Trier Social Stress Test For Children Research Articles

Poor Sleep and Altered Hypothalamic-Pituitary-Adrenocortical and Sympatho-Adrenal-Medullary System Activity in Children

Neuroendocrine alterations, with well-known links with health, may offer insight into why poor sleep is associated with poor health. Yet, studies testing associations between sleep and neuroendocrine activity in children are scarce. The aim of this study was to determine whether actigraphy-based sleep pattern is associated with hypothalamic-pituitary-adrenocortical axis and sympatho-adrenal-medullary system activity in children. We conducted a cross-sectional study in a birth cohort in Helsinki, Finland. We studied 282 8-yr-old children. We measured diurnal salivary cortisol and salivary cortisol and alpha-amylase (a sympatho-adrenal-medullary system marker) responses to the Trier Social Stress Test for Children (TSST-C). Children with short (<or=7.7 h) vs. average sleep duration (7.8-9.3 h) displayed higher cortisol awakening response and nadir (P < 0.042). Those with low (<or=77.4%) vs. average-high sleep efficiency (>77.4%) displayed higher diurnal cortisol levels across the entire day (P < 0.03), higher cortisol levels after the TSST-C stressor (P < 0.04), and higher overall alpha-amylase levels across the entire TSST-C protocol (P < 0.05). The effects were not confounded by factors that may alter sleep or hormonal patterns. Poor sleep may signal altered neuroendocrine functioning in children. The findings may offer insight into the pathways linking poor sleep with poor health.

Exploring Psychophysiological Markers of Vulnerability to Somatic Illnesses in Females

To examine the association between biological stress regulation and somatic complaints in young girls prior to the onset of clear psychopathology such as somatization disorder. Salivary cortisol, heart rate variability (HRV), and negative mood were assessed in 48 12-year-old girls in response to the Trier Social Stress Test for Children (TSST-C). Parent and child report on the Children's Somatization Inventory was used to identify girls with high and low somatic complaints. Girls with high levels of somatic complaints had significantly higher initial levels of cortisol, which decreased over time, and showed a trend for a more limited HRV in response to the TSST-C than girls with low levels of somatic complaints. High levels of cortisol and possibly low HRV among girls with somatic complaints may interfere with flexibility in responding to typical psychosocial stressors, which may increase vulnerability to the onset of somatic illnesses in females.

Moderate versus severe early life stress: Associations with stress reactivity and regulation in 10–12-year-old children

Early life stress (ELS) is expected to increase reactivity of the hypothalamic-pituitary-adrenocortical (HPA) axis; however, several recent studies have shown diminished cortisol reactivity among adults and children with ELS exposure. The goal of this study was to examine cortisol activity in 10-12-year-old internationally adopted children to determine if moderate and severe ELS have different impacts on the HPA axis. Salivary cortisol and two measures of autonomic activity were collected in response to the Trier Social Stress Test for Children (TSST-C). Three groups reflecting moderate, severe, and little ELS were studied: early adopted children who came predominantly from foster care overseas (early adopted/foster care (EA/FC), n=44), later adopted children cared for predominantly in orphanages overseas (late adopted/post-institutionalized (LA/PI), n=42) and non-adopted (NA) children reared continuously by their middle- to upper-income parents in the United States (n=38). Diminished cortisol activity was noted for the EA/FC group (moderate ELS), while the LA/PI group (severe ELS) did not differ from the NA group. Overall, few children showed cortisol elevations to the TSST-C in any group. The presence/absence of severe growth delay at adoption proved to be a critical predictive factor in cortisol activity. Regardless of growth delay, however, LA/PI children exhibited higher sympathetic tone than did NA children. These results suggest that moderate ELS is associated with diminished cortisol activity; however, marked individual differences in cortisol activity among the LA/PI children suggest that child factors modify the impact of severe ELS. Lack of effects of severe ELS even for growth delayed children may reflect the restorative effects of adoption or the generally low responsiveness of this age group to the TSST-C.

Electrodermal reactivity during the Trier Social Stress Test for children: Interaction between the serotonin transporter polymorphism and children's attachment representation

This study explores the relation between variations in the serotonin transporter gene (5-HTTLPR; long vs. short allele), the child's attachment representation (assessed with the Attachment Story Completion Task, reflecting the security of the parent-child relationship), and electrodermal reactivity during a public speaking task, the Trier Social Stress Test for Children (TSST-C) in a sample of 92 7-year-old. Electrodermal reactivity during the TSST-C was not directly associated with variations in 5-HTT. However, there was a significant gene-environment interaction effect of 5-HTT and attachment security on electrodermal reactivity. Results are interpreted in terms of cumulative protection: Children with a secure attachment representation as well as long 5-HTT alleles appeared to be less stressed during the TSST-C.

Psychological Comorbidity and Stress Reactivity in Children and Adolescents With Recurrent Abdominal Pain and Anxiety Disorders

To compare clinical symptoms, diagnoses, and physiological measures in children and adolescents with recurrent abdominal pain (RAP) (n = 14), to a group with anxiety disorders (ANX) (n = 14) and a physically and psychiatrically healthy control group (HC) (n = 14). The cross-sectional study examined group differences in clinical symptoms of anxiety, somatic complaints, depression, and behavior problems. Physiological measures included heart rate, systolic and diastolic blood pressure, and salivary cortisol in response to the Trier Social Stress Test for Children (TSST-C). Subjects were between the ages of 8 and 16 years. RAP and ANX subjects had comparable scores on most psychological measures, and their scores were higher (n < .05) than those of the HC. The ANX and RAP groups exhibited physiological findings that had more shared similarities than either group with the HC group. Few statistically significant group differences were noted in physiological measures, yet the pattern of findings in blood pressure and cortisol supported the use of the TSST-C and the direction of the findings was consistent with expectations. Understanding more about comorbidity between RAP and anxiety could have important management implications, with observed congruities between the disorders suggesting treatments already demonstrated to be efficacious for pediatric anxiety and depression might be applied productively to RAP.

Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.

Atopic dermatitis (AD) is an inflammatory skin disease characterized by a hyperactivity of the humoral immune system with an onset in infancy or early childhood. Although most of the research has focused on the pathophysiological role of the immune system in AD, the impact of endocrine signals in the pathology of AD has received only little attention. However, because the endocrine system may play a regulatory role in immune functioning, it might be of major interest to study endocrine reactivity in AD patients. The present two-part study investigated the relationship between adrenocortical stress response, heart rate response, and psychological parameters in children with AD. In Study 1, a protocol for induction of psychosocial stress in children aged 8 to 14 years was evaluated. Healthy children (N = 16) were exposed to the Trier Social Stress Test for Children (TSST-C) that mainly consists of public speaking and mental arithmetic tasks in front of an audience. Salivary cortisol was measured 35, 15, and 1 minute before as well as 1, 10, 20, and 30 minutes after the stress; heart rate was monitored continuously. Results showed that the protocol induced a highly significant increase in free cortisol response (p < .001) and heart rate (p < .001). In Study 2, the TSST-C was applied to AD children (N = 15) and age- and sex-matched healthy controls (N = 15). All patients were in remission and medication-free for at least 3 weeks. Again, the stress test induced significant increases in cortisol and heart rate. However, the AD children showed a significantly blunted cortisol response to the stressor compared with the control group (p < .05). Heart rate responses were similar in both experimental groups. Neither subjective stress ratings nor personality traits were related to the blunted cortisol response. These findings suggest that the adrenocortical response to stress is attenuated in atopic children. A hyporesponsive hypothalamus-pituitary-adrenal (HPA) axis might explain in part the stress-induced eruptions of AD symptoms.