A novel remote TSST procedure reliably increases stress reactivity in cannabis users: A pilot study.

Abstract

The Trier Social Stress Test (TSST) is a standard laboratory stressor comprised of a speech and arithmetic tasks that reliably induces physiological and psychological stress. It is traditionally administered in a room where the participant takes part in the TSST in front of two "committee" members. However, due to the recent Coronavirus disease (COVID-19) pandemic, in-person research study procedures have been limited due to potential exposure risks. Since stress reactivity is associated with drug use and the TSST reliably increases stress reactivity among cannabis users, the present pilot study examined a "remote" version of the TSST using the cloud-based virtual video communications platform, Zoom, among cannabis-using individuals (N = 15). The use of a remote platform such as Zoom allowed the participant and the committee to interact in real time while limiting in-person contact. The primary aim of this study was to test the feasibility of a remote version of the TSST in producing an increase in subjective stress response, cannabis craving, and cardiovascular stress in individuals who use cannabis. Participants completed subjective effects questionnaires and had blood pressure (BP) assessed before (baseline) and at various time points after the TSST. Heart rate (HR) was continuously measured throughout the session. This remote version of the TSST significantly and robustly increased State Anxiety and Perceived Stress scores, BP, and HR compared to baseline. There was no effect of the remote TSST on cannabis craving. Overall, the remote version of the TSST appears to be an effective laboratory stressor for future stress reactivity studies. Public Health Significance A remote version of the standardized laboratory stress paradigm, the Trier Social Stress Test (TSST), using Zoom, significantly increased subjective stress and cardiovascular measures. The remote TSST allowed for the use of the TSST with limited in-person contact during the Coronavirus disease (COVID-19) pandemic. The remote TSST may be useful for future stress-related studies in various populations.