ReviewInternational journal of environmental research and public health2018
Generalized Unsafety Theory of Stress: Unsafe Environments and Conditions, and the Default Stress Response.
Review in International journal of environmental research and public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How childhood adversity affects components of decision making.Neuroscience and biobehavioral reviews · 2025Pooled it
- Biopsychosocial and physical factors associated with firefighter musculoskeletal disorders: a systematic review.Journal of occupational health · 2025Pooled it
- Efficacy and safety of an alpha 7-nicotinic acetylcholine receptor agonist, VQW-765, in subjects with performance anxiety: randomised, double-blind, placebo-controlled trial.The British journal of psychiatry : the journal of mental science · 2025Trial
- Randomised control trial of a proactive intervention supporting recovery in relation to stress and irregular work hours: effects on sleep, burn-out, fatigue and somatic symptoms.Occupational and environmental medicine · 2022Trial
- Sociodemographic disparities in corticolimbic structures.PloS one · 2019Trial
- Preliminary Efficacy of an Emotion Regulation Intervention on Physical Activity and Depressive and Anxious Symptoms in Individuals in Cardiac Rehabilitation.The Journal of cardiovascular nursingTrial
- Stress and cardiovascular disease: Testing a vigilance pathway in two contemporary theories.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026Article
- Manifestations of Anti-Black Racism and Worry About Pregnancy and Birthing While Black: A Cross-sectional Secondary Analysis of Giving Voice to Mothers.Journal of racial and ethnic health disparities · 2026Article
- Stress Processes and Resilience Pathways of Sexually and Gender Diverse Communities: A Narrative Review of 15 Years of Evolving Research Priorities and Practices.American journal of human biology : the official journal of the Human Biology Council · 2026Review
- Psychometric Validation and Health Correlates of the Discrimination Reactivity Questionnaire.Journal of racial and ethnic health disparities · 2026Article
- Facing ambiguity: What we do in the space between stimulus and response.Current directions in psychological science · 2026Article
- The Relevance of Heart Rate Variability for Hypnotherapy and Psychotherapy.Brain sciences · 2026Review
- Integrating reflex, feedback, and prediction: a tiered model of physiological regulation for contemporary medical education.Frontiers in physiology · 2026Article
- Anticipated discrimination in daily life: Predictors, stress appraisals, and responses.PloS one · 2026Article
- Review
- Doing Science With Our Grandmother's WISDOM: A Worldview Integrating Sociality, Diversity, and Observant Meaning-Making.American journal of human biology : the official journal of the Human Biology Council · 2025Article
- Review
- Unraveling functional neurological disorder in pediatric populations: A systematic review of diagnosis, treatment, and outcomes.World journal of clinical pediatrics · 2025Article
- Greater tolerance of uncertainty facilitates thriving in doctors entering postgraduate training.BMC medical education · 2025Article
- Discrimination and Heart Rate Variability Responses in a Diverse Sample of Young Adults.Journal of psychophysiology · 2025Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prolonged physiological stress responses form an important risk factor for disease. According to neurobiological and evolution-theoretical insights the stress response is a default response that is always "on" but inhibited by the prefrontal cortex when safety is perceived. Based on these insights the Generalized Unsafety Theory of Stress (GUTS) states that prolonged stress responses are due to generalized and largely unconsciously perceived unsafety rather than stressors. This novel perspective necessitates a reconstruction of current stress theory, which we address in this paper. We discuss a variety of very common situations without stressors but with prolonged stress responses, that are not, or not likely to be caused by stressors, including loneliness, low social status, adult life after prenatal or early life adversity, lack of a natural environment, and less fit bodily states such as obesity or fatigue. We argue that in these situations the default stress response may be chronically disinhibited due to unconsciously perceived generalized unsafety. Also, in chronic stress situations such as work stress, the prolonged stress response may be mainly caused by perceived unsafety in stressor-free contexts. Thus, GUTS identifies and explains far more stress-related physiological activity that is responsible for disease and mortality than current stress theories.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.