Is All Stress Created Equal? Dr. Alexandra Crosswell is Working to Help Researchers Better Define Stress

Is all stress created equal? The concept and experience of stress is multifaceted and varies depending on the context, making it particularly challenging for scientists to study. Over the past decade, AME researchers have conducted a variety of studies that aim to understand how psychological stress can “get underneath the skin” and affect health of individuals, their relationships, families and communities. 

Want to see what we’re learning? Click on the photos above to learn about AME studies that have explored stress in communities like those listed.

Dr. Alexandra D. Crosswell, PhD, Assistant Professor in the Center for Health & Community at the University of California, San Francisco, developed  her interest and dedication to stress science early on, working as an undergraduate research assistant at the Duke University Cancer Center. "Many patients I would recruit into research studies would tell me what they thought caused their cancer, and often it was something highly stressful, like a divorce or toxic job,” said Crosswell. “I wondered if it could really be possible that what they thought and felt could reach them at a cellular level and could have caused their cancer. I’ve been fascinated by that question ever since."

Often the best measures for specific types of stress are confined to the brains of researchers who are experts in that specific area. We want that knowledge to be accessible to all researchers.

Alexandra Crosswell, PhD

University of California, San Francisco 

In the field of stress research, there is not a single unified definition or benchmark to measure the varying manifestations and causes of stress. Therefore, one of the greatest obstacles to researchers studying stress, according to Crosswell, is finding the best way to measure it, since the definition itself is vague and encompasses a wide variety of experiences.

These questions brought her to the UCSF Stress Measurement Network, an initiative by the National Institute on Aging. Here, Crosswell began collaborating with Dr. Elissa Epel and others to develop a toolbox that offers researchers a curated set of validated measures for stress.  "One of the things our Network is trying to do is increase the specificity in the ways in which people describe stress in their research studies,” said Crosswell.

The Stress Measurement Toolbox

The toolbox supports researchers in identifying tools that can more reliably measure “stressors”, or objectively stressful events, and “stress responses”, or the subjective and biological reactions to an event. In order to do this, Crosswell and her team collaborated with experts in the field to summarize the best-known measures to date. Following their responses, other experts weighed in before sharing their recommendations with the larger academic community.

The goal, according to Crosswell, is to allow professionals to leverage the toolkit as an entry point to using the best validated stress measures. "Often the best measures for specific types of stress are confined to the brains of researchers who are experts in that specific area. We want that knowledge to be accessible to all researchers."


Alexandra D. Crosswell is Ph.D., Assistant Professor in the Center for Health & Community University of California, San Francisco and Executive Director at UCSF Stress Measurement Network.

Tangible results
Accomplishments of the Network have already come to fruition and are continuing to expand. Via an impactful partnership with the NIH Initiative Gateway to Global Aging platform, Stress Network researchers collaborated over five years to harmonize stress measures across ten large epidemiological studies. "This project was a huge, interdisciplinary effort. I am very proud of it! It will allow researchers to examine cross-country differences in the relationship between stress and health,” said Crosswell.

A large body of research conducted in the United States has shown that racial discrimination is strongly related to cardiovascular disease risk, yet scientists are unsure if these findings are as applicable in other countries. Looking at stress-health relationships across different countries "may point us to the mechanisms underlying these relationships, and ideally, help us identify how to design interventions to target them," Crosswell says. These variables are already described in the Gateway to Global Aging Data website, and anyone interested can take advantage of this information.

There are several exciting new projects on the horizon for the Network, including a plan to produce a series of podcast episodes that will allow experts to debate a variety of ‘hot topics’ in the field of stress research. For example, Crosswell shares, “there is a big push to include biomarkers of stress in most stress studies, but the utility of including biological markers is not always clear. We will bring in researchers who will discuss the positives and negatives, and many pitfalls, of using biomarkers in stress research."

The mission of the Stress Measurement Network is to better understand the relationship between stress and health by improving the measurement of psychological stress in research studies through the collaboration of experts from around the world. The Network is funded by the National Institute of Aging.

If you want to learn more, watch the video below of Dr. Crosswell and stay tuned for their upcoming podcast series on the Stress Measurement Network website


Alexandra D. Crosswell Ph.D., is an Assistant Professor in the Center for Health & Community University of California, San Francisco and Executive Director of the Stress Measurement Network which is funded by the National Institute on Aging.