Trier Social Stress Test in Virtual Reality

University Medical Center Groningen55 enrolled

Overview

Background The Trier Social Stress Test (TSST) is a valid and gold standard way for inducing psychosocial stress and is widely used in research and diagnostics. One of the downsides of the TSST is the difficulty to maintain the same experimental conditions repeatedly. A TSST in virtual reality (TSST-VR) is constant and requires far less time and personnel. Our TSST-VR version consist of three stress levels (no stress, moderate stress, high stress), a novelty in this field. Aim The aim is to investigate whether there is a statistically significantly greater increase directly after the TSST-VR in psychological and physiological stress parameters in the moderate and high stress levels compared to the no stress condition (control). Method A randomized controlled trial is conducted in healthy adults, with the three stress levels as conditions. Cortisol and questionnaires on anxiety and physical arousal are measured at baseline, during and after the TSST. Heart rate is measured continuously and adverse events are monitored.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Enrollment

Conditions

Stress, Psychological Stress, Physiological

Trier social stress testBEHAVIORAL

TSST-VR-friendly: The assistant behind the desk asks the participant to prepare a small talk on their favourite holiday within 5 minutes. Then the participant is asked to tell about his holiday for 5 minutes. Then the participant is asked to do a simple math task: adding the number 5 to 0 for 5 minutes. The research assistant gives friendly gestures and verbal encouragements. TSST-VR-neutral: The assistant asks the participant to prepare a speech for a job interview in the upcoming 5 minutes. Then the participant is asked to deliver the speech for 5 minutes in front of two panelists and camera. Then the participant is asked to do a math task, subtracting the number 13 from 1022 for 5 minutes. During the performance the two panellist have neutral gestures and give neutral verbal instructions. TSST-VR unfriendly: The procedure of the TSST-VR unfriendly is the same as the neutral TSST-VR, with the addition that the two panellist give unfriendly gestures such as tapping on the table.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Healthy participants, not having a psychiatric diagnosis in the last three years or currently having an endocrine disorders * Aged between 18 and 65 years * Good understanding of the Dutch language * Normal or corrected-to-normal vision and hearing Exclusion Criteria: * History of photosensitive epilepsy * Hearing loss * Pregnant woman * Women who breastfeed * Taking heart rate altering medication such as beta-blockers. Pregnant woman and woman who breastfeed are excluded because they have a different hormone levels which can intervene with the stress reaction.

Outcomes

Primary Outcomes

Change of levels of physical stress, HRV

Change from baseline to 75 min

Time frame: continuously during the whole procedure, in total 75 minuten

Secondary Outcomes

Change of levels of psychological stress, state anxiety inventory STAI

Change from baseline to the last waiting period. 6 questions each scoring 1-4, with a total score of 24. A higher score indicates for more stress and anxiety.

Time frame: After 20 minutes waiting period, after the stress test (+15min), after another 20min waiting period, and after another 20min waiting period.

Social phobia

Social phobia scores measured by the Social Phobia Inventory

Time frame: Baseline

Sociodemographics

Age, gender, work

Time frame: baseline

Speech fluency

Speech fluency as recorded during the speech and math task

Time frame: during the speech and math task, 10 minutes in total

Change of levels of physical stress, cortisol

Change from baseline to the last waiting period

Time frame: After 20 minutes waiting period, after the stress test (+15min), after another 20min waiting period, and after another 20min waiting period.

Change of levels of physical stress, Skin conductance

Galvanic Skin Conductance