Fight or Flight Vs. Tend - and - Befriend: Exploring Differences in Women's Biological Responses to Stress

Background. Fight or flight is the canonical and prototypic human stress-response and is believed to be the core reaction to all interpersonal threat types.  However, while a stress response geared to fleeing or aggressing may be adaptive for males, there are perhaps different challenges faced by females, especially those with maternal investment in offspring.  More recent evidence compiled by Taylor et al.,  indicates that the physiology of the stress response is different for females.  While females can have a flight or fight response, a body of bio-behavioral data indicates that oxytocin (a pituitary hormone implicated in attachment) is secreted during stress in females. Oxytocin inhibits defensive behavior associated with stress, anxiety and fear.  Thus, researchers postulate a female human stress-response:  tend-and-befriend, strongly reflective of the attachment/caregiving system.  Given that receptors for oxytocin are located in the cardiovascular system and the fact that oxytocin lowers pressure, we conducted a meta-analysis of the data on female cardiovascular responses blood to stress and social support.  We did not include males because their cardiovascular responses are biologically and statistically different.

Methods. We conducted a search of the literature using PsycInfo, ERIC, SocialSciSearch data bases from 1995-2015 with the search terms: women, social support, cardiovascular reactivity, heart rate, and stress.  Inclusion criteria were:  Participants had normal cardiovascular health, were experientially stressed with and without social support and heart rates were captured during both conditions.  Nine studies were retrieved and 5 were eliminated for lack of appropriate data.  The retrieved studies resulted in an aggregated sample size of 166 adult females. Data were analyzed using Comprehensive Meta-Analysis software.   Results showed a standardized mean difference between the supported and non-supported females during stress Md = -.823, Z= -5.439, p < .000 (CI = -1.119 - .526) indicating that the supported females had a significantly lower heart rates than the non-supported females when stimulated with the same stressors.

Results & Implications. Our findings partially support the proposition that female responses to stress are often characterized by patterns of maternal and affiliative responses built on the attachment-caregiving system that depend in part on oxytocin, estrogen and other hormones as an alternative to the flight-or-fight response.  The findings have important clinical implications for interventions involving women experiencing domestic violence and involved in filial caregiving.  While it is clear that women often need to leave the abusive partner, it is also clear that biological components operate to complicate her behavioral responses.  The tend-and-befriend thesis suggests that helping women tend - care for offspring along with befriend - joining and participating in social groups, especially those involving female networks, for the exchange of resources and responsibilities would be helpful and empirically supported.  Moreover, these endeavors would be expected to increase self-efficacy and self-determination. 

While this study has a number of limitations, the findings support the importance of social support and suggest that the range of female responses to stress go beyond the acute fight-or-flight response.