The Maastricht Acute Stress Test (MAST): Physiological and Subjective Responses in Anticipation, and Post-stress

Alexandra L Shilton, Robin Laycock, Sheila G Crewther, Alexandra L Shilton, Robin Laycock, Sheila G Crewther

Abstract

The Maastricht Acute Stress Test (MAST) is designed to be a simple, quick, and non-invasive procedure aimed at activating the human stress system. The MAST has been developed by combining elements from two of the most common experimental paradigms measuring stress, the Trier Social Stress Test and the Cold Pressor Test. The aim of this study was to use the MAST procedure to elicit strong autonomic and subjective stress responses that can be quantified in terms of (systolic and diastolic) blood pressure, pulse rate (PR), and state anxiety ratings. In healthy individuals, the MAST induced a significant elevation of systolic blood pressure (SBP) from baseline for up to 30 min post-MAST, while diastolic blood pressure (DBP) dropped to baseline within 10 min post-MAST. Interestingly, the presentation of instructions alerting participants to the procedure resulted in significant elevation of both SBP and DBP above baseline. However, BP measurements prior to test initiation were not as high as those measured immediately after the MAST procedure. PR data showed limited variability across time points. Self-reported state anxiety increased dramatically from baseline to immediately following the MAST procedure. Further, individuals who reported higher levels of depression and stress were more likely to demonstrate larger increases in SBP in response to the MAST. Together, these results support the use of the MAST as a useful tool to activate both acute physiological and subjective measures of the stress response in healthy adults lasting up to 30 min.

Keywords: MAST; acute stress; anxiety; blood pressure; sympatho-adrenal-medullary (SAM) axis.

Figures

FIGURE 1
FIGURE 1
(A) Systolic blood pressure (SBP), (B) diastolic blood pressure (DBP), (C) pulse rate (PR), and (D) subjective ratings based on the STAI-Y, prior to and in response to the MAST in a healthy sample (n = 52). Error bars represent ± standard error of the mean.
FIGURE 2
FIGURE 2
Systolic blood pressure(A) and subjective state anxiety based on the STAI-Y (B) prior to, and in response to the MAST in healthy sample (n = 52) compared to individuals with severe anxiety and stress (n = 5). Error bars represent ± standard error of the mean.

References

    1. Alm P. A. (2004). Stuttering, emotions, and heart rate during anticipatory anxiety: a critical review. J. Fluency Disord. 29 123–133. 10.1016/j.jfludis.2004.02.001
    1. Bos M. G., Jacobs Van Goethem T. H., Beckers T., Kindt M. (2014). Cortisol response mediates the effect of post-reactivation stress exposure on contextualization of emotional memories. Psychoneuroendocrinology 50 72–84. 10.1016/j.psyneuen.2014.07.030
    1. Capello A. E. M., Markus C. R. (2014). Effect of sub chronic tryptophan supplementation on stress-induced cortisol and appetite in subjects differing in 5-HTTLPR genotype and trait neuroticism. Psychoneuroendocrinology 45 96–107. 10.1016/j.psyneuen.2014.03.005
    1. Chida Y., Hamer M. (2008). Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations. Psychol. Bull. 134 829–885. 10.1037/a0013342
    1. de Rooij S. R., Schene A. H., Phillips D. I., Roseboom T. J. (2010). Depression and anxiety: associations with biological and perceived stress reactivity to a psychological stress protocol in a middle-aged population. Psychoneuroendocrinology 35 866–877. 10.1016/j.psyneuen.2009.11.011
    1. Feder A., Nestler E. J., Charney D. S. (2009). Psychobiology and molecular genetics of resilience. Nat. Rev. Neurosci. 10 446–457. 10.1038/nrn2649
    1. Glass D. C., Reim B., Singer J. E. (1971). Behavioral consequences of adaptation to controllable and uncontrollable noise. J. Exp. Soc. Psychol. 7 244–257. 10.1016/0022-1031(71)90070-9
    1. Gonzalez-Bono E., Moya-Alboil L., Salvador A., Carrillo E., Ricarte J., Gomez-Amor J. (2002). Anticipatory autonomic response to a public speaking task in women: the role of trait anxiety. Biol. Psychol. 60 37–49. 10.1016/S0301-0511(02)00008-X
    1. Hao G., Wang X., Treiber F. A., Harshfield G., Kapuku G., Su S. (2017). Blood pressure trajectories from childhood to young adulthood associated with cardiovascular risk: results from the 23-year longitudinal Georgia stress and heart study. Hypertension 69 435–442. 10.1161/HYPERTENSIONAHA.116.08312
    1. Hellhammer J., Schubert M. (2012). The physiological response to Trier Social Stress Test relates to subjective measures of stress during but not before or after the test. Psychoneuroendocrinology 37 119–124. 10.1016/j.psyneuen.2011.05.012
    1. Hughes B. M. (2007). Academic study, college examinations, and stress: issues in the interpretation of cardiovascular reactivity assessments with student participants. J. Appl. Biobehav. Res. 9 23–44. 10.1111/j.1751-9861.2004.tb00090.x
    1. Johnston D. W., Tuomisto M. T., Patching G. R. (2008). The relationship between cardiac reactivity in the laboratory and in real life. Health Psychol. 27 34–42. 10.1037/0278-6133.27.1.34
    1. Kajantie E., Phillips D. I. W. (2006). The effects of sex and hormonal status on the physiological response to acute psychosocial stress. Psychoneuroendocrinology 31 151–178. 10.1016/j.psyneuen.2005.07.002
    1. Kibler J. L., Ma M. (2004). Depressive symptoms and cardiovascular reactivity to laboratory behavioural stress. Int. J. Behav. Med. 11 81–87. 10.1207/s15327558ijbm1102_3
    1. Kirschbaum C., Kudielka B. M., Gaab J., Schommer N. C., Hellhammer D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of hypothalamus-pituitary-adrenal axis. Psychosom. Med. 61 154–162. 10.1097/00006842-199903000-00006
    1. Light K. C., Kothandapani R. V., Allen M. T. (1998). Enhanced cardiovascular and catecholamine responses in women with depressive symptoms. Int. J. Psychophysiol. 28 157–166. 10.1016/S0167-8760(97)00093-7
    1. Lovibond S. H., Lovibond P. F. (1995). Manual for the Depression Anxiety Stress Scales. Sydney, NSW: Psychology Foundation.
    1. Lundberg U., Frankenhaeuser M. (1980). Pituitary-adrenal and sympathetic-adrenal correlates of distress and effort. J. Psychosom. Res. 24 125–130.10.1016/0022-3999(80)90033-1
    1. Lupien S. J., McEwen B. S., Gunnar M. R., Heim C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat. Rev. Neurosci. 10 434–445. 10.1038/nrn2639
    1. Marshall T., Anantharachagan A., Choudhary K., Chue C., Kaur I. (2002). A randomised control trial of the effect of anticipation of a blood test on blood pressure. J. Hum. Hypertens. 16 621–625. 10.1038/sj.jhh.1001460
    1. McEwen B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. Eur. J. Pharmacol. 583 174–185. 10.1016/j.ejphar.2007.11.071
    1. Meyer T., Smeets T., Giesbrecht T., Quaedflieg C. W. E. M., Merckelbach H. (2013). Acute stress differentially affects spatial configuration learning in high and low cortisol-responding healthy adults. Eur. J. Psychotraumatol. 4:19854 10.3402/ejpt.v4i0.19854
    1. National High Blood Pressure Education Program (2004). In The Seventh Report of the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure. Bethesda, MD: National Heart, Lung, and Blood Institute (US).
    1. Phillips A. C., Hunt K., Der G., Carroll D. (2011). Blunted cardiac reactions to acute psychological stress predict symptoms of depression five years later: evidence from a large community study. Psychophysiology 48 142–148.
    1. Pointer M. A., Yancey S., Abou-Chacra R., Petrusi P., Waters S. J., McClelland M. K. (2011). State anxiety is associated with cardiovascular reactivity in young, healthy African Americans. Int. J. Hypertens. 2012:268013 10.1155/2012/268013
    1. Quaedflieg C. W. E. M., Meyer T., Smulders F. T. Y., Smeets T. (2015). The functional role of individual-alpha based frontal asymmetry in stress responding. Biol. Psychol. 104 75–81. 10.1016/j.biopsycho.2014.11.014
    1. Quaedflieg C. W., Schwabe L., Meyer T., Smeets T. (2013). Time dependent effects of stress prior to encoding on event-related potentials and 24 h delayed retrieval. Psychoneuroendocrinology 38 3057–3069. 10.1016/j.psyneuen.2013.09.002
    1. Schafer A., Vagedes J. (2013). How accurate is pulse rate variability as an estimate of heart rate variability? A review on studies comparing photoplethysmographic technology with an electrocardiogram. Int. J. Cardiol. 166 15–29. 10.1016/j.ijcard.2012.03.119
    1. Schafer J. L. (1997). Analysis of Incomplete Multivariate Data. London: Chapman and Hall; 10.1201/9781439821862
    1. Schafer J. L., Olsen M. K. (1998). Multiple imputation for multivariate missing-data problems: a data analyst’s perspective. Multivariate Behav. Res. 33 545–571. 10.1207/s15327906mbr3304_5
    1. Skoluda N., Strahler J., Scholtz W., Niederberger L., Marques S., Fischer S., et al. (2015). Intra-individual psychological and physiological responses to acute laboratory stressors of different intensity. Psychoneuroendocrinology 51 227–236. 10.1016/j.psyneuen.2014.10.002
    1. Smeets T., Cornelisse S., Quaedflieg C. W. E. M., Meyer T., Jelicic M., Merckelbach H. (2012). Introducing the Maastricht Acute Stress Test (MAST): a quick and non-invasive approach to elicit robust autonomic and glucocorticoid stress responses. Psychoneuroendocrinology 37 1998–2008.10.1016/j.psyneuen.2012.04.012
    1. Spielberger C. D. (1983). Manual for the State-Trait Anxiety Inventory: STAI(Form Y). Palo Alto, CA: Consulting Psychologists Press.
    1. Tersman Z., Collins A., Eneroth P. (1991). Cardiovascular responses to psychological and physiological stressors during the menstrual cycle. Psychosom. Med. 53 185–197. 10.1097/00006842-199103000-00008
    1. Ulrich-Lai Y. M., Herman J. P. (2009). Neural regulation of endocrine and autonomic stress responses. Nat. Rev. Neurosci. 10 397–409. 10.1038/nrn2647
    1. Wang Q., Zhao H., Chen W., Li N., Wan Y. (2014). Validation of the iHealth BP7 wrist blood pressure monitor, for self-measurement, according to the European Society of Hypertension International Protocol revision 2010. Blood Press. Monit. 19 54–57. 10.1097/MBP.0000000000000017
    1. Yuenyongchaiwat K., Baker I. S., Sheffield D. (2016). Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks. Rev. Bras. Psiquiatr. 10.1590/1516-4446-2016-1935 [Epub ahead of print].

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