Psychophysiological stress response to the Open TSST VR-Y in a youth sample: A feasibility study

The Open TSST VR is a freely available virtual reality adaptation of the Trier Social Stress Test (TSST) designed to enable standardized, adaptable, and scalable stress research. However, its feasibility as a stressor has only been validated in adult populations. Here, we present results from a study using the Open TSST VR for Youths (VR-Y), a version adapted to adolescent populations. We compared self-ratings, endocrine, and heart rate responses to the VR-Y stress condition and a placebo TSST (active control condition without social-evaluative threat). A total of 37 individuals aged 13-18 years (M_age = 16.19 ± 1.72; 46% female sex, all cisgender) were randomly assigned to one of the two conditions. Significant stress responses in all parameters over time did not differ between the conditions. Including sex in exploratory analyses resulted in a greater desire to leave the situation among girls in the stress condition. Descriptively, we detected more cortisol responders in the stress condition than in the active control condition (1.61 nmol/l criterion: 31% vs 22%, and 2.19 nmol criterion: 25% vs 6%); statistically, the difference was not significant. Because of the limited cortisol responses observed, possibilities are discussed as to how uncontrollability or threat could be increased in order to further enhance the VR-Y's stress-inducing potential. Overall, these results indicate that the Open TSST VR-Y shows some promise as an experimental stress paradigm for participants aged 13 and older. Longitudinal and collaborative experimental stress research will be important to further optimize and validate its effectiveness.