Effects of panel sex composition on the physiological stress responses to psychosocial stress in healthy young men and women

Social high performers under stress behave more prosocially and detect happy emotions better in a male sample

Psychosocial stress is increasing in society, impacting our lives in all social domains. However, the conditions under which stress facilitates ("tend-and-befriend") or hinders ("fight-or-flight") social approach remain elusive. We tested whether previous heterogeneous findings might be resolved by accounting for individual differences in social performance under stress. For that purpose, we introduce the novel Trier Social Stress Test (TSST) social performance index that was aggregated across ratings from two independent observers. Moreover, we apply an innovative setup enabling electroencephalographic (EEG) data to be measured inside an electrically-shielded cabin during stress, namely the TSST-EEG. Relying on a sample of 59 healthy male participants, we collected behavioral (i.e., sharing resources with others) and cognitive (i.e., detecting facial emotional expressions) approach patterns while participants experienced either acute psychosocial stress (n = 31) or no stress (control condition; n = 28) and while EEG was being recorded. During stress exposure, high-performing participants behaved more prosocially, and differentiated better between happy and neutral emotions on both behavioral and neurophysiological levels (revealed by intensity differences in a N170-like response). Overall, our findings demonstrate the added value of both the novel TSST social performance index and the novel TSST-EEG setup. By showing that high social performance during the TSST is associated with behavioral, cognitive, and neurophysiological approach patterns, our study offers valuable insights into adaptive or maladaptive psychobiological mechanisms in coping with psychosocial stress. Future stress research should address the role of social performance differences during stress in social interaction to better understand the behavioral consequences of psychosocial stress in humans.

Relationships between drinking habits, psychological resilience, and salivary cortisol responses on the Trier Social Stress Test-Online among Japanese people

BACKGROUND

This study aimed to determine whether individual differences in resilience interacted with those in alcohol consumption habits in situations involving exposure to psychosocial stressors (Trier Social Stress Test-Online; TSST-OL). Additionally, we investigated whether individuals exhibiting resilience in their psychological scale scores showed biological responses that could be interpreted as resilience in stressful situations, such as the TSST-OL. We hypothesized that there would be no association between drinking habits and stress responses in the high-resilience group. Furthermore, high drinking habits would be associated with high stress responses in the low-resilience group.

METHODS

We recruited 22 and 20 individuals from the high and low-resilience groups, respectively, from among those who completed the online survey comprising the Alcohol Use Disorders Identification Test (AUDIT) and resilience scales; we excluded individuals with AUDIT scores of 15 or higher, and divided them by the median total resilience scale score. During the TSST-OL, self-rated stress measurement and saliva sample collection were performed seven times. Frozen samples were collected at the Tokyo site, and salivary hormonal (cortisol and dehydroepiandrosterone) levels were measured after transport in frozen state. Finally, 36 participants were included in the analysis of self-rated stress and cortisol levels.

RESULTS

We observed the typical subjective stress responses to the TSST-OL. People with higher psychological scale scores for resilience traits showed significantly higher salivary cortisol levels than those with lower scores. Due to deficiencies in the survey and experimental design, the classification criteria were changed and an exploratory analysis was performed to investigate the interaction of individual differences in resilience and drinking habits. In contrast to our expectation, those with low resilience scores showed stress responses, regardless of their drinking habits. Furthermore, those with high resilience and drinking habits showed a specific insensitivity to salivary cortisol levels. Their self-rated stress scores were similar to those of other groups.

CONCLUSIONS

Our study showed the applicability of the TSST-OL in the Japanese population, the individual relationship between psychological resilience measures and biological stress responses, and a specific insensitivity in the salivary cortisol response as a result of individual differences in high resilience and drinking habits.

The effects of everyday-life social interactions on anxiety-related autonomic responses differ between men and women

Social buffering, a phenomenon where social presence can reduce anxiety and fear-related autonomic responses, has been studied in numerous laboratory settings. The results suggest that the familiarity of the interaction partner influences social buffering while also providing some evidence for gender effects. In the laboratory, however, it is difficult to mimic the complexity of real-life social interactions. Consequently, the social modulation of anxiety and related autonomic responses in everyday life remains poorly understood. We used smartphone-based Ecological Momentary Assessment (EMA) combined with wearable electrocardiogram sensors to investigate how everyday-life social interactions affect state anxiety and related cardiac changes in women and men. On five consecutive days, 96 healthy young participants (53% women) answered up to six EMA surveys per day, indicating characteristics of their most recent social interaction and the respective interaction partner(s). In women, our results showed lower heart rate in the presence of a male interaction partner. Men showed the same effect with female interaction partners. Moreover, only women showed decreased heart rate and increased heart rate variability with increasing interaction partner familiarity. These findings specify the conditions under which social interactions reduce anxiety-related responses in women and men.

Neuroendocrine Response and State Anxiety Due to Psychosocial Stress Decrease after a Training with Subject's Own (but Not Another) Virtual Body: An RCT Study

Previous research involving healthy participants has reported that seeing a moving virtual body from the first person perspective induces the illusion of ownership and agency over that virtual body. When a person is sitting and the virtual body runs, it is possible to measure physiological, behavioral and cognitive reactions that are comparable to those that occur during actual movement. Capitalizing on this evidence, we hypothesized that virtual training could also induce neuroendocrine effects that prompt a decreased psychosocial stress response, as occurs after physical training. While sitting, 26 healthy young adults watched a virtual avatar running for 30 min from the first person perspective (experimental group), while another 26 participants watched the virtual body from the third person perspective (control group). We found a decreased salivary alpha-amylase concentration (a biomarker for the stress response) after the virtual training among the experimental group only, as well as a decreased subjective feeling of state anxiety (but no difference in heart rate). We argue that the virtual illusion of a moving body from the first person perspective can initiate a cascade of events, from the perception of the visual illusion to physiological activation that triggers other biological effects, such as the neuroendocrine stress response.

The gonadal response to social stress and its relationship to cortisol

The cortisol response to social evaluative stress has been well characterized. However, data regarding changes in gonadal hormones after stress are still scarce and inconsistent. The majority of studies have focused on testosterone reactivity to stress in men, while estradiol responses or gonadal stress responses in women have hardly been investigated. Furthermore, it has not been evaluated whether sex hormone reactivity to stress differs between men and women and the relationship between cortisol and gonadal reactivity to stress is still unclear. To address these questions, we re-analyzed saliva samples collected from 37 men and 30 women in their luteal cycle phase before and repeatedly after social-evaluative stress. Both, testosterone and estradiol levels were assessed. In both men and women, testosterone was significantly reduced after stress. Testosterone levels were at their lowest after 20 minutes, but did not return to baseline until 35 minutes after stress. Across the whole sample, estradiol was significantly increased after stress with two separate peaks after 15 and 30 minutes. Follow-up analyses revealed that 41 participants actually responded with a decrease in estradiol levels to stress, with lowest levels after 20 min, while the remaining participants responded with an increase in estradiol levels. These gonadal stress responses appear to be largely independent of the cortisol response to stress. These results demonstrate that the endocrinological stress response is not restricted to the HPA axis and stress responsivity of gonadal hormones is not simply driven by cortisol. Accordingly, the stress responsivity of gonadal hormones and their association to psychological variables is an additional avenue to explore in both men and women.

Social evaluation under stress: Does acute stress affect social attributions and eye gaze?

Acute stress has been found to elicit pro-social, anti-social or null responses in humans. The causes for these contradicting findings are currently poorly understood, and may rise from subjects' characteristics, such as sex or hormonal status, as well as stimuli-based traits, such as group membership. In the current study, 120 subjects performed either the Trier Social Stress Test or a control (non-stress inducing) condition, followed by ranking displayed faces according to several attributes (e.g., trustworthiness, attractiveness, dominance). Participants' eye gaze was also tracked while viewing facial stimuli. We examined how acute stress interacts with participants' sex, female participants' hormonal status (hormonal contraceptives, early-follicular phase and mid-luteal phase), and the observed faces’ social group (ethnicity-based in-group or out-groups). In general, frequentist and Bayesian analyses showed that acute stress exposure did not affect social attributions or gaze behavior, nor did it interact with subjects' sex or the group membership of the observed faces. Interestingly, sub-group analyses showed that in females, acute stress interacted with hormonal status to yield heterogenous anti-social effects, such as post-stress reductions in perceived trustworthiness in the early-follicular phase, and lower perceived attractiveness in the mid-luteal phase. Given the small sample sizes for the sub-groups, these results should be viewed as preliminary until further replicated. Our results highlight the necessity for large-scale studies, particularly in females, to further refine existing theories regarding the nature and contexts by which acute stress elicits changes in social cognition and behavior.

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Bayesian analysis showed that stress did not broadly affect social attributions.

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However, females' hormonal status may interact with stress to modulate attributions.

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Attributions were highly biased against out-group members, regardless of stress.

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Stress also did not influence patterns of eye gaze to faces.

Negative self-evaluation induced by acute stress indexed using facial EMG

Maladaptive stress responses are a key feature of several psychiatric disorders, but findings of stress effects on social behavior are inconsistent. Using a within-subject design, we investigated, in 35 healthy participants, the effects of acute stress on psychophysiological and behavioral responses during a simulated online social interaction task. Participants were exposed to established stress and non-stress exposure procedures in two separate sessions. During the task, participants liked or disliked pictures of other putative players and, similarly, saw their own picture being judged by others. After stress exposure, corrugator muscle activity (frowning) was significantly increased when participants saw their own picture while anticipating feedback from others. Consistently, zygomatic muscle activity (smiling) for self-evaluation was lower after stress than in the non-stress session. We found self-report of stress to be a significant predictor of corrugator activity in both sessions, indicating that higher levels of subjective stress overall were accompanied by increased negative self-evaluation. Surprisingly, no stress effects were found on behavioral measures of other-evaluation (i.e., percentage of dislikes to others), but corrugator response significantly predicted the percentage of dislikes during the stress session only. Overall, our findings suggest that stress increases negative self-evaluation as indexed by elevated corrugator activity. Furthermore, stress might sharpen the consistency between corrugator activity and negative evaluation of others. Our results indicate that negative self-evaluation might be a useful therapeutic target in patients with stress-related psychiatric disorders. In this context, facial muscle activity may be an adequate biomarker for identifying stress-related differences in self-evaluation.

Resilience and Psychobiological Response to Stress in Older People: The Mediating Role of Coping Strategies

Resilience, the ability to overcome adversity and face stressful demands and experiences, has been strongly associated with successful aging, a low risk of diseases and high mental and physical functioning. This relationship could be based on adaptive coping behaviors, but more research is needed to gain knowledge about the strategies employed to confront social stress. Thus, we aimed to investigate the role of the use of active or passive coping strategies by resilient people in dealing with stressful situations. For this purpose, we measured resilience, coping strategies, and perceived stress in 66 healthy older adults (31 men and 35 women) between 56 and 75 years old who were exposed to stress (Trier Social Stress Test, TSST) or a control situation. The stress response was analyzed at endocrine (cortisol) and psychological (anxiety) levels. In the stress condition, moderated mediation analysis showed a conditional indirect effect of resilience on cortisol reactivity through active coping. However, passive coping strategies did not mediate the resilience-cortisol relationship. In addition, neither active nor passive coping mediated the relationship between resilience and the anxiety response. These results suggest that resilience is associated with active coping strategies, which in turn could explain, at least in part, individual differences in the cortisol response to a psychosocial laboratory stressor. These factors may prevent the development of stress-related pathologies associated with aging and facilitate healthy and satisfactory aging.

"Seat of the soul"? The structure and function of the pineal gland in women with alleged spirit possession-Results of two experimental studies

BACKGROUND

Cultural traditions attribute to pineal gland an important role for spiritual experiences. Mediumship and spirit possession are cultural phenomena found worldwide which have been described as having dissociative and psychotic-like characteristics, but with nonpathological aspects. A sympathetic activation pattern in response to spirit possession has been reported in some studies, but empirical data on pineal gland is scarce in this context.

METHODS

We aimed to investigate pineal gland and pituitary volumes, as well as urinary 6-sulfatoxymelatonin levels in 16 alleged mediums (Medium Group-MG) compared with 16 healthy nonmedium controls (Control Group) (Experiment 1). Furthermore, we aimed to evaluate urinary 6-sulfatoxymelatonin and stress reactivity in GM (n = 10) under different physiological conditions (Experiment 2).

RESULTS

In Experiment 1, MG presented higher scores of anomalous experiences, but there were no between-group differences regarding mental health or subjective sleep quality. Similar pineal gland and pituitary volumes were observed between groups. There were no between-group differences in urinary 6-sulfatoxymelatonin collected under equivalent baseline conditions. In Experiment 2, the rise of anxiety and heart rate in response to mediumistic experience was intermediate between a nonstressful control task (reading) and a stressful control task (Trier Social Stress Test-TSST). No significant differences were observed in 6-sulfatoxymelatonin urinary levels between the three conditions. The pattern of stress reactivity during the TSST was normal, but with an attenuated salivary cortisol response.

CONCLUSION

The normal neuroimaging and stress reactivity findings in MG contrast with the abnormal results usually observed in subjects with psychotic and dissociative disorders.

A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research

Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.

Neural responses to social evaluative threat in the absence of negative investigator feedback and provoked performance failures

Functional neuroimaging of social stress induction has considerably furthered our understanding of the neural risk architecture of stress‐related mental disorders. However, broad application of existing neuroimaging stress paradigms is challenging, among others due to the relatively high intensity of the employed stressors, which limits applications in patients and longitudinal study designs. Here, we introduce a less intense neuroimaging stress paradigm in which subjects anticipate, prepare, and give speeches under simulated social evaluation without harsh investigator feedback or provoked performance failures (IMaging Paradigm for Evaluative Social Stress, IMPRESS). We show that IMPRESS significantly increases perceived arousal as well as adrenergic (heart rate, pupil diameter, and blood pressure) and hormonal (cortisol) responses. Amygdala and perigenual anterior cingulate cortex (pACC), two key regions of the emotion and stress regulatory circuitry, are significantly engaged by IMPRESS. We further report associations of amygdala and pACC responses with measures of adrenergic arousal (heart rate, pupil diameter) and social environmental risk factors (adverse childhood experiences, urban living). Our data indicate that IMPRESS induces benchmark psychological and endocrinological responses to social evaluative stress, taps into core neural circuits related to stress processing and mental health risk, and is promising for application in mental illness and in longitudinal study designs.

Association of naturally occurring sleep loss with reduced amygdala resting-state functional connectivity following psychosocial stress

Enduring sleep loss is a risk factor for a variety of both somatic and mental health issues. When subjected to sleep loss, the brain becomes vulnerable to critical alterations in cognitive and emotional processing. In our study, we examined the effect of psychosocial stress on amygdala resting-state functional connectivity in participants with cumulative sleep loss calculated across the seven days preceding scanning. For this purpose, forty-five healthy male participants completed a one-week sleep diary and underwent resting-state scans before and after taking part in the ScanSTRESS paradigm, which allows social stress induction during functional magnetic resonance imaging. Sleep loss was negatively associated with seed-based functional connectivity of the left amygdala with the medial prefrontal cortex, dorsal anterior cingulate cortex, anterior insula, posterior cingulate cortex, and dorsolateral prefrontal cortex. That is, participants with higher amounts of sleep loss showed reduced left amygdala connectivity after social stress induction to cortical regions encompassing main nodes of the brain's default mode network and salience network. Our results shed more light on how brain functional connectivity may shape the brain's stress response in the context of naturally occurring sleep loss, revealing a potential neural mechanism for increased vulnerability to stress-related psychopathology.

Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis

Although results of animal research show that interactions between stress and sex hormones are implicated in the development of affective disorders in women, translation of these findings to patients has been scarce. As a basic step toward advancing this field of research, we analyzed findings of studies which reported circulating cortisol levels in healthy women in the follicular vs. luteal phase of the menstrual cycle. We deemed this analysis critical not only to advance our understanding of basic physiology, but also as an important contrast to the findings of future studies evaluating stress and sex hormones in women with affective disorders. We hypothesized that cortisol levels would be lower in the follicular phase based on the proposition that changes in levels of potent GABAergic neurosteroids, including allopregnanolone, during the menstrual cycle dynamically change in the opposite direction relative to cortisol levels. Implementing strict inclusion criteria, we compiled results of high-quality studies involving 778 study participants to derive a standardized mean difference between circulating cortisol levels in the follicular vs. luteal phase of the menstrual cycle. In line with our hypothesis, our meta-analysis found that women in the follicular phase had higher cortisol levels than women in the luteal phase, with an overall Hedges' g of 0.13 (p < 0.01) for the random effects model. No significant between-study difference was detected, with the level of heterogeneity in the small range. Furthermore, there was no evidence of publication bias. As cortisol regulation is a delicate process, we review some of the basic mechanisms by which progesterone, its potent metabolites, and estradiol regulate cortisol output and circulation to contribute to the net effect of higher cortisol in the follicular phase.

Frontal Control Over Automatic Emotional Action Tendencies Predicts Acute Stress Responsivity

BACKGROUND

The ability to control social-emotional actions is relevant for everyday social interaction and may be indicative of responsiveness to actual social stress situations. This is particularly relevant for predicting stress responsiveness of the hypothalamic-pituitary-adrenal axis, known to be dysregulated in various stress-related affective disorders. Here we tested, in a large sample, whether reduced frontal control over social approach-avoidance actions can indeed signal increased hypothalamic-pituitary-adrenal axis reactivity to subsequent social stress exposure.

METHODS

A total of 279 subjects (214 men) participated in a functional magnetic resonance imaging social-emotional approach-avoidance task that involved impulsive and controlled emotional actions. Subsequently, participants underwent a stress induction including a socially evaluated cold pressor task and a mental arithmetic task. Salivary cortisol and α-amylase levels, as well as self-reported negative affect, were measured before and after stress induction.

RESULTS

Emotion control was successfully induced by the approach-avoidance task. Namely, instrumental overriding of automatic social approach-avoidance actions was associated with the typical increased bilateral anterior prefrontal cortex activation, longer reaction times, and more errors. Moreover, subsequent stress induction led to significant increases in all stress measures. Critically, bilateral anterior prefrontal cortex activation during emotion control was associated with reduced responses to the subsequent stressor in not only cortisol but also α-amylase and negative affect.

CONCLUSIONS

The ability to recruit prefrontal regions during social-emotion regulation predicts cortisol responses to an actual social stress situation. This finding provides the first evidence that instrumental control over social approach avoidance actions can signal stress responsiveness in major stress systems, providing a promising biomarker in stress vulnerability and resilience research relevant for affective disorders.

GABAB receptor mediate hippocampal neuroinflammation in adolescent male and female mice after cold expose

Stress induces many non-specific inflammatory responses in the mouse brain, especially during adolescence. Although the impact of stress on the brain has long been reported, the effects of cold stress on hippocampal neuroinflammation in adolescent mice are not well understood; furthermore, whether these effects are gender specific are also not well established. Adolescent male and female C57BL/6 mice were exposed to 4 °C temperatures for 12 h, after which behavior was assessed using the open field test. Using western blotting and immunohistochemistry we also assessed glial cell numbers and microglial activation, as well as inflammatory cytokine levels and related protein expression levels. We found that in mice subjected to cold stress: 1) There were significant behavioral changes; 2) neuronal nuclei densities were smaller and total cell numbers were significantly decreased; 3) nuclear factor (NF)-κB and phosphorylated AKT were upregulated; 4) pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α were also upregulated; and 5) microglia were activated, while glial fibrillary acid protein and ionized calcium-binding adapter molecule 1 protein expression increased. Taken together, these results indicate that cold stress induces pro-inflammatory cytokine upregulation that leads to neuroinflammation and neuronal apoptosis in the hippocampi of adolescent mice. We believe that these effects are influenced by a GABAB/Rap1B/AKT/NF-κB pathway. Finally, male mice were more sensitive to the effects of cold stress than were female mice.

Intrinsic Laryngeal Muscle Response to a Public Speech Preparation Stressor

PURPOSE

Research suggests that abnormal levels of intrinsic laryngeal muscle (ILM) contraction is a potential causal factor in stress-induced voice disorders. This study seeks to characterize the ILM stress response in a cohort of vocally healthy women.

METHOD

The authors used an unblinded, nonrandomized, repeated-measures design. Forty vocally healthy female adults were subjected to a stressful speech preparation task. Measurements of heart rate, blood pressure, trapezius muscle (positive control) activation, and tibialis muscle (negative control) activation were obtained from 37 participants before and during stressor exposure, in a nonvoice and nonspeaking task paradigm, to confirm physiological stress response compared to baseline. Fine wire electromyography of the ILMs (posterior cricoarytenoid, thyroarytenoid/lateral cricoarytenoid muscle complex, and cricothyroid) was performed simultaneously so that the activity of these muscles could be measured prior to and during stressor exposure.

RESULTS

The protocol successfully elicited the typical and expected physiological stress responses. Findings supported the hypothesis that, in some individuals, the ILMs significantly increase in activity during stress reactions compared to baseline, as do the control muscles.

CONCLUSIONS

This study characterizes ILM responses to psychological stress in vocally healthy participants. Some of the female adults in this study appeared to be "laryngeal stress responders," as evidenced by increased activity of the ILMs during a silent (i.e., nonvocal, nonspeech) speech preparation task that they considered to be stressful.

Differences in Neural Recovery From Acute Stress Between Cortisol Responders and Non-responders

Adaptive recovery from a stressor fosters resilience. So far, however, few studies have examined brain functional connectivity in the aftermath of stress, with inconsistent results reported. Focusing on the immediate recovery from psychosocial stress, the current study compared amygdala resting-state functional connectivity (RSFC) before and immediately after psychosocial stress between cortisol responders and non-responders. Differences between groups were expected for amygdala RSFC with regions involved in down-regulation of the physiological stress response, emotion regulation, and memory consolidation. Eighty-six healthy participants (36 males/50 females) underwent a social stress paradigm inside the MRI scanner. Before and immediately after stress, resting-state (RS) fMRI scans were acquired to determine amygdala RSFC. Next, changes in connectivity from pre- to post-stress were compared between cortisol responders and non-responders. Responders demonstrated a cortisol increase, higher negative affect, and decreased heart rate variability (HRV) in response to stress compared to non-responders. A significant Sex-by-Responder-by-Time interaction was found between the bilateral amygdala and posterior cingulate cortex (PCC) and precuneus (p < 0.05, corrected). As males were also more likely to show a cortisol increase to the stress task than females, follow-up analyses were conducted for both sexes separately. Whereas no difference was observed between female responders and non-responders, male non-responders showed an increase in FC after stress between the bilateral amygdala and the PCC and precuneus (p < 0.05, corrected). The increased coupling of the amygdala with the PCC/precuneus, a core component of the default mode network (DMN), might indicate an increased engagement of the amygdala within the DMN directly after stress in non-responders. Although this study was carried out in healthy participants, and the results likely reflect normal variations in the neural response to stress, understanding the mechanisms that underlie these variations could prove beneficial in revealing neural markers that promote resilience to stress-related disorders.

The burden of conscientiousness? Examining brain activation and cortisol response during social evaluative stress

Although conscientiousness has for a long time been considered generally adaptive, there are findings challenging this view, suggesting that conscientiousness might be less advantageous during uncontrollable stress. We here examined the impact of conscientiousness on brain activation during and the cortisol response following an uncontrollable social evaluative stress task in order to test this hypothesis. Brain activation and cortisol levels were measured during an fMRI stress task, where subjects (n=86) performed cognitive tasks containing preprogrammed failure under time pressure, while being monitored by a panel of experts inducing social-evaluative threat. The degree of conscientiousness was measured using the NEO-FFI. We observed a positive correlation between conscientiousness and salivary cortisol levels in response to the stressful task in male subjects only. In male subjects conscientiousness correlated positively with activation in right amygdala and left insula, and, moreover, mediated the influence of amygdala and insula activation on cortisol output. This pattern of brain activation can be interpreted as a disadvantageous response to uncontrollable stress to which highly conscientious individuals might be predisposed. This is the first study showing the effect of conscientiousness on physiology and brain activation to an uncontrollable psychosocial stressor. Our results provide neurobiological evidence for the hypothesis that conscientiousness should not just be seen as beneficial, but rather as a trait associated with either costs or benefits depending on the extent to which one is in control of the situation.

The Trier Social Stress Test: Principles and practice

Researchers interested in the neurobiology of the acute stress response in humans require a valid and reliable acute stressor that can be used under experimental conditions. The Trier Social Stress Test (TSST) provides such a testing platform. It induces stress by requiring participants to make an interview-style presentation, followed by a surprise mental arithmetic test, in front of an interview panel who do not provide feedback or encouragement. In this review, we outline the methodology of the TSST, and discuss key findings under conditions of health and stress-related disorder. The TSST has unveiled differences in males and females, as well as different age groups, in their neurobiological response to acute stress. The TSST has also deepened our understanding of how genotype may moderate the cognitive neurobiology of acute stress, and exciting new inroads have been made in understanding epigenetic contributions to the biological regulation of the acute stress response using the TSST. A number of innovative adaptations have been developed which allow for the TSST to be used in group settings, with children, in combination with brain imaging, and with virtual committees. Future applications may incorporate the emerging links between the gut microbiome and the stress response. Future research should also maximise use of behavioural data generated by the TSST. Alternative acute stress paradigms may have utility over the TSST in certain situations, such as those that require repeat testing. Nonetheless, we expect that the TSST remains the gold standard for examining the cognitive neurobiology of acute stress in humans.

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The TSST is the human experimental gold standard for evaluating the neurobiology of acute stress.

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The HPA axis response to the TSST is higher in males and lower in older adults.

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Genotype and epigenetic factors moderate the neurobiological response to the TSST.

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Multiple adaptations of the TSST are available for different testing contexts.

Hypothalamic-pituitary-adrenal axis response to acute psychosocial stress: Effects of biological sex and circulating sex hormones

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis influences the risk for developing stress-related disorders. Sex-dependent differences in the HPA axis stress response are believed to contribute to the different prevalence rates of stress-related disorders found in men and women. However, studies examining the HPA axis stress response have shown mixed support for sex differences, and the role of endogenous sex hormones on HPA axis response has not been adequately examined in humans. This study utilized the largest sample size to date to analyze the effects of biological sex and sex hormones on HPA axis social stress responses. Healthy, 18- to 30- year-old community volunteers (N=282) completed the Trier Social Stress Test (TSST), a widely used and well-validated stress-induction laboratory procedure. All women (n=135) were tested during the follicular phase of their menstrual cycle (when progesterone levels are most similar to men). Adrenocorticotropic hormone (ACTH) and cortisol measures were collected at multiple points throughout pre- and post-TSST. Testosterone and progesterone (in men) and progesterone and estradiol (in women) were determined pre-TSST. Following the TSST, men had greater ACTH and cortisol levels than women. Men had steeper baseline-to-peak and peak-to-end ACTH and cortisol response slopes than women; there was a trend for more cortisol responders among men than women. Testosterone negatively correlated with salivary cortisol response in men, while progesterone negatively correlated with ACTH and cortisol responses in women. These data confirm that men show more robust activation of the HPA axis response to the TSST than do women in the follicular phase of the menstrual cycle. Testosterone results suggest an inhibitory effect on HPA axis reactivity in men. Progesterone results suggest an inhibitory effect on HPA axis reactivity in women. Future work is needed to explain why men mount a greater ACTH and cortisol response to the TSST than do women during the follicular phase of the menstrual cycle.

The Influence of Menstrual Cycle and Androstadienone on Female Stress Reactions: An fMRI Study

Communicating threats and stress via biological signaling is common in animals. In humans, androstadienone (ANDR), a synthetic male steroid, is a socially relevant chemosignal exhibited to increase positive mood and cortisol levels specifically in (periovulatory) females in positively arousing contexts. In a negative context, we expected that such effects of ANDR could amplify social evaluative threat depending on the stress sensitivity, which differs between menstrual cycle phases. Therefore, this fMRI study aimed to examine psychosocial stress reactions on behavioral, hormonal and neural levels in 31 naturally cycling females, between 15 early follicular (EF) and 16 mid-luteal (ML) females tested with ANDR and placebo treatment in a repeated-measures design. Regardless of odor stimulation, psychosocial stress (i.e., mental arithmetic task with social evaluative threat) led to elevated negative mood and anxiety in all females. A negative association of social threat related amygdala activation and competence ratings appeared in ML-females, indicating enhanced threat processing by ANDR, particularly in ML-females who felt less competent early in the stress experience. Further, ML-females showed reduced performance and stronger stress-related hippocampus activation compared to EF-females under ANDR. Hippocampal activation in ML-females also correlated positively with post-stress subjective stress. Contrarily, such patterns were not observed in EF-females or under placebo in either group. Strikingly, unlike passive emotional processing, ANDR in a stressful context decreased cortisol concentration in all females. This points to a more complex interaction of ovarian/gonadal hormones in social threat processing and stress reactivity. Our findings suggest that ANDR enhanced initial evaluation of self-related social threat in ML-females. Female stress reactions are related to stress sensitivity through enhanced awareness and processing of social cues in a stressful context, with menstrual cycle phase being a critical factor.

Stress responses to repeated exposure to a combined physical and social evaluative laboratory stressor in young healthy males

Repeated exposure to homotypic laboratory psychosocial stressors typically instigates rapid habituation in hypothalamic-pituitary-adrenal (HPA) axis-mediated stress responses in humans. However, emerging evidence suggests the combination of physical stress and social evaluative threat may be sufficient to attenuate this response habituation. Neuroendocrine, cardiovascular and subjective stress responses following repeated exposure to a combined physical and social evaluative stress protocol were assessed to examine the habituation response dynamic in this context. The speech task of the Trier social stress test (TSST; Kirschbaum et al., 1993) and the socially evaluated cold pressor task (SECPT; Schwabe et al., 2008) were administered in a combined stressor protocol. Salivary cortisol, cardiovascular and subjective stress responses to a non-stress control and repeat stressor exposure separated by six weeks were examined in males (N=24) in a crossover manner. Stressor exposure resulted in significant elevations in all stress parameters. In contrast to the commonly reported habituation in cortisol response, a comparable post-stress response was demonstrated. Cortisol, heart rate and subjective stress responses were also characterised by a heightened response in anticipation to repeated stress exposure. Blood pressure responses were comparatively uniform across repeated exposures. Findings suggest a combined physical and social evaluative stressor is a potentially useful method for study designs that require repeated presentation of a homotypic stressor.

A Stress-Induced Shift From Trace to Delay Conditioning Depends on the Mineralocorticoid Receptor

BACKGROUND

Fear learning in stressful situations is highly adaptive for survival by steering behavior in subsequent situations, but fear learning can become disproportionate in vulnerable individuals. Despite the potential clinical significance, the mechanism by which stress modulates fear learning is poorly understood. Memory theories state that stress can cause a shift away from more controlled processing depending on the hippocampus toward more reflexive processing supported by the amygdala and striatum. This shift may be mediated by activation of the mineralocorticoid receptor (MR) for cortisol. We investigated how stress shifts processes underlying cognitively demanding learning versus less demanding fear learning using a combined trace and delay fear conditioning paradigm.

METHODS

In a pharmacological functional magnetic resonance imaging study, we tested 101 healthy men probing the effects of stress (socially evaluated cold pressor vs. control procedure) and MR-availability (400 mg spironolactone vs. placebo) in a randomized, placebo-controlled, full-factorial, between-subjects design.

RESULTS

Effective stress induction and successful conditioning were confirmed by subjective, physiologic, and somatic data. In line with a stress-induced shift, stress enhanced later recall of delay compared with trace conditioning in the MR-available groups as indexed by skin conductance responses. During learning, this was accompanied by a stress-induced reduction of learning-related hippocampal activity for trace conditioning. The stress-induced shift in fear and neural processing was absent in the MR-blocked groups.

CONCLUSIONS

Our results are in line with a stress-induced shift in fear learning, mediated by the MR, resulting in a dominance of cognitively less demanding amygdala-based learning, which might be particularly prominent in individuals with high MR sensitivity.

Thinking of attachments reduces noradrenergic stress response

Although there is much evidence that activating mental representations of attachments figure is beneficial for psychological health and can reduce stress response, no research has directly investigated whether attachment activation can ameliorate hormonal stress response. This study investigated whether activating an attachment figure or a non-attachment figure following administration of a socially evaluated cold pressor test to elicit stress impacted on glucocorticoid and noradrenergic response. Participants (N = 61) provided baseline salivary samples, underwent a cold pressor test, then imagined an attachment or non-attachment figure, and finally provided subsequent saliva samples. Participants who imagined a non-attachment figure had greater noradrenergic response following the stressor than those who imagined an attachment figure. These findings highlight that activating attachment representations can ameliorate the immediate noradrenergic stress response.

Coping with an acute psychosocial challenge: behavioral and physiological responses in young women

Despite the relevance of behavior in understanding individual differences in the strategies used to cope with stressors, behavioral responses and their relationships with psychobiological changes have received little attention. In this study on young women, we aimed at analyzing the associations among different components of the stress response and behavioral coping using a laboratory psychosocial stressor. The Ethological Coding System for Interviews, as well as neuroendocrine, autonomic and mood parameters, were used to measure the stress response in 34 young women (17 free-cycling women in their early follicular phase and 17 oral contraceptive users) subjected to the Trier Social Stress Test (TSST) and a control condition in a crossover design. No significant differences in cardiac autonomic, negative mood and anxiety responses to the stressor were observed between the two groups of women. However, women in the follicular phase showed a higher cortisol response and a larger decrease in positive mood during the social stress episode, as well as greater anxiety overall. Interestingly, the amount of displacement behavior exhibited during the speaking task of the TSST was positively related to anxiety levels preceding the test, but negatively related to baseline and stress response values of heart rate. Moreover, the amount of submissive behavior was negatively related to basal cortisol levels. Finally, eye contact and low-aggressiveness behaviors were associated with a worsening in mood. Overall, these findings emphasize the close relationship between coping behavior and psychobiological reactions, as well as the role of individual variations in the strategy of coping with a psychosocial stressor.

Emotion regulation: exploring the impact of stress and sex

Emotion regulation is a major prerequisite for adaptive behavior. The capacity to regulate emotions is particularly important during and after the encounter of a stressor. However, the impact of acute stress and its associated neuroendocrine alterations on emotion regulation have received little attention so far. This study aimed to explore how stress-induced cortisol increases affect three different emotion regulation strategies. Seventy two healthy men and women were either exposed to a stressor or a control condition. Subsequently participants viewed positive and negative images and were asked to up- or down-regulate their emotional responses or simultaneously required to solve an arithmetic task (distraction). The factors stress, sex, and strategy were operationalized as between group factors (n = 6 per cell). Stress caused an increase in blood pressure and higher subjective stress ratings. An increase in cortisol was observed in male participants only. In contrast to controls, stressed participants were less effective in distracting themselves from the emotional pictures. The results further suggest that in women stress enhances the ability to decrease negative emotions. These findings characterize the impact of stress and sex on emotion regulation and provide initial evidence that these factors may interact.

Sex differences in cognitive regulation of psychosocial achievement stress: brain and behavior

Although cognitive regulation of emotion has been extensively examined, there is a lack of studies assessing cognitive regulation in stressful achievement situations. This study used functional magnetic resonance imaging in 23 females and 20 males to investigate cognitive downregulation of negative, stressful sensations during a frequently used psychosocial stress task. Additionally, subjective responses, cognitive regulation strategies, salivary cortisol, and skin conductance response were assessed. Subjective response supported the experimental manipulation by showing higher anger and negative affect ratings after stress regulation than after the mere exposure to stress. On a neural level, right middle frontal gyrus (MFG) and right superior temporal gyrus (STG) were more strongly activated during regulation than nonregulation, whereas the hippocampus was less activated during regulation. Sex differences were evident: after regulation females expressed higher subjective stress ratings than males, and these ratings were associated with right hippocampal activation. In the nonregulation block, females showed greater activation of the left amygdala and the right STG during stress than males while males recruited the putamen more robustly in this condition. Thus, cognitive regulation of stressful achievement situations seems to induce additional stress, to recruit regions implicated in attention integration and working memory and to deactivate memory retrieval. Stress itself is associated with greater activation of limbic as well as attention areas in females than males. Additionally, activation of the memory system during cognitive regulation of stress is associated with greater perceived stress in females. Sex differences in cognitive regulation strategies merit further investigation that can guide sex sensitive interventions for stress-associated disorders.

Association between subjective and cortisol stress response depends on the menstrual cycle phase

The relation between the physiologic and subjective stress responses is inconsistently reported across studies. Menstrual cycle phases variations have been found to influence the psychophysiological stress response; however little is known about possible cycle phase differences in the relationship between physiological and subjective stress responses. This study examined the effect of menstrual cycle phase in the association between subjective stress and physiological response. Forty-five women in either the follicular (n=21) or the luteal phase of the menstrual cycle were exposed to a psychosocial stress task. Salivary cortisol, cardiovascular, and subjective stress were assessed throughout the experiment. Results revealed a significant group difference in the association between peak levels of cortisol and post task subjective stress. In women in the follicular phase a negative association was observed (r(2)=0.199, p=0.04), while this relation was positive in the group of women in the luteal phase (r(2)=0.227, p=0.02). These findings suggest a possible role of sex hormones in modulating the cortisol stress response function in emotion regulation.

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.