Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?

Background: The Trier Social Stress Test (TSST) is a widely used laboratory protocol to study acute stress reactivity, a hallmark of which is a meaningful increase in saliva cortisol (>2.5 nmol/L) in most individuals, reflecting hypothalamic-pituitary-adrenal (HPA) axis activation. The Mannheim M...

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Main Authors: Daniel S. Kashi, Marianne Hunter, Jason P. Edwards, Harry Bell, Megan Robinson, Neil P. Walsh
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Comprehensive Psychoneuroendocrinology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666497624000511
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author Daniel S. Kashi
Marianne Hunter
Jason P. Edwards
Harry Bell
Megan Robinson
Neil P. Walsh
author_facet Daniel S. Kashi
Marianne Hunter
Jason P. Edwards
Harry Bell
Megan Robinson
Neil P. Walsh
author_sort Daniel S. Kashi
collection DOAJ
description Background: The Trier Social Stress Test (TSST) is a widely used laboratory protocol to study acute stress reactivity, a hallmark of which is a meaningful increase in saliva cortisol (>2.5 nmol/L) in most individuals, reflecting hypothalamic-pituitary-adrenal (HPA) axis activation. The Mannheim Multicomponent Stress Test (MMST) has potential as a low staff burden alternative to the TSST, with one study showing statistically significant increases in subjective stress, heart rate and saliva cortisol; however, uncertainty remains about the meaningfulness of these psychobiological responses. Objective: To assess whether the MMST is a viable alternative to the TSST. Methods: Using a between subjects design, 31 healthy adults were randomised to the standard TSST or the MMST using stratified block randomisation accounting for sex and trait anxiety. The standard TSST consisted of an anticipation phase, followed by a free speech and mental arithmetic task performed in front of a panel of trained actors. The MMST consisted of a computer based Paced Auditory Serial Addition Task (cognitive stressor) with additional motivational, emotional and acoustic stressors in the presence of one unresponsive observer. Results: Group × time interactions showed that the MMST induced smaller psychobiological responses compared with the TSST (mixed model ANCOVA, P < 0.05). Post-hoc analyses revealed that the MMST induced a significant yet smaller state anxiety response (score range 20–80, MMST: 47 ± 12 vs. TSST: 57 ± 9; P < 0.01, Cohens d = 0.9) and peak heart rate response (MMST: 98 ± 17 vs. TSST: 110 ± 21 bpm; P < 0.05, Cohens d = 0.6) compared with the TSST. Despite observing stereotypical neuroendocrine responses to the TSST, the MMST did not increase saliva α-amylase or cortisol (Δ saliva cortisol, 0.1 ± 1.1 vs. TSST: 10.3 ± 12.8 nmol/L; between group difference P < 0.01, Cohens d = 1.1). Moreover, meaningful increases in saliva cortisol (>2.5 nmol/L) were observed in 80% of participants after the TSST but in no participant after the MMST. Conclusion: The Mannheim Multicomponent Stress Test increased state anxiety and heart rate but not saliva cortisol. As such, the present results do not support the utility of the Mannheim Multicomponent Stress Test as a viable alternative to The Trier Social Stress Test.
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spelling doaj-art-ad7616b73cff4c6fbf5fa5475fd89a482025-08-20T02:52:30ZengElsevierComprehensive Psychoneuroendocrinology2666-49762024-11-012010027510.1016/j.cpnec.2024.100275Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?Daniel S. Kashi0Marianne Hunter1Jason P. Edwards2Harry Bell3Megan Robinson4Neil P. Walsh5Faculty of Science, Liverpool John Moores University, Liverpool, UKFaculty of Science, Liverpool John Moores University, Liverpool, UKFaculty of Science, Liverpool John Moores University, Liverpool, UKFaculty of Science, Liverpool John Moores University, Liverpool, UKFaculty of Science, Liverpool John Moores University, Liverpool, UKCorresponding author.; Faculty of Science, Liverpool John Moores University, Liverpool, UKBackground: The Trier Social Stress Test (TSST) is a widely used laboratory protocol to study acute stress reactivity, a hallmark of which is a meaningful increase in saliva cortisol (>2.5 nmol/L) in most individuals, reflecting hypothalamic-pituitary-adrenal (HPA) axis activation. The Mannheim Multicomponent Stress Test (MMST) has potential as a low staff burden alternative to the TSST, with one study showing statistically significant increases in subjective stress, heart rate and saliva cortisol; however, uncertainty remains about the meaningfulness of these psychobiological responses. Objective: To assess whether the MMST is a viable alternative to the TSST. Methods: Using a between subjects design, 31 healthy adults were randomised to the standard TSST or the MMST using stratified block randomisation accounting for sex and trait anxiety. The standard TSST consisted of an anticipation phase, followed by a free speech and mental arithmetic task performed in front of a panel of trained actors. The MMST consisted of a computer based Paced Auditory Serial Addition Task (cognitive stressor) with additional motivational, emotional and acoustic stressors in the presence of one unresponsive observer. Results: Group × time interactions showed that the MMST induced smaller psychobiological responses compared with the TSST (mixed model ANCOVA, P < 0.05). Post-hoc analyses revealed that the MMST induced a significant yet smaller state anxiety response (score range 20–80, MMST: 47 ± 12 vs. TSST: 57 ± 9; P < 0.01, Cohens d = 0.9) and peak heart rate response (MMST: 98 ± 17 vs. TSST: 110 ± 21 bpm; P < 0.05, Cohens d = 0.6) compared with the TSST. Despite observing stereotypical neuroendocrine responses to the TSST, the MMST did not increase saliva α-amylase or cortisol (Δ saliva cortisol, 0.1 ± 1.1 vs. TSST: 10.3 ± 12.8 nmol/L; between group difference P < 0.01, Cohens d = 1.1). Moreover, meaningful increases in saliva cortisol (>2.5 nmol/L) were observed in 80% of participants after the TSST but in no participant after the MMST. Conclusion: The Mannheim Multicomponent Stress Test increased state anxiety and heart rate but not saliva cortisol. As such, the present results do not support the utility of the Mannheim Multicomponent Stress Test as a viable alternative to The Trier Social Stress Test.http://www.sciencedirect.com/science/article/pii/S2666497624000511Acute stressSalivary cortisolTSSTHPA-AxisSocial evaluative threatStress reactivity
spellingShingle Daniel S. Kashi
Marianne Hunter
Jason P. Edwards
Harry Bell
Megan Robinson
Neil P. Walsh
Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
Comprehensive Psychoneuroendocrinology
Acute stress
Salivary cortisol
TSST
HPA-Axis
Social evaluative threat
Stress reactivity
title Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
title_full Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
title_fullStr Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
title_full_unstemmed Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
title_short Is the Mannheim Multicomponent Stress Test a viable alternative to the Trier Social Stress Test?
title_sort is the mannheim multicomponent stress test a viable alternative to the trier social stress test
topic Acute stress
Salivary cortisol
TSST
HPA-Axis
Social evaluative threat
Stress reactivity
url http://www.sciencedirect.com/science/article/pii/S2666497624000511
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