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Post-traumatic stress disorder (PTSD) and acute stress symptoms are a cause of substantial disability in general population, leading to long-term problems for individuals, families and society in terms of compromised social and emotional well-being, loss of productivity and daily functioning. Pharmacological interventions have shown emerging evidence at reducing post-traumatic stress in pre-clinical investigations and first randomized controlled trials in humans with acute stress syndrome or post-traumatic stress disorder. But, so far there is no systematic review on that specific topic including all randomized control trials. According to the impact of traumatic experiences on HPA axis alterations and with regards to the first promising results of randomized controlled trials in that field our hypothesis for a meta-analysis is that a brief glucocorticoid administration will prevent post-traumatic stress symptoms or PTSD on an aggregated basis.

Ethnic discrimination negatively affects the health of ethnic minorities. The dysregulation of psychobiological stress systems, such as the autonomic nervous system (ANS) or the hypothalamic-pituitary-adrenal (HPA) axis, might be an intermediary in this association and chronicity of ethnic discrimination may matter. We studied stress responses to a standardized discriminatory event in Turkish immigrants living in Austria.Seventy-two male Turkish immigrants were recruited; n = 35 had experienced high levels of ethnic discrimination (high), n = 37 infrequent ethnic discrimination (low). During a two-hour laboratory appointment, they underwent a previously validated 10-minute ethnic discrimination paradigm, i.e., a simulated physician's consultation with verbal and non-verbal discriminatory cues. Perceived stress, perceived discrimination, salivary cortisol, and alpha-amylase were assessed seven times, and ANS measures (heart rate, heart rate variability, and electrodermal activity) were measured continuously. In addition, hair cortisol concentrations were determined.The ethnic discrimination paradigm elicited stress responses across all outcomes in both groups. Compared to the low group, the high group reported higher levels of perceived stress and discrimination, exhibited a less steep increase in cortisol in response to the paradigm, and showed higher hair cortisol concentrations. No group differences were found regarding ANS measures.The combination of high subjective stress, flattened cortisol responses, and relatively high hair cortisol concentrations may indicate a dysregulation of the HPA axis in chronic ethnic discrimination. A better understanding of the psychobiological effects of chronic ethnic discrimination is crucial given that alterations in stress response systems may, over time, lead to illness and ultimately to substantial health inequities in ethnic minorities.

Numerous studies have demonstrated that acute psychological stress, induced by the Trier Social Stress Test (TSST) paradigm, affects salivary cortisol secretion and self-reported stress measures including anxiety. Allergy has been related to altered cortisol responsiveness and increased stress vulnerability. Here, we investigated acute stress responses and emotion regulation strategies in cohorts of allergic and healthy individuals. Groups of allergics and healthy individuals were subjected to the TSST and experienced levels of stress and anxiety, as well as emotion regulation strategies, were assessed. Cortisol and oxytocin concentrations were measured in saliva or plasma. The present findings confirm earlier results of altered stress responsiveness in allergic individuals. Acute stress by the TSST evoked higher physiological arousal in allergics by means of salivary cortisol secretion. Allergics also scored higher on emotion suppression. However, individuals who were more likely to use reappraisal recovered more efficiently from the cortisol increase. No such effect for reappraisal was found in the healthy population. No differences in self-reported anxiety and stress emerged between the groups. Plasma oxytocin levels prior to the TSST were significantly higher in allergics. Our data corroborate earlier findings on altered stress susceptibility in allergics. Moreover, we identified differences in emotion regulation and oxytocin secretion which should be further explored. Accounting for the emerging global prevalence of allergy, more in-depth research into the experience of stress, coping strategies and stress-related molecules in allergic people is warranted.Short summaryThis study addressed stress experiences and emotion regulation in allergic and non-allergic adults. Allergics scored higher on emotion suppression, had higher pre-stress concentrations of plasma oxytocin and exhibited a stronger salivary cortisol response to stress than healthy people. The research outcomes indicate that allergic individuals cope less efficiently with acute stress but may benefit from adaptive emotion regulation strategies such as reappraisal.

Background Although the Trier Social Stress Test (TSST) constitutes a valid paradigm for social stress induction, less is known about the effects of a virtual reality (VR) TSST on short- and long-term hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adreno-medullar (SAM) axis responses. Hence, this study set out to evaluate reactivity and habituation of self-reported stress and HPA and SAM reactivity in a real TSST and VR-TSST when compared to a placebo TSST. Method Sixty-eight healthy young adults (50% female) were randomly assigned to either a real TSST, a VR-TSST, or a placebo TSST, all of which were conducted three times (one day and one week post initial exposure). Social presence, self-reported stress, salivary cortisol, heart rate (HR), and heart rate variability (HRV) were analyzed using ANOVAs and multilevel models. Findings On the first exposure, both the real and VR-TSST showed significantly stronger cortisol and cardiovascular responses than the placebo. On the second visit, the cortisol response was still significantly high—and the HRV response low—for the real and VR-TSST. The third visit resulted in HR, HRV, and cortisol responses comparable to the placebo group. Furthermore, the real TSST induced more self-reported stress than the placebo on all three visits, the VR-TSST only on the first two visits. Social presence was stable across conditions and had no association with stress markers. Conclusion These findings imply that the replicability of stress exposures at shorter intervals seems problematic for the traditional TSST, and for the VR-TSST.

Background Post-traumatic stress disorder (PTSD) is a debilitating disorder that is often accompanied by alterations in the hypothalamic-pituitary (HPA) axis. While there is abundant evidence for the efficacy of psychological therapies in reducing post-traumatic stress symptoms, barely anything is known about pharmacological interventions. Given the role of the HPA axis in the pathophysiology of PTSD, the aim of this study was to provide the first meta-analysis of Hydrocortisone as a potential treatment for this condition. Method A systematic review of randomized-controlled trials (RCTs) was conducted to investigate the efficacy of hydrocortisone in the prevention and curative treatment of post-traumatic stress symptoms. This study was pre-registered with the OSF (doi:10.17605/OSF.IO/GJAZF). Findings Eight studies (9 effect sizes) covering 362 participants met our inclusion criteria. We found that Hydrocortisone as compared to placebo significantly reduced PTSD symptoms (d = 0.96, 95% Cl 0.22–1.69 p = 0.011) and PTSD incidence (logRR = 0.85, 95% CI 1.12–1.59, p = 0.023). Subgroup analyses revealed a significant effect of Hydrocortisone when it was administered in a preventative context (d = 1.50; 95%CI 0.30–2.69, p = 0.014), but not when it was administered in a curative context (d = 0.28; 95%CI −0.11 to 0.66, p = 0.161). Conclusion Hydrocortisone appears to be a promising and efficient low-cost medication for the prevention of PTSD. However, the small number of included studies and their limited methodological quality emphasize the need for further rigorous studies in this field.

While ostracism constitutes a social stressor with negative effects on physical and mental health, social inclusion seems to increase resilience. This may be true not only for face-to-face settings, but also for computer-mediated interactions. Hence, this study examined the differences between ostracism and social inclusion in real-life or Virtual Reality (VR) regarding self-reported stress, neuroendocrine and cardiovascular reactivity in a subsequent real-life socio-evaluative task. 84 females were randomly assigned to a 3 (agency: face-to-face/human controlled VR-avatar/computer VR-agent) x 2 (inclusion status: inclusion/exclusion) between-subject design using a Cyberball paradigm. Subsequently, they were exposed to a real-life Trier Social Stress Test (TSST). Results indicate that the experience of ostracism constitutes a threat to fundamental social needs independent of agency. Excluded participants showed cardiovascular reactivity during TSST; also face-to-face and avatar excluded individuals had elevated salivary cortisol levels. Included participants reported more perceived social support during Cyberball and showed a blunted cortisol response to the TSST. These results suggest that face-to-face and avatar-related ostracism provokes responses in the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). Furthermore, they reveal that social inclusion may act as a stress-protector as it alters HPA- and SNS-related stress responsiveness to subsequent stressors.