Abstract
Deficits in stress-response systems are a characteristic of schizophrenia and psychosis spectrum illnesses, and recent evidence suggests that this impairment may be evident in those at clinical high-risk (CHR) for the development of a psychotic disorder. However, there is limited research specifically investigating biological and subjective stress reactivity in CHR individuals. In the present study, 38 CHR individuals and group of 38 control individuals participated in the Trier Social Stress Test (TSST), an experimentally induced psychosocial stressor. Changes in salivary cortisol and alpha amylase, as well as self-reported units of distress (SUDS), were evaluated. Interestingly, the TSST did not induce a change in cortisol levels in either group, though the CHR group did show higher overall cortisol levels throughout the TSST (pre-anticipation period through recovery period). However, indicative of an effective task manipulation, the TSST did illicit an increase in alpha amylase in both groups. CHR participants exhibited higher levels of subjective stress prior to the stressor compared to the control group and CHR SUDs did not significantly increase in response to the stressor. In contrast, the control group showed an increase in SUDS in response to the stressor. Notably, SUDS for the control group post task mirrored the levels CHR youth endorsed prior to the stressor. Taken together, these findings suggest that there may be a functional relationship between persistently elevated cortisol and chronic high levels of subjective distress in CHR individuals.
Highlights
Psychotic disorders are extremely debilitating, chronic, and costly illnesses [1, 2]; there is a current drive to identify reliable markers that permit early detection and treatment that may significantly improve long-term disorder progression and outcomes
It was predicted that the clinical high-risk (CHR) group would exhibit blunted cortisol levels in response to the stressor relative to the control group; group differences in cortisol reactivity to the Trier Social Stress Test (TSST) could not be evaluated as a significant change in cortisol after the TSST was not observed in either group
The results suggest that while the adapted version of the TSST used did induce a stress response as evident by the increase in alpha amylase levels (SNS response) and the self-reported units of distress (SUDS), an HPA-axis response was not activated
Summary
Psychotic disorders are extremely debilitating, chronic, and costly illnesses [1, 2]; there is a current drive to identify reliable markers that permit early detection and treatment that may significantly improve long-term disorder progression and outcomes. In a study examining psychological stress induced by the Montreal Imaging Stress Test (MIST), significantly greater salivary cortisol response to the stressor was found in the CHR group compared to the healthy controls [19]. The present study is the first to examine group differences in salivary cortisol (HPA-axis), salivary alpha amylase (SNS), and subjective response to an acute lab stressor experimental paradigm in CHR adolescents and a control group of adolescents. Given the parallel relationship between SNS response and subjective stress and evidence indicating that CHR individuals report higher levels of distress [20, 29], it is predicted that the CHR group will have higher alpha amylase levels and report elevated subjective stress in response to the social stressor compared to the control group
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