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Updated: May 21, 2026

The Trier Social Stress Test Protocol for Inducing Psychological Stress
Published on: October 19, 2011
Exposure to negative acts at work, psychological stress reactions and physiological stress response
Annie Hogh1, Ase M Hansen, Eva G Mikkelsen
1University of Copenhagen, Oster Fairmagsgade 2A, Copenhagen, Denmark. annie.hogh@psy.ku.dk
Objectives:
The overall aim of the study was to test the association between exposure to negative acts at work, psychological stress-reactions and cortisol secretion and whether some negative acts are more detrimental to health than others.
Methods:
A questionnaire study included 1010 respondents from 55 workplaces. Three saliva samples collected from the participants at awakening, 30 min later and at 20:00 during a workday were analysed for cortisol concentrations. Negative acts were measured using a modified version of the revised Negative Acts Questionnaire (to measure bullying behaviour). Factor analyses identified four subscales: social isolation, direct harassment, intimidating behaviour and work related acts. Psychological stress-reactions were measured by the Impact of Event Scale (IES) measuring traumatic stress-reactions.
Results:
Having controlled for gender, age, other traumatic incidents and physical violence, multiple regression analyses showed significant linear associations between social isolation and the three IES scales: hyper-arousal, intrusive thoughts, and avoidance behaviour. Work-related negative acts were significantly associated with all three outcome scales though to a lesser degree, whereas direct harassment was only associated with avoidance behaviour. Intimidating acts were significantly associated with hyper-arousal. We found significantly reduced levels of cortisol concentration for exposure to direct harassment and intimidating behaviour.
Conclusion:
The results show that some negative acts such as direct harassment and intimidating behaviour are associated with psychological stress-reactions and a negative physiological stress response. Extending previous research this indicates that some negative acts are more detrimental than others in so far as exposure to these acts affects both psychological and physiological health.
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