The role of anxiety sensitivity in subjective and physiological responses to social and physical stressors

This study examined the specificity of the relationship between anxiety sensitivity (AS), a measure of catastrophizing about arousal-related sensations, and pain responses, by examining the effect of AS on responses to stressors of a physical and social nature. Healthy men and women (n = 129) between the ages of 18 and 25 years were recruited from the community to participate in a study examining subjective, cognitive and behavioural responses to different types of stressors. Participants were randomly assigned to one of 3 groups: (i) a neutral condition in which they sat quietly and read a popular magazine; (ii) a social stress condition in which they anticipated having to give a self-disclosing speech; and (iii) a physical stress condition in which they were presented with 3 countdown to shock trials where a mild electrical shock was administered on the non-dominant arm. Subjective ratings and physiological responses were recorded in anticipation of the stressor and immediately after stress exposure. Results indicated that AS was indirectly related to pain ratings via its effect on anticipatory anxiety ratings. AS was associated with anticipatory anxiety ratings, regardless of whether the stressor was of a physical or social nature. Furthermore, AS was not shown to be directly associated with exaggerated subjective or physiological reactions to the physical stressor. These results indicate that the role of AS in pain responses may be mediated through a global effect on anxiety, and limited to the anticipatory stage of the pain experience. If future studies yield similar findings in pain patients, then they would suggest that interventions for helping individuals high in AS should focus on catastrophic thinking in anticipation of stressors in general, rather than on pain-specific stressors.     

Examination stress and components of working memory

Previous research suggests that stress can influence a broad range of memory functions. In this study we investigated the effect of a naturalistic stressor, examination stress, on working memory in young adults. In order to accomplish this aim, participants were tested on psychological and hormonal measures of stress and on Digit Span, once during a low stress period and once during a high stress period. The high examination stress condition was associated with an increase in cortisol and subjective impressions of stress. Although Digits Forward performance did not vary with examination stress, Digits Backward performance improved. These findings suggest that mild increases in stress are associated with improvement in the manipulation component of working memory. However, no correlations were found between working memory and either cortisol or psychological stress. Thus the mechanism by which mild naturalistic stressors improve the manipulation component of working memory needs further investigation.     

Working memory performance after acute exposure to the cold pressor stress in healthy volunteers

Effects of acute stress exposure on learning and memory have been frequently studied in both animals and humans. However, only a few studies have focused specifically on working memory performance and the available data are equivocal. The present study examined working memory performance during the Sternberg item recognition task after exposure to a predominantly adrenergic stressor. Twenty four healthy subjects were randomly assigned to a stress group or a control group. The stress group was exposed to the cold pressor stress test (CPS; i.e. insertion of the dominant hand into ice water for 60s), while 37 °C warm water was used with the control group. Twenty minutes after the stress exposure, working memory performance was tested with the Sternberg item recognition task with three levels of cognitive load. Sympathetic nervous system and hypothalamic pituitary adrenocortical (HPA) axis activation during CPS, were assessed by measuring heart rate and salivary cortisol before and during (heart rate) or 30 min after (cortisol) the stress procedure. Exposure to the CPS test was associated with a significant increase in heart rate but no increase in salivary cortisol. Participants exposed to the stress procedure showed significantly shorter reaction times during trials with higher cognitive load but tended to show higher false alarm rates than control subjects. The present results indicate that exposure to CPS can be associated with signs of both enhanced and impaired working memory performance. The observed behavioral pattern might represent a form of streamlined information processing advantageous in a threatening situation.     

The cortisol awakening response: Associations with trait anxiety and stress reactivity

This study investigated the extent to which trait anxiety and state anxiety in response to stress are associated with the cortisol awakening response (CAR).Fifty-one healthy participants were recruited. State anxiety measures were taken in anticipation of and during a laboratory stressor. Salivary cortisol levels were measured immediately upon awakening (at 0, 15, 30, and 45 min) on two consecutive mornings. Cortisol awakening response was assessed by the area under the curve with respect to zero (AUC_G).The magnitude of the CAR was found to be negatively associated with both trait anxiety and anticipatory anxiety. Moreover, regression analysis showed that the effects of trait anxiety on the AUC_G were mediated by anticipatory anxiety.These results suggest that the CAR is influenced by trait anxiety. Moreover, the effect of trait anxiety on the CAR seems to operate by impacting on psychological stress reactivity (i.e., anticipatory anxiety).     

Anxiety mediates the effect of acute stress on working memory performance when cortisol levels are high: a moderated mediation analysis

Background: Anxiety is an aversive emotional state characterized by perceived uncontrollability and hypervigilance to threat that can frequently cause disruptions in higher-order cognitive processes like working memory. The attentional control theory (ACT) predicts that anxiety negatively affects the working memory system. Design: This study tested the association between anxiety and working memory after the addition of stress and measured the glucocorticoid, cortisol. To better understand this relationship, we utilized a moderated mediation model. Methods: Undergraduate students from a public university (N = 103) self-reported their anxiety levels. Participants first completed a short-term memory test. During and after a forehead cold pressor task (stress vs. control procedure) participants completed a working memory test. Salivary cortisol was taken at baseline and after the last working memory test. Results: Overall, acute stress had no effect on working memory. However, we found that anxiety levels mediated the influence of condition (stressed vs. control) on working memory, but only among those individuals who had high cortisol levels after exposure to acute stress, supporting a moderated mediation model. Conclusions: These results imply that activation of the hypothalamic–pituitary–adrenal axis was necessary for working memory impairment in anxious individuals. These results provide support for the ACT.     

Psychosocial stress impairs working memory at high loads: an association with cortisol levels and memory retrieval

Stress and cortisol are known to impair memory retrieval of well-consolidated declarative material. The effects of cortisol on memory retrieval may in particular be due to glucocorticoid (GC) receptors in the hippocampus and prefrontal cortex (PFC). Therefore, effects of stress and cortisol should be observable on both hippocampal-dependent declarative memory retrieval and PFC-dependent working memory (WM). In the present study, it was tested whether psychosocial stress would impair both WM and memory retrieval in 20 young healthy men. In addition, the association between cortisol levels and cognitive performance was assessed. It was found that stress impaired WM at high loads, but not at low loads in a Sternberg paradigm. High cortisol levels at the time of testing were associated with slow WM performance at high loads, and with impaired recall of moderately emotional, but not of highly emotional paragraphs. Furthermore, performance at high WM loads was associated with memory retrieval. These data extend previous results of pharmacological studies in finding WM impairments after acute stress at high workloads and cortisol-related retrieval impairments.     

The effects of an acute psychosocial stressor on episodic memory

Although stressors are believed to impair memory, experimental studies with humans have provided inconsistent support for this conclusion. The current study was designed to examine the effect of an acute psychosocial stressor, and subsequent reactivity, on episodic memory. One hundred participants completed a list-recall task before and after random assignment into a stressor or nonstressor condition. Participants assigned to the stressor condition exhibited both impaired delayed and immediate recall, and also exhibited increasesin the commission of intrusions and perseverations. The experience of off-task thoughts and intentional suppression of such thoughts, were associated with greater impairment of immediate recall. Changes in state anxiety, negative mood, and heart rate were unrelated to changes in memory. These data indicate that exposure to a stressor impaired the recall of previously learned information, and compromised the recall of newly acquired information. Furthermore, cognitive interference is an important factor regarding stress-related impairments of episodic memory.     

Timing matters: Temporal dynamics of stress effects on memory retrieval

Stress may impair memory retrieval. This retrieval impairment has been attributed to the action of the stress hormone cortisol, which is released with a delay of several minutes after a stressful encounter. Hence, most studies tested memory retrieval 20–30 min after stress, when the stress-induced cortisol increase peaks. In the present experiment, we investigated whether retrieval impairments can also be found at later intervals after stress. To this end, participants learned a list of words on day 1. Twenty-four hours later, they were first exposed to a stressor or a nonstressful control manipulation and completed a recognition test for the words either immediately thereafter, 25 min later, or 90 min later. Our findings showed that stress did not impair memory retrieval when memory was tested immediately after the stressor, before cortisol levels were elevated. However, retrieval performance was impaired 25 min after stress, when cortisol levels peaked, as well as 90 min after the stressor, when cortisol levels had already returned to baseline. The retrieval impairment 90 min after stress appeared to be even stronger than the one after 25 min. These findings suggest that the detrimental effects of stress on retrieval performance may last longer than is usually assumed.     

The impact of cortisol reactivity to acute stress on memory: sex differences in middle-aged people

Stress has been identified as a main factor involved in the cognitive changes that occur during the aging process. This study investigated sex differences in the relationship between the magnitude of the acute stress-induced salivary cortisol response and memory performance among middle-aged people. To this end, 16 men and 16 women (aged 54-72 years) were exposed to the Trier Social Stress Test and a control condition in a crossover design. Afterwards their memory performance was measured using a standardized memory test (Rey's Auditory Verbal Learning Test). Only among women, there was an acute impact of stress on memory performance and a significant relationship between a higher cortisol response to the stressor and poorer memory performance in both the stress and control conditions. Additionally, a poorer memory performance was related to earlier timing of sexual maturation (age at menarche), which was also marginally related to higher cortisol reactivity to stress. These results confirm that sex is a critical factor in the relationship between cortisol and poor memory performance. Furthermore, the findings emphasize a strong link between the individual cortisol response to stress and memory functioning among postmenopausal women.     

Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder

People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an alpha(2)-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Sprague-Dawley rats were administered a total of 31 days of psychosocial stress, composed of acute and chronic components. The acute component was a 1-h stress session (immobilization during cat exposure), which occurred on Days 1 and 11. The chronic component was that on all 31 days the rats were given unstable housing conditions. We found that psychosocially stressed rats had reduced growth rate, reduced thymus weight, increased adrenal gland weight, increased anxiety, an exaggerated startle response, cognitive impairments, greater cardiovascular and corticosterone reactivity to an acute stressor and heightened responsivity to yohimbine. This work demonstrates the effectiveness of acute inescapable episodes of predator exposure administered in conjunction with daily social instability as an animal model of PTSD.     

Relationship of Mindfulness to Distress and Cortisol Response in Adolescent Girls At-Risk for Type 2 Diabetes

Altered stress response theoretically contributes to the etiology of cardiometabolic disease. Mindfulness may be a protective buffer against the effects of stress on health outcomes by altering how individuals evaluate and respond to stress. We engaged adolescent girls at risk for developing Type 2 diabetes in a cold-pressor test in order to determine the relationship of dispositional mindfulness to cortisol response and subjective stress, including perceived pain and unpleasantness during the stressor, and negative affect following the stressor. We also evaluated mindfulness as a moderator of psychological distress (depressive/anxiety symptoms) and stress response. Participants were 119 girls age 12–17 years with overweight/obesity, family history of diabetes, and mild-to-moderate depressive symptoms. Greater mindfulness was associated with less perceived pain and negative affect, but was unrelated to cortisol response to the stressor. Regardless of mindfulness, greater depressive/anxiety symptoms related to a more blunted cortisol response. Mindfulness might promote better distress tolerance in adolescents at risk for diabetes by altering how youth perceive and relate to acute stress, rather than through altering the physiological stress response. At all levels of mindfulness, depressive/anxiety symptoms relate to greater blunting of cortisol response. Findings contribute to emerging literature on the role of mindfulness in promoting the mental and physical health and well-being of individuals at risk for Type 2 diabetes.     

Timing is everything: Anticipatory stress dynamics among cortisol and blood pressure reactivity and recovery in healthy adults

Psychological states of anticipation modulate biological stress responsivity. While researchers generally investigate how subjective distress corresponds to the magnitude of stress reactivity, physiological recovery after acute stressors must also be considered when investigating disease vulnerabilities. This study assessed whether anticipatory stress would correspond to stress reactivity and recovery of salivary cortisol and blood pressure levels in response to a well-validated psychosocial stressor. Thirty participants (63% female; mean?±?SEM age 45.4?±?2.12 years) were exposed to the Trier Social Stress Test (TSST) consisting of a public speech and mental arithmetic. Ten salivary cortisol samples and systolic and diastolic blood pressure recordings were collected at time points spanning 50?min before and up to 50?min after stress exposure. These data were transformed into parameters representing stress reactivity (area under the curve) and stress recovery (percent change). The Primary Appraisal Secondary Appraisal scale assessed anticipatory stress before exposure to the TSST. Our results revealed that increased anticipatory stress predicted increased stress reactivity for cortisol (p?=?0.009) but not blood pressure. For stress recovery, increased anticipatory stress predicted greater decrements of cortisol concentration (p?=?0.015) and blood pressure (p?=?0.039), even when controlling for total systemic "output" by incorporating baseline activity. This efficient shutdown of stress responses would have otherwise been ignored by solely investigating reactive increases. These findings underscore the importance of measuring multiple dynamic parameters such as recovery when investigating physiological stress response patterns as a function of psychosocial factors.     

Effects of acute psychosocial stress exposure on endocrine and affective reactivity in college students differing in the 5-HTTLPR genotype and trait neuroticism

Enhanced stress vulnerability has been implicated in the pathogenesis of affective disorders. Although both genetic (5-HTTLPR) and cognitive (neuroticism) factors are known to increase stress vulnerability, no experimental study has investigated the interaction between these two factors on psychobiological reactivity following acute stress exposure. This study used a balanced experimental design to examine the interaction between the 5-HTTLPR genotype and trait neuroticism in neuroendocrine and affective stress responses. From a large group of 771 students, 48 carriers of the short/short (S/S) allele and 48 carriers of the long/long (L/L) allele with the lowest and the highest neuroticism scores (77 females, 19 males; mean age?±?SD: 20.6?±?2 years) were selected and exposed to an acute psychosocial stressor. Mood was assessed before and after the stressor, and salivary cortisol concentrations were measured before and at 20, 30, and 60?min after stressor onset. Acute stress increased salivary cortisol concentration regardless of either 5-HTTLPR genotype or neuroticism, but it caused a less profound negative mood change in L/L compared to S/S-allele carriers with the lowest neuroticism scores. The 5-HTTLPR genotype influences affective reactivity to acute stress conditional upon neuroticism, improving resilience to acute stress in L/L-allele carriers if they do not already possess high cognitive-affective (neuroticism) vulnerability.     

Verbal ability, social stress, and anxiety in children with autistic disorder

The aims of this study were to evaluate the physiological stress and anxiety responses in children with autism following completion of a standardized, social-evaluative stressor (Trier Social Stress Test-Child version), document the relationship between verbal ability, stress, and anxiety, and determine the association between stress and anxiety in children with autism and typical development. Results demonstrated the Trier Social Stress Test-Child version to be a benign stressor for children with autism. Lower verbal ability in children with autism did not predict salivary cortisol or anxiety responses. There was a lack of association between stress and anxiety for both groups, highlighting the importance of considering these terms as separate constructs. Clinical implications and the limited utility of the Trier Social Stress Test-Child version in evaluating psychosocial stress in autism are discussed.     

Glucocorticoid release and memory consolidation in men and women

Glucocorticoid hormones have been shown to enhance memory consolidation when applied at low doses posttraining, but are ineffective or impair memory at high doses. In a test of whether this quadratic relationship also exists for endogenously released glucocorticoids, healthy men and women received cold-pressor stress (CPS) or a control procedure immediately after reading a relatively neutral story and were tested for retention 1 week later. Cortisol levels in response to the stressor were assayed from saliva. CPS significantly elevated salivary cortisol in both sexes, but enhanced memory only in male subjects. Among CPS-treated male subjects, there was a significant quadratic correlation between cortisol release posttraining and subsequent memory. Thus, these findings represent the first demonstration of an inverted-U relationship between activity of endogenous stress hormones and human memory.     

Development of a Protocol for Simultaneous Assessment of Cognitive Functioning Under Psychosocial Stress

This study presents a protocol for induction of moderate psychosocial stress and investigates its impact on psychological and physiological responses. The proposed procedure was designed to enable researchers to assess cognitive performance under effect of various classes of stressors. The protocol's structure contains three main periods: baseline, assessment, and recovery. The assessment stage starts with task anticipation, during which audience (three-member commission) is introduced and apparatus (cameras, microphones, lights, and physiological measuring devices) stationed. Subsequently, cognitive performance was tested. The protocol was evaluated on 56 university students that were randomly assigned to control or stress (protocol) treatment and administered three cognitive tests (working memory operation span, remote associates test, and semantic fluency). Compared to control sessions, protocol induced state anxiety, interfering worry thoughts, and disturbance during recovery period. In addition, the stress group also showed elevated levels of skin conductance, higher average heart rates, and larger drops in peripheral temperature. Even though more research is needed, these results suggest that the protocol effectively induces both psychological and physiological stress responses and therefore encourages utilization in cognitive-affective and cognitive-biological fields of research.     

Does the level of physical exercise affect physiological and psychological responses to psychosocial stress in women?

ObjectivesTo test the Cross-Stressor Adaptation hypothesis for females by examining whether physically exercising young women show reduced physiological and psychological stress responses to a psychosocial stressor.DesignForty-seven healthy young women with different levels of physical exercise (17 not or rarely exercising, 15 moderately exercising, 15 vigorously exercising) underwent the Trier Social Stress Test for Groups (TSST-G); physiological and psychological stress responses during and after stress induction were compared.MethodANOVAs with repeated measures were used to compare stress reactivity and recovery between the three exercise groups. Heart rate and salivary free cortisol were used as indicators of physiological stress response, state anxiety, mood, and calmness as indicators of psychological stress response. For physiological stress reactivity, the areas under the curve with respect to the ground (AUC_G) were compared.ResultsIn all three exercise groups, experimentally induced stress led to a significant rise in heart rate, cortisol, and state anxiety; mood and calmness significantly decreased. As hypothesized, the pattern of the physiological stress response differed for the three exercise groups, with lowered reactivity in the more active groups. However, the psychological stress response partly went in the opposite direction: Exercising participants reported a higher mood decrease, suggesting a dissociation of the physiological and psychological stress responses.ConclusionsThe findings suggest that the Cross-Stressor Adaptation hypothesis is also valid for young women; however, only with regard to physiological stress response. The unexpected findings for psychological stress response need to be further explored in experimental studies.     

Acute stress impairs recognition for positive words--association with stress-induced cortisol secretion

Some studies suggest that stress-induced effects of cortisol on memory are modulated by the valence of the stimuli to be learned and retrieved. The present study investigated the effect of acute stress-induced cortisol secretion on acquisition and retrieval of pleasant, unpleasant and neutral words. Sixty healthy men were randomly assigned to one of the three experimental groups. Participants were either exposed to a standardized laboratory stressor (the Trier Social Stress Test) before learning a wordlist, or before retrieval, or were not stressed. Free recall and recognition were tested 24 h later. Free recall was not affected by stress exposure. For recognition, there was no main effect of the stressor, but a main effect of valence and a valence by group interaction emerged: recognition for positive words was significantly impaired when subjects were stressed before retrieval. In addition, a positive correlation between the cortisol response and errors of commission was found. The results suggest that acute stress impairs memory for positive stimuli and that stress-induced cortisol secretion interferes with accuracy of memory retrieval, i.e. the ability to discriminate true memories from false ones.     

Childhood poverty and health: cumulative risk exposure and stress dysregulation

A massive literature documents the inverse association between poverty or low socioeconomic status and health, but little is known about the mechanisms underlying this robust relation. We examined longitudinal relations between duration of poverty exposure since birth, cumulative risk exposure, and physiological stress in two hundred seven 13-year-olds. Chronic stress was assessed by basal blood pressure and overnight cortisol levels; stress regulation was assessed by cardiovascular reactivity to a standard acute stressor and recovery after exposure to this stressor. Cumulative risk exposure was measured by multiple physical (e.g., substandard housing) and social (e.g., family turmoil) risk factors. The greater the number of years spent living in poverty, the more elevated was overnight cortisol and the more dysregulated was the cardiovascular response (i.e., muted reactivity). Cardiovascular recovery was not affected by duration of poverty exposure. Unlike the duration of poverty exposure, concurrent poverty (i.e., during adolescence) did not affect these physiological stress outcomes. The effects of childhood poverty on stress dysregulation are largely explained by cumulative risk exposure accompanying childhood poverty.     

Objective and perceived physiological arousal in trait social anxiety and post-event processing of a prepared speaking task

This study investigated the influence of trait social anxiety on subjective and physiological responses to an anticipated stressor. Seventy normotensive female students characterized as either high or low in social anxiety engaged in a demanding speech task after an anticipation period of one week that provided opportunity to prepare for the task. Trait social anxiety substantially influenced objective and perceived physiological arousal. High socially anxious individuals displayed greater heart rate reactivity and greater increases in perceived arousal that were in excess of objective HR reactivity. Perceived, but not objective arousal, partially mediated the relationship between social anxiety and negative post-task reappraisals of perceived coping resources. Furthermore, self-evaluations were found to be an essential determinant of post-task rumination. The results provide support for central predictions of cognitive models on social phobia.