, life stress, toxic stress, bio psychosocial biobehavioral. The results are dismal. So if you think that your kids are going to have primary care physicians that will be more knowledgeable around stress, health and resilience than your than were own providers, we’re going to fall short.
We need much more education in around stress, health and resilience. In medical school education than we have today. I have 30s left, five seconds left, ten year mission number one, teach the science of stress, health and resilience to every interested health care provider in the world. Number two, embed psychosocial resilience training in every interested campus company and community in the world. And number three, launch an institute to transform the science of resilience into new programs, products, partnerships and possibilities. And guess what? We have a site for that. This is a 130 acre site that’s 12 minutes from the Presidio in San Francisco, a short, jaunt down the road here, in strawberry. We have 200,000ft² that will be devoted just to social health and resilience, a lot of capacity here.
We’re just starting a welcome center that been developed. 40 faculty offices, 27 classrooms, a culinary center, art and events center, all to basically give a brick and mortar location for social health and resilience that really deserves. You can think of this should be if we can create it, if the people in this room can stand this up, a, MIT or a, a Caltech for Social Health and Resilience, let’s do it.
So if you if you are a scientist or an educator, a creative, a culinary expert, a health care provider, a strategic partner, a philanthropist, or a good human being, come and change the world. Let’s figure how to do it together.