Validation of an online version of the trier social stress test in adult men and women

Stress-related eating in pregnancy? An RCT examining links between prenatal stress and food choices

BACKGROUND

Diet quality during pregnancy is important for maternal health and offspring development. However, national dietary recommendations are not always met. A potential barrier for healthy food choices might be the experience of stress. Previous literature in non-pregnant populations suggests a negative effect of acute stress on diet quality. This preregistered study is the first to test whether an acute stressor leads to unhealthy food choices in pregnancy and examine the moderating role of stress, depressive and anxiety complaints in daily life.

METHOD

Pregnant women (N = 110, 3rd trimester) completed online self-reported surveys measuring stress, depressive and anxiety complaints in daily life. Hereafter, participants were invited for a laboratory visit, in which they were exposed to the Trier Social Stress Test or a control task. After this manipulation, self-reported and actual food choices and food intake were assessed. At the end of the visit, a hair sample was collected. Throughout the visit, visual analogue scales on negative affect were completed and saliva samples were collected.

RESULTS

The stress group experienced significantly more psychological stress than the control group during the experimental manipulation. Main regression analyses showed that the acute laboratory stressor did not cause unhealthy food choices in the third trimester of pregnancy. In fact, the stress group chose fewer unhealthy foods and consumed fewer kilocalories compared to the control group. Additionally, the findings point at a moderating role of depressive and stress complaints in daily life on food choices within the control group: higher scores were related to more unhealthy food choices and more kilocalories consumed.

DISCUSSION

As this was the first study to test the effect of an acute stressor on food choices in pregnant women, more research is needed to obtain a better understanding of stress-related eating in pregnancy. This knowledge may inform future interventions to support pregnant women in improving their diet quality.

Acute stress influences the emotional foundations of executive control: Distinct effects on control-related affective and cognitive processes

Acute stress is known to influence performance on various task outcomes indicative of executive functioning (i.e., the top-down, goal-directed control of cognition and behavior). The most common interpretation of these effects is that stress influences control processes themselves. Another possibility, though, is that stress does not impair control per se, but instead alters the affective dynamics underlying the recruitment of control (e.g., reducing the extent to which making an error is aversive), resulting in less recruitment of control and thus poor performance. To date, however, no work has examined whether stress effects on executive function outcomes are driven by affective dynamics related to the recruitment of control. In the current study, we found that acute stress influenced-and cortisol responses related to-both executive control-related performance outcomes (e.g., post-error slowing) and control-related affective dynamics (e.g., negative affect following recruitment of control) in a modified Stroop task, but that these effects appeared to be independent of each other: The effects of stress on, and associations of cortisol with, control-related cognitive outcomes were not statistically mediated by task- or control-related affective dynamics. These results thus suggest that although stress influences affective dynamics underlying executive function, the effects of stress on executive function outcomes appear to be at least partially dependent on nonaffective processes, such as control processes themselves.

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.

(A lack of) effects of acute social stress on attentional bias to threat

Attentional biases toward or away from emotionally evocative stimuli have been well documented and are known to be clinically relevant, making it important to understand how various factors contribute to them. Some work has suggested that acute stress modulates attentional biases, but this work has produced inconsistent results. For example, many studies have found that stress enhances attentional bias, others that stress decreases attentional bias, and others still that there is no effect of stress at all. Methodological differences may explain these inconsistencies. For example, discrepancies exist between studies in participant sex (e.g., mixed sample vs. all men) and in the type of attentional bias paradigm. We addressed these gaps by examining the effects of an acute social stressor (vs. control) on attentional bias assessed via facial dot probe, focusing on potential sex differences in these effects (N = 141). We found that, overall, participants were significantly biased towards threat, but biases did not differ by stress condition or sex. These findings help to clarify the existing discrepancy in the literature, as we found that stress exerts little if any effect on attentional bias assessed via a facial dot probe.

Cardiovascular, self-report, and behavioral stress reactivity to the group-based Trier Social Stress Test with pandemic-related protocol adaptations

Research using stress induction protocols such as the Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) during the coronavirus disease (COVID-19) pandemic has been challenging. While institutional review boards have provided guidance on returning to face-to-face research using COVID-19 adaptations (e.g., masking, social distancing), whether these adaptations influence the effectiveness of social-evaluative stress induction remains unknown. We conducted a secondary data analysis from a randomized controlled trial to establish whether using COVID-19 adaptations (i.e., masking, social distancing, and using a single large conference room for the duration of the experiment) to the TSST-G protocol was able to reliably induce stress across cardiovascular, self-report, and behavioral indices of stress. Young adults (N = 53) underwent the TSST-G with COVID-19 adaptations. We measured systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), self-reported, and behavioral responses to the TSST-G, and all variables indicated successful stress induction. Increases in SBP (18 mmHg) and DBP (14 mmHg) were similar in magnitude as those in standard in-person TSST protocols. Increases in HR (9 beats per minute) were smaller in magnitude than standard in-person TSST protocols, but slightly larger than increases documented in remote TSST protocols. The cardiovascular, self-report, and behavioral indices of stress reactivity provide confidence in the effectiveness of TSST-G with COVID-19 adaptations to reliably induce stress. In-person TSST protocols with COVID-19 adaptations represent an alternate option to remote TSST protocols for stress induction researchers to use during times when masking or social distancing are necessary.