TSST-home - A pilot study investigating a home version of the 'Trier Social Stress Test'

The Trier Social Stress Test (TSST) is a well-established laboratory stress-inducing paradigm. However, its implementation requires a research environment with dedicated personnel (usually at a research institution). When participants cannot travel to a research institution (due to age, mobility, or geographical restrictions), a home version of the TSST is needed. We have developed the TSST-home, which shares the essential characteristics with the laboratory version but is implemented at the participant's home. In this pilot study, we aimed to investigate the feasibility of the TSST-home and its ability to induce stress responses in comparison to a non-stressful control condition. Seventeen healthy men (mean age and range: 24 years; 18-30 years) were exposed, in randomized order, to the TSST-home and the placebo-TSST-home (control condition) in their respective homes. During each session we assessed perceived stress, salivary cortisol, salivary alpha-amylase, heart rate to account for the multifaceted nature of acute stress responses. Conservative and liberal cortisol responder rates (≥2.5 and ≥ 1.5 nmol/l increase) in the TSST-home condition were 70% and 82%, respectively. The TSST-home and placebo-TSST-home differed significantly in their trajectories of stress markers with stronger stress-induced responses across all stress measures in the TSST-home condition. Findings suggest that the TSST-home elicits reliable and valid acute stress responses across different stress markers comparable to those found in the original laboratory-based TSST. This tool can be used to investigate stress responses of participants who cannot otherwise participate in laboratory-based studies at research institutions.