Induction of acute stress through an internet-delivered Trier Social Stress Test as assessed by photoplethysmography on a smartphone

Abstract

Recent studies have demonstrated the feasibility of administering the Trier Social Stress Test (TSST) through the internet, with major implications for promoting international inclusivity in research participation through extending typical sampling procedures beyond traditional geographical boundaries. However, online TSST studies to date are limited by the lack of a control group, which may be particularly problematic for studies administered through video mediated platforms, given evidence these interactions may be inherently stressful due to a minimization of nonverbal cues and overemphasis on facial expression. Furthermore, there is a need for biological measures of stress reactivity that can be fully implemented online, as extant research has relied upon laboratory measures that must be shipped back and forth between laboratory and participant. Here, we test smartphone-based photoplethysmography as a measure of heart rate reactivity to an online variant of the TSST. Results demonstrate significant acceleration in heart rate and self-reported stress and anxiety in the TSST condition relative to a placebo version of the TSST. The placebo procedures lead to a significant increase in self-reported stress and anxiety relative to baseline levels, but this increase was smaller in magnitude than that observed in the TSST condition. These findings highlight the potential for smartphone-based photoplethysmography in internet-delivered studies of cardiac reactivity and demonstrate that it is critical to utilize random assignment to a control or stressor condition when administering acute stress online.

An online Trier social stress paradigm to evoke affective and cardiovascular responses

“…The current findings are consistent with recently published work showing that rTSST protocols can elicit changes in self‐reported negative affect (Gunnar et al, 2021;Eagle et al, 2021 ; Harvie et al, 2021), salivary cortisol and alpha‐amylase (Gunnar et al, 2021), heart rate (Eagle et al, 2021; Harvie et al, 2021), and heart rate variability (Eagle et al, 2021). We extended this work by demonstrating that a rTSST can also elicit blood pressure reactivity in response to the speech task relative to a control condition.…”

“…During in‐person TSSTs, heart rate typically increases by 15–25 bpm during the task (Kudielka et al, 2007). Previous rTSST paradigms elicit a heart rate response between 2 and 7 bpm, which is considerably lower than anticipated (Eagle et al, 2021; Harvie et al, 2021). By contrast the current rTSST protocol led to a larger increase in heart rate that more closely aligns with in‐person reports (11–16 bpm).…”

“…In the current protocol, participants were placed into a second virtual (breakout) room where they interacted with two judges while the main researcher stayed in the main, or original, virtual room. By contrast, both prior studies left the participant alone during the preparation period and kept the participant in the main virtual room during the entire procedure (Eagle et al, 2021; Harvie et al, 2021). Sending participants into a second virtual room with the judges could lead to a sense of novelty.…”

“…To date, there are only three such studies that have created and implemented a rTSST (Eagle et al, 2021; Gunnar et al, 2021; Harvie et al, 2021). Gunnar et al (2021) published the first study, showing reliable increases in cortisol and alpha‐amylase, a marker of sympathetic activation, in response to rTSST in an adolescent sample.…”

Smartphone Photoplethysmography Covaries with Stress and Anxiety During a Digital Acute Social Stressor Preprint

“…1 Time slots for participation took place between 09:00 and 17:30. For a more complete description of procedures see Harvie et al (2021).…”