Trier social stress test

The Trier social stress test (TSST) is a laboratory procedure used to reliably induce stress in human research participants. It is a combination of procedures that were previously known to induce stress, but previous procedures did not do so reliably. It was created in 1993 at the University of Trier by Clemens Kirschbaum and colleagues.

Psychosocial stress is associated with a variety of biomarkers, such as salivary and blood serum cortisol, prolactin, human growth hormone (hGH), adrenocorticotropic hormone (ACTH), and heart rate. Prior to 1993, a number of laboratory tasks were used to elicit these stress markers for research, including the cold pressor test, the Stroop test, public speaking, and others.

These studies encountered two problems: First, there was large interindividual variability in the physiological response to stress, and second, the methods previously used tended to produce effects that were too small to be reliably measured. Consequently, the results from these studies tended to be inconsistent and unreliable.

Clemens Kirschbaum and his colleagues at the University of Trier sought to overcome these limitations by combining different stress-generating tasks in a highly standardized format, which included elements of public speaking, mental arithmetic, and anticipation. They also needed to design a task that would be mild enough to be approved by most human subjects protection committees. Their task, which they named the Trier social stress test, consistently produced very large physiological effects in the majority of their participants, thus overcoming the limitations of earlier research. They first reported on the test in 1993, in the journal Neuropsychobiology.

In the years since, the TSST has been widely used in stress research. As of August 2011, 358 published studies using the test were listed on Pubmed. Also, numerous variants of the test have been developed, including a version for use with children (the TSST-C), a non-stressful placebo version, and a version for use with mentally ill participants. Most research with the TSST has focused on physiological responses to stress, but some researchers are advocating for a closer examination of how the TSST affects psychological responses to stress, and how those responses may correlate with physiological responses.

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