Abstract
Background
Stress is a major risk factor for depression, which shares important changes in decision-making
patterns. However, decades of research have only weakly connected physiological measurements
of stress to the subjective experience of depression. Here, we examined the relationship
between prolonged physiological stress, mood, and explore-exploit decision-making
in a population navigating a dynamic environment under stress: healthcare workers
during the COVID-19 pandemic.
Methods
We measured hair cortisol levels in healthcare workers who completed symptom surveys
and performed an explore-exploit restless-bandit decision-making task; 32 participants
were included in the final analysis. Hidden Markov and reinforcement learning (RL)
models assessed task behavior.
Results
Participants with higher hair cortisol exhibited less exploration (r = -0.36, p = 0.046). Higher cortisol levels predicted less learning during exploration (beta
= -0.42, FDR corrected p = 0.022). Importantly, mood did not independently correlate with cortisol concentration
but explained additional variance (beta = 0.46, FDR corrected p = 0.022) and strengthened the relationship between higher cortisol and lower levels
of exploratory learning (beta = -0.47, FDR corrected p = 0.022) in a joint model. These results were corroborated by an RL model, which
revealed less learning with higher hair cortisol and low mood (beta = -0.67, FDR corrected
p = 0.002).
Conclusion
These results imply prolonged physiological stress may limit learning from new information
and lead to cognitive rigidity, potentially contributing to burnout. Decision-making
measures link subjective mood states to measured physiological stress, suggesting
they should be incorporated into future biomarker studies of mood and stress conditions.
Keywords
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Article info
Publication history
Accepted:
December 1,
2022
Received in revised form:
November 16,
2022
Received:
August 16,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Archival Report
Funding and Disclosures:
This work was supported by the University of Minnesota Office of Academic and Clinical Affairs COVID-19 Rapid Response Grant. Research in this publication was also supported in part by the Office Of The Director, National Institutes of Health under Award Number P51OD011106 to the Wisconsin National Primate Research Center, University of Wisconsin-Madison. This research was conducted in part (as applicable) at a facility constructed with support from Research Facilities Improvement Program grant numbers RR15459-01 and RR020141-01. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. All authors report no biomedical financial interests or potential conflicts of interest.
Author Contributions:
AH, DD, EK conceived the study. AH, DD, BE, NG, AK, and EK contributed to the study design and methodology. EK, CM collected the data. EK, FY drafted the manuscript. AH, DD supervised the project and edited the manuscript. CC, CM, BE, NG, AK contributed significantly to data analysis and modeling. AH, DD had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors gave final approval for the paper and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Code Availability: All experimental and analysis codes used in this paper are available upon request.
Data Sharing Statement: Deidentified data available upon request. Proposals should be directed to the corresponding author; to gain access, data requestors will need to have investigator support and sign a data access agreement.
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