Anxiety and physiological responses to the Trier Social Stress Test for Children in adolescents with cyclic vomiting syndrome

Sally E. Tarbell*, Amanda Millar, Mark Laudenslager, Claire Palmer, John E. Fortunato

*Corresponding author for this work

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C). 11 anxiety and 7 CVS subjects had ≥ 1 anxiety disorder. 82% in the anxiety and CVS groups met criteria for an anxiety disorder on the SCARED. Combining groups, cortisol increased from baseline to recovery during the TSST-C (p = 0.0004) and the stressor to recovery (p = 0.005). α-amylase did not differ during the TSST-C for the total sample, but increased for anxiety compared to controls from baseline to recovery (p = 0.01). HRV decreased during the stressor (p = 0.0001) and increased at recovery (p = 0.004). No associations were found between biomarkers and trait anxiety. Associations were found between baseline HRV and pre-test state anxiety (r = − 0.406, p = 0.012) and between recovery HRV and post-test state anxiety (r = − 0.501, p = 0.002) for the total sample. Anxiety is prevalent in CVS warranting screening. HRV may serve as a biomarker for evaluating stress as a potential trigger for CVS episodes. State but not trait anxiety was associated with changes in HRV, suggesting acute anxiety may be more relevant in linking stress and CVS episodes.

Original languageEnglish (US)
Pages (from-to)79-85
Number of pages7
JournalAutonomic Neuroscience: Basic and Clinical
Volume202
DOIs
StatePublished - Jan 1 2017

Fingerprint

Exercise Test
Anxiety
Heart Rate
Anxiety Disorders
Familial cyclic vomiting syndrome
Amylases
Hydrocortisone
Biomarkers
Appointments and Schedules

Keywords

  • Alpha amylase
  • Child anxiety
  • Cyclic vomiting syndrome
  • Heart rate variability
  • Salivary cortisol
  • Trier Social Stress Test

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology
  • Cellular and Molecular Neuroscience

Cite this

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title = "Anxiety and physiological responses to the Trier Social Stress Test for Children in adolescents with cyclic vomiting syndrome",
abstract = "This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C). 11 anxiety and 7 CVS subjects had ≥ 1 anxiety disorder. 82{\%} in the anxiety and CVS groups met criteria for an anxiety disorder on the SCARED. Combining groups, cortisol increased from baseline to recovery during the TSST-C (p = 0.0004) and the stressor to recovery (p = 0.005). α-amylase did not differ during the TSST-C for the total sample, but increased for anxiety compared to controls from baseline to recovery (p = 0.01). HRV decreased during the stressor (p = 0.0001) and increased at recovery (p = 0.004). No associations were found between biomarkers and trait anxiety. Associations were found between baseline HRV and pre-test state anxiety (r = − 0.406, p = 0.012) and between recovery HRV and post-test state anxiety (r = − 0.501, p = 0.002) for the total sample. Anxiety is prevalent in CVS warranting screening. HRV may serve as a biomarker for evaluating stress as a potential trigger for CVS episodes. State but not trait anxiety was associated with changes in HRV, suggesting acute anxiety may be more relevant in linking stress and CVS episodes.",
keywords = "Alpha amylase, Child anxiety, Cyclic vomiting syndrome, Heart rate variability, Salivary cortisol, Trier Social Stress Test",
author = "Tarbell, {Sally E.} and Amanda Millar and Mark Laudenslager and Claire Palmer and Fortunato, {John E.}",
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Anxiety and physiological responses to the Trier Social Stress Test for Children in adolescents with cyclic vomiting syndrome. / Tarbell, Sally E.; Millar, Amanda; Laudenslager, Mark; Palmer, Claire; Fortunato, John E.

In: Autonomic Neuroscience: Basic and Clinical, Vol. 202, 01.01.2017, p. 79-85.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Anxiety and physiological responses to the Trier Social Stress Test for Children in adolescents with cyclic vomiting syndrome

AU - Tarbell, Sally E.

AU - Millar, Amanda

AU - Laudenslager, Mark

AU - Palmer, Claire

AU - Fortunato, John E.

PY - 2017/1/1

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N2 - This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C). 11 anxiety and 7 CVS subjects had ≥ 1 anxiety disorder. 82% in the anxiety and CVS groups met criteria for an anxiety disorder on the SCARED. Combining groups, cortisol increased from baseline to recovery during the TSST-C (p = 0.0004) and the stressor to recovery (p = 0.005). α-amylase did not differ during the TSST-C for the total sample, but increased for anxiety compared to controls from baseline to recovery (p = 0.01). HRV decreased during the stressor (p = 0.0001) and increased at recovery (p = 0.004). No associations were found between biomarkers and trait anxiety. Associations were found between baseline HRV and pre-test state anxiety (r = − 0.406, p = 0.012) and between recovery HRV and post-test state anxiety (r = − 0.501, p = 0.002) for the total sample. Anxiety is prevalent in CVS warranting screening. HRV may serve as a biomarker for evaluating stress as a potential trigger for CVS episodes. State but not trait anxiety was associated with changes in HRV, suggesting acute anxiety may be more relevant in linking stress and CVS episodes.

AB - This study compared anxiety and physiological responses during the Trier Social Stress Test for Children (TSST-C) in adolescents. 38 subjects (26 females) were enrolled: 11 cyclic vomiting syndrome (CVS), 11 anxiety, and 16 controls. Salivary cortisol, α-amylase and heart rate variability (HRV) were assessed during the TSST-C. Anxiety was measured by the Screen for Childhood Anxiety Related Emotional Disorders (SCARED), Anxiety Disorders Interview Schedule, and State-Trait Anxiety Inventory for Children (STAI-C). 11 anxiety and 7 CVS subjects had ≥ 1 anxiety disorder. 82% in the anxiety and CVS groups met criteria for an anxiety disorder on the SCARED. Combining groups, cortisol increased from baseline to recovery during the TSST-C (p = 0.0004) and the stressor to recovery (p = 0.005). α-amylase did not differ during the TSST-C for the total sample, but increased for anxiety compared to controls from baseline to recovery (p = 0.01). HRV decreased during the stressor (p = 0.0001) and increased at recovery (p = 0.004). No associations were found between biomarkers and trait anxiety. Associations were found between baseline HRV and pre-test state anxiety (r = − 0.406, p = 0.012) and between recovery HRV and post-test state anxiety (r = − 0.501, p = 0.002) for the total sample. Anxiety is prevalent in CVS warranting screening. HRV may serve as a biomarker for evaluating stress as a potential trigger for CVS episodes. State but not trait anxiety was associated with changes in HRV, suggesting acute anxiety may be more relevant in linking stress and CVS episodes.

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KW - Heart rate variability

KW - Salivary cortisol

KW - Trier Social Stress Test

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