儿童版特里尔社会应激测试对儿童唾液皮质醇、唾液α-淀粉酶和情绪的影响
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摘要
研究以150名五、六年级的学生为被试,考察儿童版特里尔社会应激测试(TSST-C)对儿童客观生理反应(唾液皮质醇和唾液α-淀粉酶)和主观情绪反应的影响。结果发现,TSST-C引起了儿童显著的应激反应,包括皮质醇和唾液α-淀粉酶水平的升高,以及主观消极情绪(如焦虑和紧张)的增加,这表明TSST-C在中国儿童中的适用情况良好,能够有效诱发儿童的应激反应。同时,研究也发现,皮质醇反应和唾液α-淀粉酶反应不存在相关,生理反应和情绪反应之间也不存在相关。
There is substantial evidence indicating that repeated exposures to psychosocial stress in childhood may alter the function of hypothalamicpituitary-adrenal(HPA) axis and sympathetic nervous system(SNS), which in turn increase the risk of various diseases in adulthood. Studying physiological responses to psychosocial stressors, especially in childhood, may help to understand the underlying mechanisms that are involved in diseases pathogenesis, and to intervene early in life. Trier Social Stress Test for Children(TSST-C) is a protocol for induction of moderate to intense psychosocial stress in a laboratory setting. It comprises of a 10-min anticipatory period, a 5-min public speaking task(children receive the beginning of a story, and finish telling the story as exciting as possible) and a 5-min mental arithmetic task(children are required to subtract 7 serially from 758 as quickly and accurately as possible, and children have to restart at 758 when a mistake is made) facing two evaluative and non-responsive audience members. The TSST-C is the most widely used psychosocial stress protocol in stress research of human subjects that reliably elicits physiological stress responses, including salivary cortisol and salivary α-amylase responses, which have been recognized as reliable biomarkers for the HPA axis and SNS function, respectively. However, the applicability of TSST-C in inducing cortisol and salivary α-amylase responses among healthy Chinese children remains largely unknown. With this background, our study examined both cortisol and salivary α-amylase responses to the TSST-C in a sample of healthy children(N=150, 76 boys, 11.15 ±.86 years) in Beijing, China. Following recent stress response research(Yim et al., 2010), children completed an adapted version of the TSST-C using a different public speaking task(introducing oneself to a hypothetical new classroom of students), which was likely to induce comparable physiological responses in individuals within somewhat wider age ranges than what had been examined in the past. All laboratory sessions were scheduled during the afternoon(between 14:00 and 17:30) to control for the diurnal variations of cortisol secretion. Participants were asked to refrain from any food or drink for at least 30 min before laboratory sessions. A total of six segments of salivary samples and subjective stress measures were obtained throughout the session: baseline(-20 min), after preparation(-3 min), after TSST-C task(+1 min), first recovery(+10 min), second recovery(+25 min) and third recovery(+50 min). The salivary samples were collected for analyzing cortisol and salivary α-amylase. And the subjective stress measures were used for assessing children's psychological response. The results showed that:(1) Children exhibited significant increases in cortisol and salivary α-amylase levels, and reported higher levels of negative affect, such as anxiety and nervousness, following the TSST-C.(2) The associations among cortisol response, salivary α-amylase response, and subjective emotional response failed to reach significance. In conclusion, the findings indicate that TSST-C induces both physiological and psychological responses of sufficient magnitude in Chinese children. TSST-C is a protocol with good applicability in healthy Chinese children, and can be used for stress research to explore the associations among psychosocial stressors, stress responses of HPA axis and SNS, and physical health in Chinese children.
There is substantial evidence indicating that repeated exposures to psychosocial stress in childhood may alter the function of hypothalamicpituitary-adrenal(HPA) axis and sympathetic nervous system(SNS), which in turn increase the risk of various diseases in adulthood. Studying physiological responses to psychosocial stressors, especially in childhood, may help to understand the underlying mechanisms that are involved in diseases pathogenesis, and to intervene early in life. Trier Social Stress Test for Children(TSST-C) is a protocol for induction of moderate to intense psychosocial stress in a laboratory setting. It comprises of a 10-min anticipatory period, a 5-min public speaking task(children receive the beginning of a story, and finish telling the story as exciting as possible) and a 5-min mental arithmetic task(children are required to subtract 7 serially from 758 as quickly and accurately as possible, and children have to restart at 758 when a mistake is made) facing two evaluative and non-responsive audience members. The TSST-C is the most widely used psychosocial stress protocol in stress research of human subjects that reliably elicits physiological stress responses, including salivary cortisol and salivary α-amylase responses, which have been recognized as reliable biomarkers for the HPA axis and SNS function, respectively. However, the applicability of TSST-C in inducing cortisol and salivary α-amylase responses among healthy Chinese children remains largely unknown. With this background, our study examined both cortisol and salivary α-amylase responses to the TSST-C in a sample of healthy children(N=150, 76 boys, 11.15 ±.86 years) in Beijing, China. Following recent stress response research(Yim et al., 2010), children completed an adapted version of the TSST-C using a different public speaking task(introducing oneself to a hypothetical new classroom of students), which was likely to induce comparable physiological responses in individuals within somewhat wider age ranges than what had been examined in the past. All laboratory sessions were scheduled during the afternoon(between 14:00 and 17:30) to control for the diurnal variations of cortisol secretion. Participants were asked to refrain from any food or drink for at least 30 min before laboratory sessions. A total of six segments of salivary samples and subjective stress measures were obtained throughout the session: baseline(-20 min), after preparation(-3 min), after TSST-C task(+1 min), first recovery(+10 min), second recovery(+25 min) and third recovery(+50 min). The salivary samples were collected for analyzing cortisol and salivary α-amylase. And the subjective stress measures were used for assessing children's psychological response. The results showed that:(1) Children exhibited significant increases in cortisol and salivary α-amylase levels, and reported higher levels of negative affect, such as anxiety and nervousness, following the TSST-C.(2) The associations among cortisol response, salivary α-amylase response, and subjective emotional response failed to reach significance. In conclusion, the findings indicate that TSST-C induces both physiological and psychological responses of sufficient magnitude in Chinese children. TSST-C is a protocol with good applicability in healthy Chinese children, and can be used for stress research to explore the associations among psychosocial stressors, stress responses of HPA axis and SNS, and physical health in Chinese children.
引文
陈光辉,孔艳红.(2016).特里尔社会应激测验对儿童皮质醇分泌的影响.心理发展与教育,32(5),532-538.
陆青云,陶芳标,侯方丽,孙莹.(2014).青少年应激下皮质醇应答与风险决策相关性的性别差异.心理学报,46(5),647-655.
王晓蕾,陈丽华,卜钰,林丹华.(2018).父子依恋、母子依恋与儿童应激下皮质醇反应的关系.心理发展与教育,34(1),10-20.
杨娟,侯燕,杨瑜,张庆林.(2011).特里尔社会应激测试(TSST)对唾液皮质醇分泌的影响.心理学报,43(4),403-409.
朱琳,陈佩杰.(2012).自填式青春期发育量表(中译版)的检验.中国运动医学杂志,31(6),512-516.
Ali,N.,&Pruessner,J.C.(2012).The salivary alpha amylase over cortisol ratio as a marker to assess dysregulations of the stress systems.Physiology and Behavior,106(1),65-72.
Bae,Y.J.,Stadelmann,S.,Klein,A.M.,Jaeger,S.,Hiemisch,A.,Kiess,W.,et al.(2015).The hyporeactivity of salivary cortisol at stress test(TSST-C)in children with internalizing or externalizing disorders is contrastively associated withα-amylase.Journal of Psychiatric Research,71,78-88.
Bauer,A.M.,Quas,J.A.,&Boyce,W.T.(2002).Associations between physiological reactivity and children's behavior:Advantages of a multisystem approach.Journal of Developmental and Behavioral Pediatrics,23(2),102-113.
Buske-Kirschbaum,A.,Jobst,S.,Wustmans,A.,Kirschbaum,C.,Rauh,W.,&Hellhammer,D.(1997).Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.Psychosomatic Medicine,59(4),419-426.
Buske-Kirschbaum,A.,von Auer,K.,Krieger,S.,Weis,S.,Rauh,W.,&Hellhammer,D.(2003).Blunted cortisol responses to psychosocial stress in asthmatic children:A general feature of atopic disease?Psychosomatic Medicine,65(5),806-810.
Campbell,J.,&Ehlert,U.(2012).Acute psychosocial stress:Does the emotional stress response correspond with physiological responses?Psychoneuroendocrinology,37(8),1111-1134.
Chen,F.R.,Raine,A.,Rudo-Hutt,A.S.,Glenn,A.L.,Soyfer,L.,&Granger,D.A.(2015).Harsh discipline and behavior problems:The moderating effects of cortisol and alpha-amylase.Biological Psychology,104,19-27.
Chrousos,G.P.(2009).Stress and disorders of the stress system.Nature Reviews Endocrinology,5(7),374-381.
Denson,T.F.,Creswell,J.D.,Terides,M.D.,&Blundell,K.(2014).Cognitive reappraisal increases neuroendocrine reactivity to acute social stress and physical pain.Psychoneuroendocrinology,49,69-78.
Dickerson,S.S.,&Kemeny,M.E.(2004).Acute stressors and cortisol responses:A theoretical integration and synthesis of laboratory research.Psychological Bulletin,130(3),355-391.
Doom,J.R.,Hostinar,C.E.,VanZomeren-Dohm,A.A.,&Gunnar,M.R.(2015).The roles of puberty and age in explaining the diminished effectiveness of parental buffering of HPA reactivity and recovery in adolescence.Psychoneuroendocrinology,59,102-111.
Foley,P.,&Kirschbaum,C.(2010).Human hypothalamus-pituitary-adrenal axis responses to acute psychosocial stress in laboratory settings.Neuroscience and Biobehavioral Reviews,35(1),91-96.
Gordis,E.B.,Granger,D.A.,Susman,E.J.,&Trickett,P.K.(2006).Asymmetry between salivary cortisol andα-amylase reactivity to stress:Relation to aggressive behavior in adolescents.Psychoneuroendocrinology,31(8),976-987.
Granger,D.A.,Kivlighan,K.T.,El-Sheikh,M.,Gordis,E.B.,&Stroud,L.R.(2007).Salivaryα-amylase in biobehavioral research:Recent developments and applications.Annals of the New York Academy of Sciences,1098,122-144.
Gunnar,M.R.,Talge,N.M.,&Herrera,A.(2009).Stressor paradigms in developmental studies:What does and does not work to produce mean increases in salivary cortisol.Psychoneuroendocrinology,34(7),953-967.
Hartman,C.A.,Hermanns,V.W.,de Jong,P.J.,&Ormel,J.(2013).Self-or parent report of(co-occurring)internalizing and externalizing problems,and basal or reactivity measures of HPA-axis functioning:A systematic evaluation of the internalizing-hyperresponsivity versus externalizing-hyporesponsivity HPA-axis hypothesis.Biological Psychology,94(1),175-184.
Hellhammer,D.H.,Wüst,S.,&Kudielka,B.M.(2009).Salivary cortisol as a biomarker in stress research.Psychoneuroendocrinology,34(2),163-171.
Huang,Y.M.,Zhou,R.L.,Wu,M.Y.,Wang,Q.G.,&Zhao,Y.(2015).Premenstrual syndrome is associated with blunted cortisol reactivity to the TSST.Stress,18(2),160-168.
Kirschbaum,C.,Pirke,K.M.,&Hellhammer,D.H.(1993).The‘Trier Social Stress Test’-a tool for investigating psychobiological stress responses in a laboratory setting.Neuropsychobiology,28(1-2),76-81.
Klumbies,E.,Braeuer,D.,Hoyer,J.,&Kirschbaum,C.(2014).The reaction to social stress in social phobia:Discordance between physiological and subjective parameters.PLo S ONE,9(8),e105670.
Koss,K.J.,&Gunnar,M.R.(2018).Annual Research Review:Early adversity,the hypothalamic-pituitary-adrenocortical axis,and child psychopathology.The Journal of Child Psychology and Psychiatry,59(4),327-346.
Lu,Q.Y.,Tao,F.B.,Hou,F.L.,Zhang,Z.C.,Sun,Y.,Xu,Y.Y.,et al.(2014).Cortisol reactivity,delay discounting and percent body fat in chinese urban young adolescents.Appetite,72,13-20.
Mc Ewen,B.S.(1998).Protective and damaging effects of stress mediators.The New England Journal of Medicine,338(3),171-179.
Nater,U.M.,La Marca,R.,Florin,L.,Moses,A.,Langhans,W.,Koller,M.M.,&Ehlert,U.(2006).Stress-induced changes in human salivary alpha-amylase activity-associations with adrenergic activity.Psychoneuroendocrinology,31(1),49-58.
Nater,U.M.,&Rohleder,N.(2009).Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system:Current state of research.Psychoneuroendocrinology,34(4),486-496.
Pacák,K.,&Palkovits,M.(2001).Stressor specificity of central neuroendocrine responses:Implications for stress-related disorders.Endocrine Reviews,22(4),502-548.
Petersen,A.C.,Crockett,L.,Richards,M.,&Boxer,A.(1988).A self-report measure of pubertal status:Reliability,validity,and initial norms.Journal of Youth and Adolescence,17(2),117-133.
Pruessner,J.C.,Kirschbaum,C.,Meinlschmid,G.,&Hellhammer,D.H.(2003).Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change.Psychoneuroendocrinology,28(7),916-931.
Rohleder,N.,&Nater,U.M.(2009).Determinants of salivaryα-amylase in humans and methodological considerations.Psychoneuroendocrinology,34(4),469-485.
Seltzer,L.J.,Ziegler,T.,Connolly,M.J.,Prososki,A.R.,&Pollak,S.D.(2014).Stress-induced elevation of oxytocin in maltreated children:Evolution,neurodevelopment,and social behavior.Child Development,85(2),501-512.
Tyrka,A.R.,Wier,L.M.,Anderson,G.M.,Wilkinson,C.W.,Price,L.H.,&Carpenter,L.L.(2007).Temperament and response to the trier social stress test.Acta Psychiatrica Scandinavica,115(5),395-402.
Yim,I.S.,Quas,J.A.,Cahill,L.,&Hayakawa,C.M.(2010).Children's and adults’salivary cortisol responses to an identical psychosocial laboratory stressor.Psychoneuroendocrinology,35(2),241-248.
陆青云,陶芳标,侯方丽,孙莹.(2014).青少年应激下皮质醇应答与风险决策相关性的性别差异.心理学报,46(5),647-655.
王晓蕾,陈丽华,卜钰,林丹华.(2018).父子依恋、母子依恋与儿童应激下皮质醇反应的关系.心理发展与教育,34(1),10-20.
杨娟,侯燕,杨瑜,张庆林.(2011).特里尔社会应激测试(TSST)对唾液皮质醇分泌的影响.心理学报,43(4),403-409.
朱琳,陈佩杰.(2012).自填式青春期发育量表(中译版)的检验.中国运动医学杂志,31(6),512-516.
Ali,N.,&Pruessner,J.C.(2012).The salivary alpha amylase over cortisol ratio as a marker to assess dysregulations of the stress systems.Physiology and Behavior,106(1),65-72.
Bae,Y.J.,Stadelmann,S.,Klein,A.M.,Jaeger,S.,Hiemisch,A.,Kiess,W.,et al.(2015).The hyporeactivity of salivary cortisol at stress test(TSST-C)in children with internalizing or externalizing disorders is contrastively associated withα-amylase.Journal of Psychiatric Research,71,78-88.
Bauer,A.M.,Quas,J.A.,&Boyce,W.T.(2002).Associations between physiological reactivity and children's behavior:Advantages of a multisystem approach.Journal of Developmental and Behavioral Pediatrics,23(2),102-113.
Buske-Kirschbaum,A.,Jobst,S.,Wustmans,A.,Kirschbaum,C.,Rauh,W.,&Hellhammer,D.(1997).Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis.Psychosomatic Medicine,59(4),419-426.
Buske-Kirschbaum,A.,von Auer,K.,Krieger,S.,Weis,S.,Rauh,W.,&Hellhammer,D.(2003).Blunted cortisol responses to psychosocial stress in asthmatic children:A general feature of atopic disease?Psychosomatic Medicine,65(5),806-810.
Campbell,J.,&Ehlert,U.(2012).Acute psychosocial stress:Does the emotional stress response correspond with physiological responses?Psychoneuroendocrinology,37(8),1111-1134.
Chen,F.R.,Raine,A.,Rudo-Hutt,A.S.,Glenn,A.L.,Soyfer,L.,&Granger,D.A.(2015).Harsh discipline and behavior problems:The moderating effects of cortisol and alpha-amylase.Biological Psychology,104,19-27.
Chrousos,G.P.(2009).Stress and disorders of the stress system.Nature Reviews Endocrinology,5(7),374-381.
Denson,T.F.,Creswell,J.D.,Terides,M.D.,&Blundell,K.(2014).Cognitive reappraisal increases neuroendocrine reactivity to acute social stress and physical pain.Psychoneuroendocrinology,49,69-78.
Dickerson,S.S.,&Kemeny,M.E.(2004).Acute stressors and cortisol responses:A theoretical integration and synthesis of laboratory research.Psychological Bulletin,130(3),355-391.
Doom,J.R.,Hostinar,C.E.,VanZomeren-Dohm,A.A.,&Gunnar,M.R.(2015).The roles of puberty and age in explaining the diminished effectiveness of parental buffering of HPA reactivity and recovery in adolescence.Psychoneuroendocrinology,59,102-111.
Foley,P.,&Kirschbaum,C.(2010).Human hypothalamus-pituitary-adrenal axis responses to acute psychosocial stress in laboratory settings.Neuroscience and Biobehavioral Reviews,35(1),91-96.
Gordis,E.B.,Granger,D.A.,Susman,E.J.,&Trickett,P.K.(2006).Asymmetry between salivary cortisol andα-amylase reactivity to stress:Relation to aggressive behavior in adolescents.Psychoneuroendocrinology,31(8),976-987.
Granger,D.A.,Kivlighan,K.T.,El-Sheikh,M.,Gordis,E.B.,&Stroud,L.R.(2007).Salivaryα-amylase in biobehavioral research:Recent developments and applications.Annals of the New York Academy of Sciences,1098,122-144.
Gunnar,M.R.,Talge,N.M.,&Herrera,A.(2009).Stressor paradigms in developmental studies:What does and does not work to produce mean increases in salivary cortisol.Psychoneuroendocrinology,34(7),953-967.
Hartman,C.A.,Hermanns,V.W.,de Jong,P.J.,&Ormel,J.(2013).Self-or parent report of(co-occurring)internalizing and externalizing problems,and basal or reactivity measures of HPA-axis functioning:A systematic evaluation of the internalizing-hyperresponsivity versus externalizing-hyporesponsivity HPA-axis hypothesis.Biological Psychology,94(1),175-184.
Hellhammer,D.H.,Wüst,S.,&Kudielka,B.M.(2009).Salivary cortisol as a biomarker in stress research.Psychoneuroendocrinology,34(2),163-171.
Huang,Y.M.,Zhou,R.L.,Wu,M.Y.,Wang,Q.G.,&Zhao,Y.(2015).Premenstrual syndrome is associated with blunted cortisol reactivity to the TSST.Stress,18(2),160-168.
Kirschbaum,C.,Pirke,K.M.,&Hellhammer,D.H.(1993).The‘Trier Social Stress Test’-a tool for investigating psychobiological stress responses in a laboratory setting.Neuropsychobiology,28(1-2),76-81.
Klumbies,E.,Braeuer,D.,Hoyer,J.,&Kirschbaum,C.(2014).The reaction to social stress in social phobia:Discordance between physiological and subjective parameters.PLo S ONE,9(8),e105670.
Koss,K.J.,&Gunnar,M.R.(2018).Annual Research Review:Early adversity,the hypothalamic-pituitary-adrenocortical axis,and child psychopathology.The Journal of Child Psychology and Psychiatry,59(4),327-346.
Lu,Q.Y.,Tao,F.B.,Hou,F.L.,Zhang,Z.C.,Sun,Y.,Xu,Y.Y.,et al.(2014).Cortisol reactivity,delay discounting and percent body fat in chinese urban young adolescents.Appetite,72,13-20.
Mc Ewen,B.S.(1998).Protective and damaging effects of stress mediators.The New England Journal of Medicine,338(3),171-179.
Nater,U.M.,La Marca,R.,Florin,L.,Moses,A.,Langhans,W.,Koller,M.M.,&Ehlert,U.(2006).Stress-induced changes in human salivary alpha-amylase activity-associations with adrenergic activity.Psychoneuroendocrinology,31(1),49-58.
Nater,U.M.,&Rohleder,N.(2009).Salivary alpha-amylase as a non-invasive biomarker for the sympathetic nervous system:Current state of research.Psychoneuroendocrinology,34(4),486-496.
Pacák,K.,&Palkovits,M.(2001).Stressor specificity of central neuroendocrine responses:Implications for stress-related disorders.Endocrine Reviews,22(4),502-548.
Petersen,A.C.,Crockett,L.,Richards,M.,&Boxer,A.(1988).A self-report measure of pubertal status:Reliability,validity,and initial norms.Journal of Youth and Adolescence,17(2),117-133.
Pruessner,J.C.,Kirschbaum,C.,Meinlschmid,G.,&Hellhammer,D.H.(2003).Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change.Psychoneuroendocrinology,28(7),916-931.
Rohleder,N.,&Nater,U.M.(2009).Determinants of salivaryα-amylase in humans and methodological considerations.Psychoneuroendocrinology,34(4),469-485.
Seltzer,L.J.,Ziegler,T.,Connolly,M.J.,Prososki,A.R.,&Pollak,S.D.(2014).Stress-induced elevation of oxytocin in maltreated children:Evolution,neurodevelopment,and social behavior.Child Development,85(2),501-512.
Tyrka,A.R.,Wier,L.M.,Anderson,G.M.,Wilkinson,C.W.,Price,L.H.,&Carpenter,L.L.(2007).Temperament and response to the trier social stress test.Acta Psychiatrica Scandinavica,115(5),395-402.
Yim,I.S.,Quas,J.A.,Cahill,L.,&Hayakawa,C.M.(2010).Children's and adults’salivary cortisol responses to an identical psychosocial laboratory stressor.Psychoneuroendocrinology,35(2),241-248.