Executive functioning as a predictor of physiological and subjective acute stress responses in non-clinical adult populations: A systematic literature review and meta-analysis

Abstract

The goal of this systematic review and meta-analysis was to evaluate whether executive functioning predicts subsequent acute stress responses. A systematic search (conducted between May 22nd and 30th, 2019; updated on April 4th, 2020) on Cochrane, OpenGray, Proquest Dissertations and Thesis Global, PsycInfo, Pubmed, Scopus, and Web of Science revealed 27 correlational and five interventional studies. For quality appraisal, we used the BIOCROSS Tool, the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the Revised Cochrane Risk-of-bias Tool for Randomized Trials. Attentional control was most consistently associated with acute stress. A robust variation estimation meta-analysis, conducted when sufficient data was available, revealed a small, significant, and negative correlation between higher working memory and subsequent lower cortisol reactivity (r = .09, p = .025, 95 % CI [0.15, 0.02]). These results highlight the role of executive functioning for acute stress responses, the scarcity of relevant data, and the need for both interventional designs and the consideration of mediators and moderators to understand underlying mechanisms.

Keywords: Acute stress; Attentional control; Cognitive Flexibility; Cortisol; Executive functioning; Heart rate; Inhibition; Meta-analysis; Planning; Subjective stress; Systematic literature review; Updating; Working memory.