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Schote AB, Dietrich K, Linden AE, Dzionsko I, Molano Moreno LDLA, Winnikes U, Zimmer P, Domes G, Meyer J. Real sweating in a virtual stress environment: Investigation of the stress reactivity in people with primary focal hyperhidrosis. PLoS One 2022; 17:e0272247. [PMID: 35917298 PMCID: PMC9345359 DOI: 10.1371/journal.pone.0272247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 07/16/2022] [Indexed: 12/04/2022] Open
Abstract
Background Hyperhidrosis (excessive sweating, OMIM %114110) is a complex disorder with multifactorial causes. Emotional strains and social stress increase symptoms and lead to a vicious circle. Previously, we showed significantly higher depression scores, and normal cortisol awakening responses in patients with primary focal hyperhidrosis (PFH). Stress reactivity in response to a (virtual) Trier Social Stress Test (TSST-VR) has not been studied so far. Therefore, we measured sweat secretion, salivary cortisol and alpha amylase (sAA) concentrations, and subjective stress ratings in affected and non-affected subjects in response to a TSST-VR. Method In this pilot study, we conducted TSST-VRs and performed general linear models with repeated measurements for salivary cortisol and sAA levels, heart rate, axillary sweat and subjective stress ratings for two groups (diagnosed PFH (n = 11), healthy controls (n = 16)). Results PFH patients showed significantly heightened sweat secretion over time compared to controls (p = 0.006), with highest quantities during the TSST-VR. In both groups, sweating (p < 0.001), maximum cortisol levels (p = 0.002), feelings of stress (p < 0.001), and heart rate (p < 0.001) but not sAA (p = 0.068) increased significantly in response to the TSST-VR. However, no differences were detected in subjective ratings, cortisol concentrations and heart rate between PFH patients and controls (pall > 0.131). Conclusion Patients with diagnosed PFH showed stress-induced higher sweat secretion compared to healthy controls but did not differ in the stress reactivity with regard to endocrine or subjective markers. This pilot study is in need of replication to elucidate the role of the sympathetic nervous system as a potential pathway involved in the stress-induced emotional sweating of PFH patients.
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Affiliation(s)
- Andrea B. Schote
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Katharina Dietrich
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Adrian E. Linden
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Inga Dzionsko
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | | | - Ulrike Winnikes
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
| | - Patrick Zimmer
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer, Trier, Germany
| | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, Johanniterufer, Trier, Germany
- * E-mail:
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Norden M, Hofmann AG, Meier M, Balzer F, Wolf OT, Böttinger E, Drimalla H. Inducing and Recording Acute Stress Responses on a Large Scale With the Digital Stress Test (DST): Development and Evaluation Study. J Med Internet Res 2022; 24:e32280. [PMID: 35838765 PMCID: PMC9338415 DOI: 10.2196/32280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background Valuable insights into the pathophysiology and consequences of acute psychosocial stress have been gained using standardized stress induction experiments. However, most protocols are limited to laboratory settings, are labor-intensive, and cannot be scaled to larger cohorts or transferred to daily life scenarios. Objective We aimed to provide a scalable digital tool that enables the standardized induction and recording of acute stress responses in outside-the-laboratory settings without any experimenter contact. Methods On the basis of well-described stress protocols, we developed the Digital Stress Test (DST) and evaluated its feasibility and stress induction potential in a large web-based study. A total of 284 participants completed either the DST (n=103; 52/103, 50.5% women; mean age 31.34, SD 9.48 years) or an adapted control version (n=181; 96/181, 53% women; mean age 31.51, SD 11.18 years) with their smartphones via a web application. We compared their affective responses using the international Positive and Negative Affect Schedule Short Form before and after stress induction. In addition, we assessed the participants’ stress-related feelings indicated in visual analogue scales before, during, and after the procedure, and further analyzed the implemented stress-inducing elements. Finally, we compared the DST participants’ stress reactivity with the results obtained in a classic stress test paradigm using data previously collected in 4 independent Trier Social Stress Test studies including 122 participants overall. Results Participants in the DST manifested significantly higher perceived stress indexes than the Control-DST participants at all measurements after the baseline (P<.001). Furthermore, the effect size of the increase in DST participants’ negative affect (d=0.427) lay within the range of effect sizes for the increase in negative affect in the previously conducted Trier Social Stress Test experiments (0.281-1.015). Conclusions We present evidence that a digital stress paradigm administered by smartphone can be used for standardized stress induction and multimodal data collection on a large scale. Further development of the DST prototype and a subsequent validation study including physiological markers are outlined.
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Affiliation(s)
- Matthias Norden
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amin Gerard Hofmann
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Martin Meier
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Felix Balzer
- Institute of Medical Informatics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Erwin Böttinger
- Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York City, NY, United States
| | - Hanna Drimalla
- Faculty of Technology, Bielefeld University, Bielefeld, Germany.,Digital Health Center, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
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Choi JW, Thakur H, Cohen JR. Cardiac autonomic functioning across stress and reward: Links with depression in emerging adults. Int J Psychophysiol 2021; 168:1-8. [PMID: 34280425 DOI: 10.1016/j.ijpsycho.2021.07.625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022]
Abstract
The autonomic nervous system (ANS) has received much attention as a potential low-cost, peripheral indicator of depression. Despite theoretical support, however, results have been mixed as to whether indices of the ANS reliably index depression. In response, the present study sought to clarify the relation between ANS activity and depression by examining cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR), two composite indices of the parasympathetic and sympathetic nervous system, within both a stressful and rewarding context. We hypothesized that CABStress, representing the difference between the parasympathetic and sympathetic branches in response to stress, and CARReward, representing the summation of the two branches in response to reward, will be most indicative of depressogenic risk. We examined the parasympathetic (i.e., respiratory sinus arrhythmia) and sympathetic (i.e., pre-ejection period) responses of 97 emerging adults (Mage = 18.93) for a stress (i.e., negative mood induction) and reward (i.e., probabilistic learning) task, as well as their depressive symptoms at baseline, 3-week, and 6-week follow-up. Analyses found partial support for our hypotheses, revealing greater CARReward (i.e., coactivation of both branches) was related to lower depressive symptoms. Further, exploratory analyses examining gender differences found lower CABStress (i.e., sympathetically-oriented response) was predictive of an increasing trajectory of depression, but only among males. Overall, the current study highlights the importance of simultaneously examining both branches of the ANS across various environmental contexts. Research and clinical implications of the current findings are discussed.
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Affiliation(s)
- Jae Wan Choi
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
| | - Hena Thakur
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
| | - Joseph R Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, USA.
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Vatheuer CC, Vehlen A, von Dawans B, Domes G. Gaze behavior is associated with the cortisol response to acute psychosocial stress in the virtual TSST. J Neural Transm (Vienna) 2021; 128:1269-1278. [PMID: 33914146 DOI: 10.1007/s00702-021-02344-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 04/21/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Trier Social Stress Test (TSST) is a reliable tool for psychobiological stress induction. Because of its socio-evaluative nature, it has been useful for investigating gaze behavior. It has been shown that healthy people avoid looking toward faces when under stress, a finding that corroborates studies demonstrating avoidance of eye contact in social anxiety disorder. Yet, little is known about the relationship between gaze behavior and the biological stress response. METHODS In a final sample of 74 healthy males, a virtual reality version of the Trier Social Stress Test (TSST-VR) with an integrated eye tracker was implemented to investigate gaze behavior during acute stress induction. Stress response measures were collected via saliva samples and subjective stress ratings. Additional questionnaires were administered for examining the influence of social anxiety traits. RESULTS The TSST-VR elicited a significant psychobiological stress response. Overall, higher gaze times on judges compared to surroundings were found in the speech task while this pattern was reversed in the arithmetic task. Critically, there was a significant negative association between gaze time on judges and cortisol output in cortisol responders. CONCLUSIONS In a non-clinical sample, avoidance of gaze is associated with a stronger cortisol response to acute stress. This study demonstrates the potential of eye tracking to disentangle the effects of acute stress on social interaction, warranting further investigation in clinical populations characterized by high levels of anxiety in social situations, such as social anxiety and autism spectrum disorder.
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Affiliation(s)
- C Carolyn Vatheuer
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290, Trier, Germany
| | - Antonia Vehlen
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290, Trier, Germany
| | - Bernadette von Dawans
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290, Trier, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Johanniterufer 15, 54290, Trier, Germany.
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Craw OA, Smith MA, Wetherell MA. Manipulating Levels of Socially Evaluative Threat and the Impact on Anticipatory Stress Reactivity. Front Psychol 2021; 12:622030. [PMID: 33692723 PMCID: PMC7937816 DOI: 10.3389/fpsyg.2021.622030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
Previous work suggests that relative increases in socially evaluative threat modulate the psychobiological stress response. However, few studies have compared stressors which manipulate the level of socially evaluative threat to which the participant is exposed. Here we present two studies. In the first, we assessed the integrity of an ecologically valid, laboratory stressor (direct socially evaluated multitasking) and its effects on acute psychobiological reactivity and ability to evoke an anticipatory response prior to participation. Specifically, we assessed whether the expectation and experience of direct social evaluation (multitasking while standing and facing an evaluator) evokes greater reactivity than indirect evaluation (over-the-shoulder evaluation). In the second study, we sought to replicate the findings regarding acute stress reactivity whilst extending the assessment window to assess the extent to which the stressor evokes anticipatory responses. As hypothesized, greater reactivity was observed following direct social evaluation compared with indirect observation. Increases in anxiety, heart rate and blood pressure were demonstrated across both studies and the paradigm therefore provides an ecologically valid technique for the activation of psychological and cardiovascular stress responding. Additionally, anticipation of experiencing socially evaluated multitasking led to increases in anxiety, tension, and worry prior to the event itself, supporting previous suggestions that threat anticipation may prolong the activation of stress mechanisms. In the present studies we assessed whether the expectation and experience of direct social evaluation evokes greater reactivity than indirect evaluation. The findings have demonstrated that direct social evaluation of multitasking is a more potent stressor than multitasking with indirect evaluation. Furthermore, our findings indicate that the period of anticipation of stressful events may be critical to understanding the process of stress regulation, and as such we recommend extending the sampling window to allow for the investigation of these processes.
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Affiliation(s)
- Olivia A. Craw
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael A. Smith
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mark A. Wetherell
- Stress Research Group, Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
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Larradet F, Niewiadomski R, Barresi G, Caldwell DG, Mattos LS. Toward Emotion Recognition From Physiological Signals in the Wild: Approaching the Methodological Issues in Real-Life Data Collection. Front Psychol 2020; 11:1111. [PMID: 32760305 PMCID: PMC7374761 DOI: 10.3389/fpsyg.2020.01111] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/30/2020] [Indexed: 12/26/2022] Open
Abstract
Emotion, mood, and stress recognition (EMSR) has been studied in laboratory settings for decades. In particular, physiological signals are widely used to detect and classify affective states in lab conditions. However, physiological reactions to emotional stimuli have been found to differ in laboratory and natural settings. Thanks to recent technological progress (e.g., in wearables) the creation of EMSR systems for a large number of consumers during their everyday activities is increasingly possible. Therefore, datasets created in the wild are needed to insure the validity and the exploitability of EMSR models for real-life applications. In this paper, we initially present common techniques used in laboratory settings to induce emotions for the purpose of physiological dataset creation. Next, advantages and challenges of data collection in the wild are discussed. To assess the applicability of existing datasets to real-life applications, we propose a set of categories to guide and compare at a glance different methodologies used by researchers to collect such data. For this purpose, we also introduce a visual tool called Graphical Assessment of Real-life Application-Focused Emotional Dataset (GARAFED). In the last part of the paper, we apply the proposed tool to compare existing physiological datasets for EMSR in the wild and to show possible improvements and future directions of research. We wish for this paper and GARAFED to be used as guidelines for researchers and developers who aim at collecting affect-related data for real-life EMSR-based applications.
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Affiliation(s)
- Fanny Larradet
- Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Radoslaw Niewiadomski
- Contact Unit, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Giacinto Barresi
- Rehab Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
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