Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Andrew P Allen; Paul J Kennedy; John F Cryan; Timothy G Dinan; Gerard Clarke

doi:10.1016/j.neubiorev.2013.11.005

Biological and psychological markers of stress in humans: focus on the Trier Social Stress Test

Neurosci Biobehav Rev. 2014 Jan:38:94-124. doi: 10.1016/j.neubiorev.2013.11.005. Epub 2013 Nov 14.

Authors

Andrew P Allen¹, Paul J Kennedy¹, John F Cryan², Timothy G Dinan¹, Gerard Clarke³

Affiliations

¹ Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland; Department of Psychiatry, University College Cork, Cork, Ireland.
² Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland.
³ Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland; Department of Psychiatry, University College Cork, Cork, Ireland. Electronic address: G.Clarke@ucc.ie.

PMID: 24239854
DOI: 10.1016/j.neubiorev.2013.11.005

Abstract

Validated biological and psychological markers of acute stress in humans are an important tool in translational research. The Trier Social Stress Test (TSST), involving public interview and mental arithmetic performance, is among the most popular methods of inducing acute stress in experimental settings, and reliably increases hypothalamic-pituitary-adrenal axis activation. However, although much research has focused on HPA axis activity, the TSST also affects the sympathetic-adrenal-medullary system, the immune system, cardiovascular outputs, gastric function and cognition. We critically assess the utility of different biological and psychological markers, with guidance for future research, and discuss factors which can moderate TSST effects. We outline the effects of the TSST in stress-related disorders, and if these responses can be abrogated by pharmacological and psychological treatments. Modified TSST protocols are discussed, and the TSST is compared to alternative methods of inducing acute stress. Our analysis suggests that multiple readouts are necessary to derive maximum information; this strategy will enhance our understanding of the psychobiology of stress and provide the means to assess novel therapeutic agents.

Keywords: ACTH; Brain–gut axis; Cortisol; Genetics; HPA axis; Heart rate; Immune system; Serotonin; Stress; Sympathetic-adrenal-medullary system.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Biomarkers
Humans
Mental Disorders / diagnosis
Mental Disorders / physiopathology
Mental Disorders / therapy
Psychological Tests*
Stress, Psychological* / physiopathology
Stress, Psychological* / psychology

Substances

Biomarkers