Asymmetry of salivary cortisol and α-amylase responses to psychosocial stress in anorexia nervosa but not in bulimia nervosa

BackgroundThe stress response involves the activation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). As a role for stress in determining of the onset and the natural course of eating disorders (EDs) has been proposed, the study of the psychobiology of the stress response in patients with anorexia nervosa (AN) and bulimia nervosa (BN) should be helpful in understanding the pathophysiology of these disorders. The two neurobiological components of the stress response can be easily explored in humans by the measurement of salivary cortisol and α-amylase response to a stressor. Therefore, we assessed salivary cortisol and α-amylase responses to the Trier Social Stress Test (TSST) in symptomatic patients with AN and BN compared to healthy controls.MethodSeven AN women, eight BN women and eight age-matched healthy females underwent the TSST between 1530 and 1700 h. Salivary cortisol and α-amylase levels were measured by an enzyme-linked immunosorbent assay (ELISA).ResultsCompared to healthy women, AN patients showed a normal cortisol response to the TSST, although this occurred at significantly increased hormone levels, and an almost complete absence of response of α-amylase. BN women, however, exhibited enhanced pre-stress levels of salivary α-amylase but a normal response of the enzyme and cortisol to the TSST.ConclusionsThese findings demonstrate, for the first time, the occurrence of an asymmetry between the HPA axis and SNS components of the stress response in the acute phase of AN but not in BN. The pathophysiological significance of this asymmetry remains to be determined.

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Emotional reactivity and eating disorder related attitudes in response to the trier social stress test: An experimental study in people with anorexia nervosa and with bulimia nervosa.

Journal of Affective Disorders ◽

10.1016/j.jad.2020.05.051 ◽

2020 ◽

Vol 274 ◽

pp. 23-30 ◽

Cited By ~ 3

Author(s):

Alessio Maria Monteleone ◽

Valeria Ruzzi ◽

Giuseppina Patriciello ◽

Giammarco Cascino ◽

Francesca Pellegrino ◽

...

Keyword(s):

Experimental Study ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Bulimia Nervosa ◽

Social Stress ◽

Emotional Reactivity ◽

Stress Test ◽

Trier Social Stress Test

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The Relationship Between Perceived Control and Hypothalamic–Pituitary–Adrenal Axis Reactivity to the Trier Social Stress Test in Healthy Young Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2021.683914 ◽

2021 ◽

Vol 12 ◽

Author(s):

Qian Liu ◽

Jianhui Wu ◽

Liang Zhang ◽

Xiaofang Sun ◽

Qing Guan ◽

...

Keyword(s):

Young Adults ◽

Stress Response ◽

Hpa Axis ◽

Stress Responses ◽

Perceived Control ◽

Social Stress ◽

Stress Test ◽

Control Level ◽

Trier Social Stress Test ◽

Hypothalamic Pituitary Adrenal

Psychological factors can modulate the hypothalamic–pituitary–adrenal (HPA) axis activity toward stressors. Animal studies demonstrated that uncontrollability was one critical factor associated with HPA axis stress response, but the results in human studies were inconsistent. The current study adopted a standardized laboratory stress induction procedure, the Trier Social Stress Test (the TSST), as the stressor to regulate the objective controllability level, and young adult participants were asked to rate their subjectively perceived control level toward the stressor and measured their cortisol stress responses (N=54; 19 females and 35 males) to address this concern. Results showed that participants’ perceived control on the TSST was related to the cortisol stress response. In other words, under the stress of a certain objective controllability level, the lower the subjectively perceived control level, the greater the HPA axis response. This finding suggested that, in addition to objective controllability, subjectively perceived control is a psychological factor that regulates activation of the HPA axis in young adults.

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Increased BNST reactivity to affective images is associated with greater α-amylase response to social stress

Social Cognitive and Affective Neuroscience ◽

10.1093/scan/nsaa010 ◽

2019 ◽

Vol 14 (12) ◽

pp. 1263-1272

Author(s):

Walker S Pedersen ◽

Tammi R A Kral ◽

Melissa A Rosenkranz ◽

Jeanette A Mumford ◽

Richard J Davidson

Keyword(s):

Stress Response ◽

Salivary Cortisol ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Stress System ◽

Cortisol Response ◽

Stria Terminalis ◽

Bed Nucleus ◽

Human Stress

Abstract While rodent research suggests that the bed nucleus of the stria terminalis (BNST) and centromedial amygdala (CM) coordinate the hormonal stress response, little is known about the BNST’s role in the human stress response. The human BNST responds to negatively valenced stimuli, which likely subserves its role in responding to threat. Thus, variation in BNST reactivity to negatively valenced stimuli may relate to differences in the stress response. We measured participants’ blood oxygenated level-dependent response to affective images and salivary cortisol and α-amylase (AA) levels in response to a subsequent Trier social stress test (TSST). Greater BNST activation to emotionally evocative images was associated with a larger TSST-evoked AA, but not cortisol response. This association remained after controlling for CM activation, which was not related to the cortisol or AA response. These results suggest that the BNST response to negatively valenced images subserves its role in coordinating the stress response, a BNST role in the stress response independent from the CM, and highlight the need for investigation of the conditions under which BNST activation predicts the cortisol response. Our findings are critical for the future study of mood and anxiety disorders, as dysregulation of the stress system plays a key role in their pathogenesis.

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Validation of VR-based Immersive High-altitude Scene in Inducing Stress Response

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181319631036 ◽

2019 ◽

Vol 63 (1) ◽

pp. 2257-2261

Author(s):

Juan Liu ◽

Yulin Zhang ◽

Zhubin Wang ◽

Guozhen Zhao

Keyword(s):

Stress Response ◽

High Altitude ◽

Salivary Cortisol ◽

Social Stress ◽

Cognitive Task ◽

Stress Test ◽

Trier Social Stress Test ◽

Before And After ◽

Salivary Cortisol Level ◽

Back Task

Cognitive impairment under stress is a topic of concern in the field of human factors. Compared to traditional stress-inducing paradigms, the current study aimed to establish a repeatable and easy-to-operate stress-inducing paradigm and verify its effectiveness in inducing an individual’s stress response. A VR-based immersive high-altitude scene and a corresponding simulated long prop was created and three stress-inducing tasks (“experiencing the high-altitude”, “rescuing the cat”, and “avoiding flying birds”) were designed. A cognitive task (n-back) was nested into the VR scene as well to assess the effects of stress on the cognitive performance. Participants were asked to accomplish the three stress-inducing tasks on the long board and the same n-back task before and after the stress. Both reported stress level and salivary cortisol level were collected. Results showed that the current VR-based immersive high-altitude scene was able to induce an individual’s stress response according to both subjective and objective indices, which could reach the similar level as that of the previous VR-based Trier Social Stress Test (TSST) paradigm.

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Immunoassay or LC-MS/MS for the measurement of salivary cortisol in children?

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2015-0412 ◽

2016 ◽

Vol 54 (5) ◽

Cited By ~ 13

Author(s):

Yoon Ju Bae ◽

Alexander Gaudl ◽

Sonia Jaeger ◽

Stephanie Stadelmann ◽

Andreas Hiemisch ◽

...

Keyword(s):

Salivary Cortisol ◽

Social Stress ◽

Statistical Power ◽

Stress Test ◽

Externalizing Disorders ◽

Cross Reactivity ◽

Trier Social Stress Test ◽

Healthy Children ◽

Kinetic Assay ◽

The Difference

AbstractBackground:Dysregulation of the adrenal cortex has been assessed with measurement of salivary cortisol. So far salivary cortisol is routinely measured with immunoassay (IA). However, liquid chromatography-tandem mass spectrometry (MS) is known to offer better specificity. We compared the concentrations of salivary cortisol measured by MS and IA at basal and stress induced conditions and evaluated reasons for the difference in method-dependent cortisol results.Methods:Saliva samples (n=2703) were collected from 169 children (age range: 8–14 years; 81 healthy children; 55 with internalizing and 33 with externalizing disorders) under circadian conditions and during the Trier Social Stress Test for Children (TSST-C). Biochemical analyses were performed with MS for cortisol and cortisone, IA (IBL, RE62011) for cortisol, and enzyme kinetic assay for α-amylase.Results:MS and IA showed mostly comparable results for circadian activity and TSST-C response with similar statistical power. However, IA measured cortisol concentrations about 2.39-fold higher than MS. We found that this difference in measured values between MS and IA was mainly due to different standardization of IA compared to MS. In addition, at cortisol IA concentration below 5 nmol/L, cross-reactivity with cortisone was found to contribute to the lower concordance between MS and IA.Conclusions:Immunoassay and LC-MS/MS were largely comparable in the interpretation of salivary cortisol dynamics in stress research. But the IA method revealed a restricted accuracy in the measuring range below 5 nmol/L.

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Childhood Adversities and Salivary Cortisol Responses to the Trier Social Stress Test: A Systematic Review of Studies Using the Children Trauma Questionnaire (CTQ)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010029 ◽

2020 ◽

Vol 18 (1) ◽

pp. 29

Author(s):

Chuk Ling Julian Lai ◽

Daryl Yu Heng Lee ◽

Monique On Yee Leung

Keyword(s):

Salivary Cortisol ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Future Research ◽

Cortisol Response ◽

Childhood Adversities ◽

Social Stressors ◽

Childhood Trauma Questionnaire ◽

Cortisol Responses

Alteration in cortisol response to acute social stressors has been hypothesized to mediate childhood adversities (CA) and increased morbidity in adulthood. However, the evidence supporting an association between CA and cortisol response to social stressors is inconclusive. The present review addressed this issue by reviewing the literature on CA and cortisol response to acute social stressors, with a focus on studies with adolescents or adults, using the Childhood Trauma Questionnaire (CTQ) to assess CA, and examining salivary cortisol response to the Trier Social Stress Test (TSST). Systematic searches of relevant articles in PsycINFO, PubMed, Web of Science and ScienceDirect in February and March 2020 identified 12 articles including 1196 participants with mean ages ranging from 15.3 to 52.3 yrs. across studies. CTQ scores were significantly associated with cortisol response in 2 studies. In addition, the physical abuse and emotional neglect subscales were associated with cortisol response respectively in 2 separate studies. The lack of association between CA and cortisol response calls for more longitudinal studies, and the use of formal records of maltreatment or informant reports in future research to complement information collected by retrospective measures. In addition, increased attention to biological mechanisms other than that associated with the regulation of cortisol in explaining the connection between CA and psychiatry morbidity is warranted.

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A Virtual Reality Version of the Trier Social Stress Test: A Pilot Study

Presence Teleoperators & Virtual Environments ◽

10.1162/pres_a_00052 ◽

2011 ◽

Vol 20 (4) ◽

pp. 325-336 ◽

Cited By ~ 20

Author(s):

Mattias Wallergård ◽

Peter Jönsson ◽

Gerd Johansson ◽

Björn Karlson

Keyword(s):

Virtual Reality ◽

Stress Response ◽

Pilot Study ◽

Social Stress ◽

Stress Test ◽

Structured Interview ◽

Trier Social Stress Test ◽

Physiological Data ◽

Virtual Humans ◽

Arithmetic Task

One of the most common methods of inducing stress in the laboratory in order to examine the stress response in healthy and clinical populations is the Trier Social Stress Test (TSST). Briefly, the participant is asked to deliver a speech and to perform an arithmetic task in front of an evaluating committee. The committee, consisting of three trained actors, does not respond emotionally during the test, which makes the situation very stressful for the participant. One disadvantage of the TSST is that it can be difficult to hold the experimental conditions constant. In particular, it may be difficult for actors to hold their acting constant across all sessions. Furthermore, there are several practical problems and costs associated with hiring professional actors. A computerized version of the TSST using virtual humans could be a way to avoid these problems provided that it is able to induce a stress response similar to the one of the original TSST. The purpose of the present pilot study was therefore to investigate the stress response to a virtual reality (VR) version of the TSST visualized using an immersive VR system (VR-TSST). Seven healthy males with an average age of 24 years (range: 23–26 years) performed the VR-TSST. This included delivering a speech and performing an arithmetic task in front of an evaluating committee consisting of three virtual humans. The VR equipment was a CAVE equipped with stereoscopy and head tracking. ECG and respiration were recorded as well as the participant's behavior and comments. Afterward, a semi-structured interview was carried out. In general, the subjective and physiological data from the experiment indicated that the VR version of the TSST induced a stress response in the seven participants. In particular, the peak increase in heart rate was close to rates observed in studies using the traditional TSST with real actors. These results suggest that virtual humans visualized with an immersive VR system can be used to induce stress under laboratory conditions.

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Stress system dysfunction revealed by integrating reactivity of stress pathways to psychological stress in lean and overweight/obese men

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00276.2021 ◽

2021 ◽

Author(s):

Sisitha Udara Jayasinghe ◽

Sarah Janet Hall ◽

Susan Jane Torres ◽

Anne Isabella Turner

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Psychological Stress ◽

Hpa Axis ◽

Social Stress ◽

Blood Pressure Response ◽

Stress Test ◽

Trier Social Stress Test ◽

Stress System

While the patterns of response within the sympatho-adrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems that is not evident when considering either system alone. Age matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary alpha amylase, systolic blood pressure, diastolic blood pressure and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. While analysis of reactivity of individual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Further, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation of the other.

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