The Effect of Trier Social Stress Test (TSST) on Item and Associative Recognition of Words and Pictures in Healthy Participants

White-matter correlates of anxiety: The contribution of the corpus-callosum to the study of anxiety and stress-related disorders

OBJECTIVES

Traumatic stress has been associated with increased risk for brain alterations and development of anxiety disorders. Studies conducted in posttraumatic patients have shown white-mater volume and diffusion alterations in the corpus-callosum. Decreased cognitive performance has been demonstrated in acute stress disorder and posttraumatic patients. However, whether cognitive alterations result from stress related neuropathology or reflect a predisposition is not known. In the current study, we examined in healthy controls, whether individual differences in anxiety are associated with those cognitive and brain alterations reported in stress related pathologies.

METHODS

Twenty healthy volunteers were evaluated for anxiety using the state-trait inventory (STAI), and were tested for memory performance. Brain imaging was employed to extract volumetric and diffusion characteristics of the corpus-callosum.

RESULTS

Significant correlations were found between trait anxiety and all three diffusion parameters (fractional-anisotropy, mean and radial-diffusivity). Associative-memory performance and corpus-callosum volume were also significantly correlated.

CONCLUSION

We suggest that cognitive and brain alterations, as tested in the current work and reported in stress related pathologies, are present early and possibly persist throughout life. Our findings support the hypothesis that individual differences in trait anxiety predispose individuals towards negative cognitive outcomes and brain alterations, and potentially to stress related disorders.

Thinking about it: the impact of COVID-19-related stimuli on prospective memory

Background

Since 2020, information regarding COVID-19 has been a constant presence in the news, in our conversations and thoughts. Continuous exposure to this type of stimuli could have an impact on cognitive processes essential for our everyday activities, such as prospective memory (PM). PM is the ability to remember to perform an intention at a specific point in the future, like remembering to take prescribed medicines at a specific time or to turn off the stove after cooking. Do COVID-related stimuli affect our ability to perform a PM task?

Methods

To answer this question, we proposed a novel version of the classical paradigm used to investigate PM. Namely, this paradigm includes a baseline condition, in which an ongoing task is presented alone, and a PM condition in which the same task is proposed again together with a second (prospective) task. In this study, a short video clip was presented between the baseline and the PM condition. The video clip displayed either neutral, negative, or COVID-related content. Additionally, participants were asked to respond to two questionnaires and a series of questions regarding their well-being and experience with the pandemic. Namely, the DASS-21 scale (evaluating depression, anxiety, and stress), and the COVID-19-PTSD questionnaire (a questionnaire evaluating post-traumatic stress disorder symptoms related to the pandemic experience) were administered. Participants' performance and responses were analyzed using a linear mixed effect (LME) model approach, and correlation analyses were run to highlight possible correlations between participants' scores in the DASS-21, the COVID-19-PTSD, and the additional questions on their personal experience with the pandemic.

Results

The LME models revealed significant effects of the displayed video on performance: in line with previous studies, the clip displaying standard negative contents led to impaired accuracy in the ongoing task in the PM condition, compared to the Baseline. In contrast, participants who saw the COVID-related clip showed improved accuracy in the ongoing task compared to the other participants, selectively in the block performed after the video clip was displayed (PM condition). Furthermore, the explanatory power of the LME model calculated on accuracy to the ongoing trials was enhanced by the inclusion of the scores in the anxiety subscale of the DASS-21, suggesting a detrimental role of anxiety. Altogether, these results indicate a different effect of the exposure to classical negative contents (associated with a cost in terms of accuracy in the ongoing task between the baseline and the PM condition) and the pandemic-related one, which was instead characterized by a higher accuracy to ongoing trials compared to the other video clips. This counterintuitive finding seems to suggest that COVID-related stimuli are processed as "acute stressors" rather than negative stimuli, thus inducing a state of increased alertness and responsivity.

A method to induce stress in human subjects in online research environments

This paper presents a method to induce stress in human subjects during online participation in research studies without the presence of researchers. In this study, participants in the stress-inducing condition (N = 52, 44%) were asked to answer general knowledge and mathematical questions which people often get wrong, and did so under time pressure as well as receiving feedback. In contrast, participants in the control condition (N = 66, 56%) did not have time pressure or receive feedback. The stress manipulation was found to be effective, as the reported state anxiety and visual analog scale on stress scores were higher for the stress group than for the non-stress group (both findings, p < 0.001). Consistent findings were found when accounting for trait anxiety as a moderator, with the exception of the state anxiety levels in high trait anxiety group. This stressing method combines the established stress conditions of uncontrollability (such as time pressures) and social evaluative threats (such as negative feedback). In addition, the method contains specific measures (such as a commitment statement and attention check questions) to enhance the internal validity by preventing and detecting cheating or random responses. This method can be deployed through any commonly available online software. It offers a simple and cost-effective way to collect data online - which fits the increasing need to carry out research in virtual and online environments.

Associations between saliva alpha-amylase, heart rate variability, saliva cortisol and cognitive performance in individuals at ultra high-risk for psychosis

BACKGROUND

Cognitive impairments are present in individuals at ultra-high risk (UHR) of psychosis and UHR individuals exhibit a hyperactive and dysfunctional HPA-axis. Increasing stress levels could potentially lead to cognitive impairments and no previous studies have examined the association between physiological stress biomarkers and cognition in UHR individuals. This study aims to examine the association between saliva alpha amylase (SAA), heart rate variability (HRV), saliva cortisol, and cognition in UHR individuals.

METHOD

We included 72 UHR individuals, aged 18-40, fulfilling criteria of the comprehensive assessment of at-risk mental state (CAARMS). Cognitive tests indexed the 7 core domains as stated by Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS). Physiological stress levels were observed for one day: saliva was collected at awakening, 30 min and 60 min after awakening and at bedtime. HRV was measured during sleep and before awakening. We used generalized linear model and controlled for multiple testing using false discovery rate (FDR).

RESULTS

Higher levels of SAA were significantly associated with lower cognitive performance in the domains of verbal and visual learning and memory, sustained attention, working memory and global neurocognition looking at unadjusted data. Controlling for FDR visual memory, sustained attention and global neurocognition remained significant associated with SAA. We discovered no associations between cortisol and cognition.

CONCLUSION

Visual learning and memory, sustained attention and global neurocognition remained significantly associated with SAA. This finding supports our hypothesis that an association between abnormal stress biomarkers and impaired cognition might be present in UHR individuals.

Neither Threat of Shock nor Acute Psychosocial Stress Affects Ambiguity Attitudes

Decisions under uncertainty can be differentiated into two classes: risky, which has known probabilistic outcomes, and ambiguous, which has unknown probabilistic outcomes. Across a variety of types of decisions, people find ambiguity extremely aversive, subjectively more aversive than risk. It has been shown that the transient sympathetic arousal response to a choice predicts decisions under ambiguity but not risk, and that lifetime stress uniquely predicts attitudes toward ambiguity. Building on these findings, this study explored whether we could bias ambiguity and risk preferences with an arousal or acute stress manipulation that is incidental to the choice in two independent experiments. One experiment induced sympathetic arousal with an anticipatory threat paradigm, and the other manipulated incidental acute stress via a psychosocial stressor. The efficacy of the manipulations was confirmed via pupil dilation and salivary cortisol, respectively. Participants made choices between a guaranteed $5 option and a lottery with either a known (risky) or unknown (ambiguous) probabilistic outcome. Consistent with previous findings, participants were more averse to a given level of ambiguity than to a numerically equal level of risk. However, in contrast to our hypothesis, we found no evidence that transient arousal or acute stress that is incidental to the choice biases ambiguity preferences.

Human state anxiety classification framework using EEG signals in response to exposure therapy

Human anxiety is a grave mental health concern that needs to be addressed in the appropriate manner in order to develop a healthy society. In this study, an objective human anxiety assessment framework is developed by using physiological signals of electroencephalography (EEG) and recorded in response to exposure therapy. The EEG signals of twenty-three subjects from an existing database called "A Database for Anxious States which is based on a Psychological Stimulation (DASPS)" are used for anxiety quantification into two and four levels. The EEG signals are pre-processed using appropriate noise filtering techniques to remove unwanted ocular and muscular artifacts. Channel selection is performed to select the significantly different electrodes using statistical analysis techniques for binary and four-level classification of human anxiety, respectively. Features are extracted from the data of selected EEG channels in the frequency domain. Frequency band selection is applied to select the appropriate combination of EEG frequency bands, which in this study are theta and beta bands. Feature selection is applied to the features of the selected EEG frequency bands. Finally, the selected subset of features from the appropriate frequency bands of the statistically significant EEG channels were classified using multiple machine learning algorithms. An accuracy of 94.90% and 92.74% is attained for two and four-level anxiety classification using a random forest classifier with 9 and 10 features, respectively. The proposed state anxiety classification framework outperforms the existing anxiety detection framework in terms of accuracy with a smaller number of features which reduces the computational complexity of the algorithm.

From Wellbeing to Social Media and Back: A Multi-Method Approach to Assessing the Bi-Directional Relationship Between Wellbeing and Social Media Use

Literature concerning the relationship between social media use and wellbeing is inconsistent in its findings, and most research has focused on time spent on social media rather than on what emerging adults do there, with whom and why. Here, we investigated whether momentary social stress affects emerging adults’ social media use, and whether this social media use relates to subsequent changes in wellbeing. We implemented a multi-method paradigm utilising objective and self-report data to investigate how social stress relates to how (much) and why emerging adults use social media. We report on findings based on 114 17–25-year-old emerging adults recruited on university campus. Our findings suggest that social stress does not affect adolescents’ subsequent social media use and that there is no relationship between social media use after stress and changes in momentary wellbeing. Our work illustrates the need for detailed approaches in social media and psychological wellbeing research.

Current psychosocial stress, childhood trauma and cognition in patients with schizophrenia and healthy participants

BACKGROUND

Cognitive difficulties are experienced frequently in schizophrenia (SZ) and are strongly predictive of functional outcome. Although severity of cognitive difficulties has been robustly associated with early life adversity, whether and how they are affected by current stress is unknown. The present study investigated whether acute stress reactivity as measured by heart rate and mood changes predict cognitive performance in patients with schizophrenia and healthy individuals, and whether this is moderated by diagnosis and previous childhood trauma exposure.

METHODS

One hundred and four patients with schizophrenia and 207 healthy participants were administered a battery of tasks assessing cognitive performance after psychosocial stress induction (Trier Social Stress Test; TSST). Mood states (Profile of Mood States; POMS) and heart rate were assessed at baseline, immediately before, and after the TSST.

RESULTS

Both healthy participants and patients showed increases in POMS Tension and Total Mood Disturbance scores between Time Point 2 (pre-TSST) and Time Point 3 (post-TSST). These changes were not associated with variation in cognition. Although childhood trauma exposure was associated with higher stress reactivity and poorer cognitive function in all participants, childhood trauma did not moderate the association between stress reactivity and cognition. Neither was diagnosis a moderator of this relationship.

DISCUSSION

These findings suggest that while chronic stress exposure explains significant variation in cognition, acute stress reactivity (measured by changes in Tension and Total Mood Disturbance) did not. In the context of broader developmental processes, we conclude that stressful events that occur earlier in development, and with greater chronicity, are likely to be more strongly associated with cognitive variation than acute transient stressors experienced in adulthood.

Does Acute Stress Impact Declarative and Procedural Learning?

It is well established that acute stress can influence memory function, yet its influence may differ across memory systems. Whereas stress sometimes exerts a negative influence on declarative learning, it does not necessarily harm learning in general, as demonstrated in the case of procedural learning. Probabilistic category learning is mediated by the striatum, but delaying feedback by a few seconds shifts learning to become more hippocampal-dependent. Here, we examined the influence of acute stress on this type of learning, under different conditions that favor either procedural-based (immediate feedback) vs. declarative-based (delayed feedback) learning. Sixty-two participants randomly assigned to either stress or non-stress groups, performed a probabilistic category learning task, in which they were instructed to learn associations between cues and outcomes under different feedback conditions (immediate feedback, short-delayed feedback, and long-delayed feedback). Acute stress was induced by the Maastricht Acute Stress Test (MAST), and stress levels were gauged by Galvanic Skin Response (GSR) measures and a self-reported questionnaire. Results showed that although the MAST was effective in inducing stress, this did not harm learning in either of the feedback conditions. These findings suggest that not all hippocampal-based learning types are negatively influenced by stress.

Repressors exhibit lower cortisol reactivity to group psychosocial stress

Repressors are well-known to monitor potential psychosocial threats to their self-esteem and self-concept. In research, repressors are traditionally categorised as those scoring low on trait anxiety and high on defensiveness (as measured by social desirability scales). Examining repressors' cortisol reactivity to a group socio-evaluative laboratory stressor could be an important way to extend work on the classic 'repressor dissociation', which proposes that this group experience higher levels of physiological stress, but lower levels of subjective affect, during stressful situations. Research however has focused mainly on repressors' higher, more risk-prone levels of autonomic, rather than hypothalamic-pituitary-adrenal (HPA), reactivity to stressful stimuli. We assessed cortisol reactivity using a group-based acute psychosocial stressor, the Trier Social Stress Test for groups (TSST-G), which required participants to individually perform public speaking and mental arithmetic tasks in front of up to six other group members, as well as an evaluative panel of judges. Seventy-seven healthy young females (mean age ± SD: 20.2 ± 3.2 years) took part, of which 64 met the conventional criterion for a response to the TSST-G (<15.5% increase from baseline sample). The Stress-Arousal Checklist was completed pre- and post-TSST-G. Participants also completed the Perceived Stress Scale, the Trait Anxiety Inventory and the Marlow-Crowne Social Desirability Scale. The latter two measures were used to provide a categorisation of repressive coping style. Participants identified as repressive copers exhibited significantly lower cortisol reactivity during the TSST-G. Repressors also self-reported less subjective stress. These findings provide some evidence against the notion of the repressor dissociation and are discussed in terms of how cortisol hyporeactivity may be a pathway through which repressive coping adversely affects health.

Protective and therapeutic effects of exercise on stress-induced memory impairment

The objective of this paper was to systematically evaluate the potential preventive and therapeutic effects of exercise in attenuating stress-induced memory impairment. A systematic review was employed, searching PubMed, PsychInfo, Sports Discus and Google Scholar databases. For eligibility, studies had to be published in English, employ an experimental design, have the acute or chronic bout of exercise occur prior to, during or after the stressor, implement a psychophysiological stressor, and have an assessment of memory function occurring after the stressor. In total, 23 studies were evaluated, all of which were conducted among animal models. All 23 studies employed a chronic exercise protocol and a chronic stress protocol. Eight studies evaluated a preventive model, three employed a concurrent model, ten studies employed a therapeutic model, and two studies evaluated both a preventive and therapeutic model within the same study. Among the eight studies employing a preventive model, all eight demonstrated that the stress regimen impaired memory function. In all eight of these studies, when exercise occurred prior to the stressor, exercise attenuated the stress-induced memory impairment effect. Among the ten studies employing a therapeutic model, one study showed that the stress protocol enhanced memory function, one showed that the stress protocol did not influence memory, and eight demonstrated that the stress regimen impaired memory function. Among the eight studies showing that the stress protocol impaired memory function, all eight studies demonstrated that exercise, after the stressor, attenuated stress-induced memory impairment. Within animal models, chronic stress is associated with memory impairment and chronic exercise has both a preventive and therapeutic effect in attenuating stress-induced memory impairment. Additional experimental work in human studies is needed. Such work should also examine acute exercise and stress protocols.

The impact of threat of shock-induced anxiety on memory encoding and retrieval

Anxiety disorders are the most common mental health disorders, and daily transient feelings of anxiety (or "stress") are ubiquitous. However, the precise impact of both transient and pathological anxiety on higher-order cognitive functions, including short- and long-term memory, is poorly understood. A clearer understanding of the anxiety-memory relationship is important as one of the core symptoms of anxiety, most prominently in post-traumatic stress disorder (PTSD), is intrusive reexperiencing of traumatic events in the form of vivid memories. This study therefore aimed to examine the impact of induced anxiety (threat of shock) on memory encoding and retrieval. Eighty-six healthy participants completed tasks assessing: visuospatial working memory, verbal recognition, face recognition, and associative memory. Critically, anxiety was manipulated within-subjects: information was both encoded and retrieved under threat of shock and safe (no shock) conditions. Results revealed that visuospatial working memory was enhanced when information was encoded and subsequently retrieved under threat, and that threat impaired the encoding of faces regardless of the condition in which it was retrieved. Episodic memory and verbal short-term recognition were, however, unimpaired. These findings indicate that transient anxiety in healthy individuals has domain-specific, rather than domain-general, impacts on memory. Future studies would benefit from expanding these findings into anxiety disorder patients to delineate the differences between adaptive and maladaptive responding.