Brief cognitive interventions interact with resilience to modulate ACTH response to the Trier Social Stress Test

Rationale/statement of the problem : Stress undermines health, perhaps via activation of the hypothalamic-pituitary andrenal (HPA) axis. There is evidence that psychological factors (i.e., sense of control, familiarity, effective coping, and social support) can buffer stress effects and HPA axis activation. There is also evidence that resilience and compassionate goal orientations (striving to help others rather than promoting the self) are associated with health and well-being, perhaps via HPA-buffering effects. We utilized a laboratory model of social evaluative threat (Trier Social Stress Test, TSST) to activate the HPA axis and study the stress-buffering effects of control, familiarity/coping, and compassionate goals, testing for interactions with resilience. Cortisol results were previously presented (41st International Society of Psychoneuroendocrinology (ISPNE) annual conference). Adrenocorticotropic hormone (ACTH) responses, which have now been analyzed, have strengthened the original findings. Methods : Healthy participants (n=54) were exposed to a TSST after receiving a standard instruction or one of three intervention instructions (access to control over threat exposure, cognitive intervention to increase familiarity and effective coping, or a compassion intervention designed to shift goal orientation from self-promotion to helping others). ACTH responses were analyzed using a median split into low and high resilient participants (CD-RISC, Connor and Davidson, 2003). Results : Overall, the type of instruction significantly interacted with resilience in modulating ACTH responses throughout the TSST (p=0.006). Low resilient participants receiving the coping intervention demonstrated higher ACTH baseline levels when compared to the other instruction groups. High resilient subjects given the compassion intervention showed reduced ACTH reactivity to the stressor relative to the other instructions. Conclusion : The ACTH results mirror previously reported findings with cortisol responses to the TSST: Coping instructions increased anticipatory stress in low resilient participants, whereas compassionate goal instructions reduced stress reactivity to the TSST in high resilient participants. Further work assessing individual differences in resilience, and tailoring stress inoculation techniques accordingly, may facilitate development of more effective means of reducing the detrimental health effects of stress.