Subjective arousal and perceived control clarify heterogeneity in inflammatory and affective outcomes.

Only a portion of individuals experiencing chronic stress and associated increases in inflammation go on to develop pathological elevations in mood and anxiety symptoms. Some prevailing models suggest that the outcomes of chronic stress may largely depend on individual differences in perceived control. In the current study, we used this theoretical framework to disambiguate the influence of autonomic arousal and perceived control on inflammatory and psychological outcomes in a large sample of adults from the Midlife in the United States dataset (wave 2; MIDUS-2) (Final N ​= ​1030), and further replicated our approach in a second (MIDUS-Refresher) cohort (Final N ​= ​728). Using k-means clustering we created subgroups systematically differing in subjective arousal (high/low) and perceived control (low/high) and compared these subgroups on inflammatory markers and psychological outcomes. Overall results showed that individuals in the high subjective arousal subgroups had higher levels of IL-6, CRP, and FIB, independent of level of CNTL. However, distinctive, and pathological psychological symptom patterns became more apparent when individuals were characterized by both subjective arousal and perceived control. These findings suggest that subtyping individuals based on subjective arousal and perceived control can help us disentangle pathological versus adaptive mental health outcomes in those with co-occurring inflammation and may help identify those vulnerable to psychopathology in the context of physical or psychological stressor exposure.