Related Articles Validation of an online version of the Trier Social Stress Test in a study of adolescents Psychoneuroendocrinology 2020 Dec 14 125 105111 Authors Gunnar MR Reid BM Donzella B Miller ZR Gardow S Tsakonas NC Thomas KM DeJoseph M Bendez JJ Abstract INTRODUCTION The Trier Social Stress Test TSST is the most widely used protocol for activating a stress response of the hypothalamic pituitary adrenocortical HPA axis and other stress mediating systems A number of variants of the TSST exist including ones for children groups and virtual reality All of these versions though require in person assessment The COVID 19 pandemic has made in person assessment impossible or extremely difficult and potentially dangerous The purpose of this study was to validate a completely remote online version of the TSST for children METHOD A sample of 68 27 female 15 and 16 year old participants were administered the TSST Online TSST OL during the late afternoon hours 3 6 p m start time The participants judges one male one female and experimenter female all joined the assessment from their own homes via the online platform ZOOM Two sessions were conducted one to obtain consent explain procedures work with the family to arrange the computer and room set up for the TSST OL and one within two weeks to conduct the procedure The participants were trained to take their own saliva samples and a saliva sampling kit was mailed to the home in between the first and second session The samples were then mailed to the researchers within a day of collection The participant was observed during saliva collection to determine correct procedures were followed Salivary cortisol salivary amylase and self reports of stress were measured multiple times over the second session RESULTS rmANOVAs yielded a significant effect of trials for cortisol F 1 37 90 46 15 13 p 001 sAA F 2 75 146 68 6 91 p 001 and self rated stress F 3 43 222 69 118 73 p 001 There were no significant sex by trials interactions for any measure although females reported more stress than males F 1 65 9 14 p 004 For cortisol from baseline to expected peak 30 min after the onset of speech preparation the Cohen s effect size was dz 0 57 Using 1 5 nmol l or 0 54 g dl as the criterion for a response Miller Plessow Kirschaum Stalder 2013 63 of the participants produced a significant increase in cortisol CONCLUSIONS The responses to the TSST OL are consistent with in person responses among children and adolescents see recent meta analysis Seddon et al 2020 The protocol is a viable way of assessing reactivity of the HPA axis and other stress systems without needing to bring the participant into the research laboratory This method will be useful during periods of widespread infection It should also work to study populations who all live too far from the research laboratory to be assessed in person PMID 33341502 PubMed as supplied by publisher