Panel manipulation in social stress testing: The Bath Experimental Stress Test for Children (BEST-C)

Abstract

SummaryBackground: Whilst acute stress paradigms in adults make use of adult panel members, similar paradigms modified for child participants have not manipulated the panel.Most work has utilised an audience of adult confederates, regardless of the age of the population being tested. The aim of this study was to trial a social stress test for children that provided a meaningful environment using age-matched child peers as panel actors.Methods: Thirty-three participants (7-11 years) underwent the Bath Experimental Stress Test for Children (BEST-C). Based on the Trier Social Stress Test (TSST), it comprises a shortened six-minute public speaking task and four-minute maths challenge. It differs from previous stress tests by using age-matched children on the panel, pre-recorded and presented as a live feed, and includes an expanded manipulation check of subjective experience. Salivary cortisol was assessed at four time points, pre-post stress testing; life events, daily hassles and coping strategies were measured through questionnaires. A simple numerical coding scheme was applied to post-test interview data. Results:The BEST-C generated a typical stress and adaptation response in salivary cortisol (p=.032). Age and gender differences were observed during recovery. Cortisol responses mapped directly onto three distinct subjective response patterns: i) expected response and recovery; ii) expected response, no recovery; iii) no response. Conclusions:The BEST-C, utilising child confederates of participant target age is a meaningful social stress test for children. This is the first social stress test developed specifically for children that manipulates panel characteristics by using child confederates and a pre-recorded sham panel. Greater cortisol responses to the test were also found to match subjective verbal accounts of the experience. It offers a meaningful acute stress paradigm with potential applications to other child and adolescent age groups. Furthermore, it leads the way in the use of panel manipulation in social stress testing.

Resilience characteristics and prior life stress determine anticipatory response to acute social stress in children aged 7–11 years

“…Responses to the BEST‐C differed between the four prior stress–resilience groups, with children who had previously experienced more stress and had more characteristics of resilience displaying the lowest salivary cortisol responses to the task. There were no statistically significant increases in salivary cortisol in response to the BEST‐C stress testing phase, contrary to previous findings (Cheetham & Turner‐Cobb, ). However, heart rate did increase in response to the task and 31 out of 34 participants self‐reported that they found the task stressful or worrying and were relieved when it was over.…”

“…There was an increase in salivary cortisol in anticipation of the task, suggesting the prospect of completing the BEST‐C was stress‐inducing. This anticipation effect is in line with findings regarding anticipation stress (Cheetham & Turner‐Cobb, ). Heightened levels of salivary cortisol during the anticipation period could also explain why salivary cortisol did not increase further during the task as peak salivary cortisol levels may have been reached.…”

“…Males showed higher levels of salivary cortisol than females in the post‐test recovery period, suggesting that males continued to feel stressed for longer after the stressful experience, whereas females recovered more quickly. This corroborates previous findings (Cheetham & Turner‐Cobb, ) with research suggesting that males display higher heart rate than females when recovering from stress because they use less emotion‐focussed strategies to cope with stressors (Connor‐Smith, Compas, Wadsworth, Thomsen, & Saltzman, ). Other research using the TSST‐C in adolescents noted the importance of focussing on age and sex differences in the recovery period to better understand the nuances of children's stress responses (Ji, Negriff, Kim, & Susman, ).…”

“…Using a child audience, it makes the stress test more ecologically valid as peer interaction and evaluation is a prominent feature of children's life experience. The BEST‐C was found to reliably induce a salivary cortisol response in young children, suggesting that peer matching the audience was an effective modification to laboratory social stress testing (Cheetham & Turner‐Cobb, ).…”

‘Every day I worry about something’: A qualitative exploration of children’s experiences of stress and coping

“…Therefore, it is imperative to explore children's early experiences of stress and coping. The importance of interviewing child-parent dyads together has been highlighted as providing the most illuminating and rich data as children and their parents interact to build a narrative (Cheetham & Turner-Cobb, 2016). While questionnaire-assessed life events report the number of major stressors children have encountered, they do not reveal the extent to which the stressors have influenced the child, capturing data on only certain aspects of children's stress experience (Holmes & Rahe, 1967).…”