A friendly version of the Trier Social Stress Test does not activate the HPA axis in healthy men and women

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

Psychological Medicine ◽

10.1017/s0033291711000092 ◽

2011 ◽

Vol 41 (9) ◽

pp. 1963-1969 ◽

Cited By ~ 28

Author(s):

P. Monteleone ◽

P. Scognamiglio ◽

B. Canestrelli ◽

I. Serino ◽

A. M. Monteleone ◽

...

Keyword(s):

Anorexia Nervosa ◽

Stress Response ◽

Bulimia Nervosa ◽

Hpa Axis ◽

Salivary Cortisol ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Enzyme Linked Immunosorbent Assay ◽

First Time

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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Childhood Trauma and Cortisol Response to the Trier Social Stress Test in Symptomatic Patients with Eating Disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.286 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S91-S91

Author(s):

F. Marciello ◽

V.-M. Buonomenna ◽

V. Caivano ◽

G. Cascino ◽

G. D’Agostino ◽

...

Keyword(s):

Childhood Trauma ◽

Hpa Axis ◽

Childhood Maltreatment ◽

Social Stress ◽

Stress Test ◽

Trauma Exposure ◽

Trier Social Stress Test ◽

Cortisol Response ◽

History Of Childhood ◽

History Of

IntroductionChildhood trauma exposure is associated with the risk of eating disorders (EDs) in adulthood. The biological basis of this link may involve a persistent dysregulation of the endogenous stress response system, in particular the hypothalamic-pituitary-adrenal (HPA) axis, as a consequence of early life maltreatment.ObjectiveAdult patients with EDs and history of childhood trauma may have a dysregulation of the HPA axis that could be different from EDs patients without childhood trauma exposure.AimsIn order to assess the effects of childhood trauma experiences on HPA-axis activity in EDs, we compared the salivary cortisol response to the Trier Social Stress Test (TSST) of adult patients with EDs according to their history of childhood trauma.MethodTwenty-seven EDs patients and 13 healthy women participated in the study. Salivary cortisol responses during exposure to the TSST was measured. Participants also completed the childhood trauma questionnaire (CTQ) and eating-related psychopathological rating scales.ResultsAccording to CTQ, 15 individuals with EDs reported childhood maltreatment whereas 12 EDs patients and all the healthy women did not experience childhood maltreatment. Compared with the control group, non-maltreated EDs patient group exhibited a slightly enhanced cortisol response to TSST, whereas the group of non-maltreated EDs patients showed a normal cortisol response. Moreover, EDs patients with childhood maltreatment exhibited statistically significant blunting of cortisol compared to non-maltreated ones.ConclusionsThe present findings support the evidence that, in patients with EDs, there is a dysregulation of HPA-axis activity and that childhood trauma exposure may contribute to this dysregulation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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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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Acute Response of Stress System in Multiple Sclerosis

Archives of Neuroscience ◽

10.5812/ans.115781 ◽

2021 ◽

Vol 8 (4) ◽

Author(s):

Ahmadreza Askari Ashtiani ◽

Vahid Shaygannejad ◽

Foad Ghobadi ◽

Roozbeh Bathaie ◽

Shima Shahyad ◽

...

Keyword(s):

Multiple Sclerosis ◽

Hpa Axis ◽

Social Stress ◽

Acute Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Stress System ◽

Rate Variation ◽

Healthy Individuals ◽

Related Disorder

Background: It has long been suspected that exposure to stress is a major factor that can increase the risk of Multiple Sclerosis (MS) and exacerbate it, as a stress-related disorder. Therefore, we conducted this study to investigate the response of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullar (SAM) system to acute social stress. Methods: A total of 46 MS patients and 23 age-sex-matched healthy controls were recruited in the study. The Trier Social Stress Test (TSST) was used to induce acute psychosocial stress. We measured salivary cortisol (SC) to evaluate the HPA axis. In addition, electrocardiography (ECG) was recorded to evaluate the SAM system based on the linear and non-linear features of Heart Rate Variation (HRV). Then, SC and HRV were measured before and after the stress exposure. We also used the Depression Anxiety Stress Scale (DASS) and Emotional Visual Analog Scale (EVAS) to conduct the psychometric assessment and evaluate the perceived stress level, respectively. Results: The mean age of the MS group was 35.38 ± 15 years, with a mean disease duration of 7.4 ± 60. Besides, the HC group's mean age was 35.8 ± 9 years. There were no significant differences in demographic features and DASS scores between the two groups. In response to TSST, both MS and healthy individuals showed a significant increase in the SC levels and EVAS scores, as well as changes in the HRV indices. Notably, significant differences were also found between the two groups regarding the basic and post-stress SC levels, EVAS score, and HRV indices. Unlike the HC group, the SC level returned to its baseline after recovery in the MS group, and the sympathetic tone was more sensitive. Conclusions: Our results indicated that both MS and healthy individuals respond to acute stress regarding neuroendocrine assessment; however, patients with multiple sclerosis show some impairments in this response.

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Sex and stress: Men and women show different cortisol responses to psychological stress induced by the Trier social stress test and the Iowa singing social stress test

Journal of Neuroscience Research ◽

10.1002/jnr.23851 ◽

2016 ◽

Vol 95 (1-2) ◽

pp. 106-114 ◽

Cited By ~ 39

Author(s):

Alaine E. Reschke-Hernández ◽

Katrina L. Okerstrom ◽

Angela Bowles Edwards ◽

Daniel Tranel

Keyword(s):

Psychological Stress ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Men And Women ◽

Cortisol Responses

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Life stress and cortisol reactivity: An exploratory analysis of the effects of stress exposure across life on HPA-axis functioning

Development and Psychopathology ◽

10.1017/s0954579419001779 ◽

2020 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Ethan S. Young ◽

Jenalee R. Doom ◽

Allison K. Farrell ◽

Elizabeth A. Carlson ◽

Michelle M. Englund ◽

...

Keyword(s):

Early Childhood ◽

Hpa Axis ◽

Life Stress ◽

Social Stress ◽

Acute Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Stress Exposure ◽

Cortisol Reactivity ◽

Biological Stress

Abstract Stressful experiences affect biological stress systems, such as the hypothalamic–pituitary–adrenal (HPA) axis. Life stress can potentially alter regulation of the HPA axis and has been associated with poorer physical and mental health. Little, however, is known about the relative influence of stressors that are encountered at different developmental periods on acute stress reactions in adulthood. In this study, we explored three models of the influence of stress exposure on cortisol reactivity to a modified version of the Trier Social Stress Test (TSST) by leveraging 37 years of longitudinal data in a high-risk birth cohort (N = 112). The cumulative stress model suggests that accumulated stress across the lifespan leads to dysregulated reactivity, whereas the biological embedding model implicates early childhood as a critical period. The sensitization model assumes that dysregulation should only occur when stress is high in both early childhood and concurrently. All of the models predicted altered reactivity, but do not anticipate its exact form. We found support for both cumulative and biological embedding effects. However, when pitted against each other, early life stress predicted more blunted cortisol responses at age 37 over and above cumulative life stress. Additional analyses revealed that stress exposure in middle childhood also predicted more blunted cortisol reactivity.

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Cumulative effects of prenatal substance exposure and early adversity on foster children’s HPA-axis reactivity during a psychosocial stressor

International Journal of Behavioral Development ◽

10.1177/0165025411406863 ◽

2011 ◽

Vol 36 (1) ◽

pp. 29-35 ◽

Cited By ~ 36

Author(s):

Philip A. Fisher ◽

Hyoun K. Kim ◽

Jacqueline Bruce ◽

Katherine C. Pears

Keyword(s):

Physical Abuse ◽

Hpa Axis ◽

Social Stress ◽

Stress Test ◽

Area Under The Curve ◽

Trier Social Stress Test ◽

Early Adversity ◽

Psychosocial Stressor ◽

Prenatal Substance Exposure ◽

Substance Exposure

Dysregulated hypothalamic-pituitary-adrenocortical (HPA) axis stress response has been reported among individuals with prenatal substance exposure and those with early adversity exposure. However, few researchers have examined the combined effects of these risk factors. Patterns of HPA reactivity among maltreated foster children with and without prenatal substance exposure ( N = 53; ages 9–12 years) were examined using the Trier Social Stress Test for Children. Area under the curve with respect to increase (AUCI) analyses revealed that prenatal substance exposure or physical abuse significantly increased the likelihood of a negative AUCI (i.e., little or no HPA reactivity). Among children with prenatal substance exposure and physical abuse, 85% exhibited a negative AUCI. The results underscore the importance of addressing this combined risk.

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Attachment Style And Cortisol Response To Psychosocial Stress In Eating Disorder Patients

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1545 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S426-S427

Author(s):

R. Giugliano ◽

A.M. Monteleone ◽

F. De Riso ◽

M. Nigro ◽

F. Monaco ◽

...

Keyword(s):

Attachment Style ◽

Hpa Axis ◽

Social Stress ◽

Attachment Styles ◽

Stress Test ◽

Stressful Events ◽

Insecure Attachment ◽

Trier Social Stress Test ◽

Secure Attachment ◽

Hpa Response

IntroductionStress exposure is a risk factor for both the onset and the maintenance of Eating Disorders (EDs). The attachment theory may provide a framework to explain the relationship between social stress and EDs, since secure attachment promotes the seeking for support in order to help people to face stressful events. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, is likely involved in mediating the role of attachment in the subjects’ coping with stressful situations.Objectives and aimsWe explored cortisol responses to the Trier Social Stress Test (TSST) of patients with EDs in order to evaluate possible associations between subjects’ attachment styles and HPA axis functioning.MethodsTwenty-one adult patients with EDs (7 with secure attachment and 14 with insecure attachment) filled in the Experience in Close Relationship (ECR) questionnaire, which assesses the adult attachment style, and were exposed to the TSST. Saliva samples were collected before and after the stress in order to measure cortisol levels.ResultsAs compared to ED patients with secure attachment, those with insecure attachment showed a significant different pattern of the HPA response to the stress test.DiscussionPresent findings suggest that attachment style may influence the HPA response to stress in patients with EDs and this effect may have relevant implications for the pathophysiology of EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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DHEA Moderates the Impact of Childhood Trauma on the HPA Axis in Adolescence

Neuropsychobiology ◽

10.1159/000511629 ◽

2021 ◽

pp. 1-14

Author(s):

Sarah J. Taylor-Cavelier ◽

Valerie J. Micol ◽

Andrea G. Roberts ◽

Elisa G. Geiss ◽

Nestor Lopez-Duran

Keyword(s):

Childhood Trauma ◽

Hpa Axis ◽

Childhood Maltreatment ◽

Social Stress ◽

Stress Test ◽

Trier Social Stress Test ◽

Neuroprotective Effects ◽

Response To Stress ◽

The Impact

Background: Trauma can lead to long-term downregulation of the hypothalamic pituitary adrenal (HPA) axis. However, dehydroepiandrosterone (DHEA) has neuroprotective effects that may reduce the need for downregulation of the axis in response to stress. Furthermore, high DHEA/cortisol ratios are often conceptualized as better markers of DHEA’s availability than DHEA alone, as ratios account for the coupling of DHEA and cortisol in response to stress. Objectives: In this study, we explored if DHEA and DHEA/cortisol ratios moderated the association between childhood maltreatment and the HPA axis stress response. Methods: The sample consisted of 101 adolescents (ages 12–16) who completed the Child Trauma Questionnaire (CTQ) and the Trier Social Stress Test (TSST). Cortisol was modeled using saliva samples at 8 time points throughout the TSST. Cortisol and DHEA ratios were examined at baseline and 35 min after stress initiation. Results: Childhood maltreatment was associated with less steep cortisol activation slope and peak cortisol levels, but DHEA and DHEA/cortisol ratios moderated this effect. At high levels of DHEA, the impact of childhood maltreatment on cortisol peak levels was no longer significant. In contrast, high DHEA/cortisol ratios were associated with an intensification of the impact of childhood maltreatment on peak levels. Conclusions: Results suggest that DHEA can limit the blunting of the HPA axis in response to childhood maltreatment. However, this protective effect was not reflected in high DHEA/cortisol ratios as predicted. Therefore, high DHEA and high DHEA/cortisol ratios may reflect different, and potentially opposite, processes.

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