Validation of the Trier Social Stress Test for Children Online (TSST-OL)

• In Event: Successes and Challenges Adapting the Trier Social Stress Test for Remote, Diverse, and fMRI Populations

Abstract

Research on how the developing body responds and adapts to stress has found that the physiological reaction to psychosocial stress can have long-term influence on the developing brain and subsequent behavior (Lupien et al., 2009). One of the most reliable ways to measure the physiological reaction to stress in children is the Trier Social Stress Test for Children (TSST-C), a social evaluative stressor conducted in the lab with multiple salivary cortisol samples (Kirschbaum, Pirke, & Hellhammer, 1993; Gunnar, Talge, & Herrera, 2009). However, the COVID-19 pandemic has made this laboratory assessment unfeasible, as the TSST-C is traditionally conducted in person with a live panel of adult judges. Limitations imposed by the COVID-19 pandemic on in-person assessment and experimental procedures like the TSST-C has ushered the call for internet-based modifications (Lourenco & Tasimi, 2020; Townsend et al, 2020). Here, we present a novel adaptation of the laboratory-based version of the TSST-C that conducts the entire task live via video call. The TSST-Online (TSST-OL) is conducted in real time, connecting participants (adolescents, parents), experimenters, and adult judges (one male, one female) from the convenience of their own homes and offices. In the current study, we examine the initial feasibility of the TSST-OL with a sample of 47 adolescents (Mage = 15 years, 96% White, 45% female, income range $40,000 to >$200,000).
A friendly experimenter conducted two video conference sessions. During Session 1, experimenters worked with prospective participants to assess the reliability of their internet connection, determine where in the home the TSST-OL might take place (e.g., quiet room free from distraction or other members of the household), and provide instruction on proper saliva collection measures. During Session 2 (within a week of Session 1), the TSST-OL protocol was conducted. The Session 2 protocol consisted of online consent/assent, an acclimation period, and then a ten-minute speech and math challenge delivered online to a live, video-conferenced panel of judges (Figure 1). Of note, the experimenter was not present during the speech and math challenge. Following the TSST-OL, the experimenter returned and led the adolescent through a recovery period. Over the course of Session 2, adolescents collected 7 saliva samples using a home-delivered kit. Currently, saliva on 47 adolescents has been received, with 21 adolescents’ data so far assayed. Preliminary results show significant within-subject increases in salivary cortisol (p=.017; Figure 2) with 67% of adolescents mounting a cortisol response at least 10% greater than pre-stress baseline levels, comparable to the rate of responders in laboratory-based versions of the TSST-C (Kirschbaum, 1993; Gunnar, 2009). Data collection is on-going, with over 100 total participants expected by conference presentation. Additional analyses will test associations between COVID-19 stress indices and HPA-axis response in this larger sample. Current findings provide initial validation for the use of an online version of a traditional laboratory-based socio-evaluative stressor. We will discuss method insights along with the benefits, including ability to reach families with limited access to transportation, reduction of staffing time and related costs, and the opportunity for more representative sampling.

Authors

• Brie M Reid, Brown University
  Presenting Author

• Bonny Donzella, University of Minnesota - Twin Cities
  Non-Presenting Author

• Zachary Miller, University of Minnesota - Twin Cities
  Non-Presenting Author

• Samantha Gardow, University of Minnesota - Twin Cities
  Non-Presenting Author

• Nikola Tsakonas, University of Minnesota - Twin Cities
  Non-Presenting Author

• Meriah L. DeJoseph, University of Minnesota - Twin Cities
  Non-Presenting Author

• Jason Bendezu, Pennsylvania State University, University Park
  Non-Presenting Author

• Kathleen M. Thomas, University of Minnesota - Twin Cities
  Non-Presenting Author

• Megan R. Gunnar, University of Minnesota - Twin Cities
  Non-Presenting Author