Poster #17 - A Systematic Review of Physiological Reactivity to Trier Social Stress Test in Autism Spectrum Disorder

• In Event: Poster Session 10

Abstract

Abstract:
The Trier Social Stress Test (TSST) is a well-validated psychosocial stressor in typically developing population. However, whether TSST can be considered as reliable in autism spectrum disorder (ASD) population is uncertain, especially considering the social communication challenges inherent in ASD. All papers were screened following our recently published protocol. Fifteen studies were included and examined. Results and implications are discussed.
1. Introduction
The Trier Social Stress Test (TSST) was originally developed for use with typically developing adults. The adapted version for use in children and adolescents is TSST-C or sometimes simply called TSST. A typical TSST is a 20-minute task with four components: 1) speech preparation, 2) a public speaking task to a panel (instructed to be unresponsive and appear aloof), 3) serial subtraction, and 4) debriefing. Some studies have adopted a friendly version (TSST-F) in which children can describe himself or herself, and/or a favorite book or other interest in front of a novel peer. In a few recent studies, TSST or modified versions have been used in ASD.
Physiological reactivity refers to the difference between physiological activation in response to the stimuli, which is commonly measured by heart rate variability (HRV), skin conductance level (SCL), and cortisol. This is the first systematic review which investigates the existing evidence of physiological reactivity to TSST in ASD.
2. Methods
The PRISMA flow chart can be found in Figure 1.
2.1. Participants: We included any studies with children and adolescents with ASD between 0 and 18 years.
2.2. Interventions and Comparators: All studies which used TSST or modified versions were included.
2.3. Outcome(s) of Interest: The outcome of interest were not restrictive.
2.4. Methodological Quality Assessment
The quality assessment used by a study (Lydon et al., 2016) was very suitable after careful consideration.
2.5. Software Considerations
Identified records were imported into Covidence where duplicates were removed.
3. Results
The analyses are still undergoing and detailed results will be provided at the conference.
3.1. Sample Characteristics
The total sample size was 1073, in which 604 were samples with ASD. The ages of the participants ranged from 8 to 18 years with a mean of 11.22 years.
3.2. TSST Intervention and Physiological Measures
There were three main types of interventions, including the TSST-C (or simply called TSST in some papers), TSST-F, and some modified versions. There were a total of seven unique physiological measures, in which cortisol (73.33%) was most commonly used. Some examples can be found in table 1.
4. Discussions
Based on preliminary analyses, the differences across the studies might have contributed to the mixed findings, such as whether the participants had comorbidity with anxiety or at puberty stage, and the amount of eye contact with others throughout the TSST. Overall, adopting the appropriate TSST protocol, considering sufficient variety of physiological measures, and providing participants’ detailed characteristics are crucial in future related research. The results may also have important clinical implications on the intervention strategies for social emotional learning and educational policy in children and adolescents with ASD.

Authors

• Agnes S.K. Wong, University of Toronto
  Presenting Author

• Samantha Caitlin Burns, University of Toronto

• Earl Woodruff, University of Toronto