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.
N1 - Publisher Copyright:
© 2016 Elsevier B.V.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2017/1/1
Y1 - 2017/1/1
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.
KW - Alpha amylase
KW - Child anxiety
KW - Cyclic vomiting syndrome
KW - Heart rate variability
KW - Salivary cortisol
KW - Trier Social Stress Test
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U2 - 10.1016/j.autneu.2016.08.010
DO - 10.1016/j.autneu.2016.08.010
M3 - Review article
C2 - 27554769
AN - SCOPUS:84995911598
VL - 202
SP - 79
EP - 85
JO - Autonomic Neuroscience: Basic and Clinical
JF - Autonomic Neuroscience: Basic and Clinical
SN - 1566-0702
ER -