Research Article: Acute social and physical stress interact to influence social behavior: The role of social anxiety

Date Published: October 25, 2018

Publisher: Public Library of Science

Author(s): Bernadette von Dawans, Amalie Trueg, Clemens Kirschbaum, Urs Fischbacher, Markus Heinrichs, Alexandra Kavushansky.


Stress is proven to have detrimental effects on physical and mental health. Due to different tasks and study designs, the direct consequences of acute stress have been found to be wide-reaching: while some studies report prosocial effects, others report increases in antisocial behavior, still others report no effect. To control for specific effects of different stressors and to consider the role of social anxiety in stress-related social behavior, we investigated the effects of social versus physical stress on behavior in male participants possessing different levels of social anxiety. In a randomized, controlled two by two design we investigated the impact of social and physical stress on behavior in healthy young men. We found significant influences on various subjective increases in stress by physical and social stress, but no interaction effect. Cortisol was significantly increased by physical stress, and the heart rate was modulated by physical and social stress as well as their combination. Social anxiety modulated the subjective stress response but not the cortisol or heart rate response. With respect to behavior, our results show that social and physical stress interacted to modulate trust, trustworthiness, and sharing. While social stress and physical stress alone reduced prosocial behavior, a combination of the two stressor modalities could restore prosociality. Social stress alone reduced nonsocial risk behavior regardless of physical stress. Social anxiety was associated with higher subjective stress responses and higher levels of trust. As a consequence, future studies will need to investigate further various stressors and clarify their effects on social behavior in health and social anxiety disorders.

Partial Text

Chronic stress reduces wellbeing, exacerbates mental disorders, and can be a significant risk factor for several diseases [1–3]. The stress response comprises several psycho-biological levels or parameters. These psycho-physiological adaptations help the organism adjust to environmental demands that may require increases in blood sugar or other metabolic alterations. These metabolic changes ensure the maintenance of homeostasis in the body [1]. The hypothalamus pituitary axis (HPA) with salivary cortisol as its most prominent marker, the sympathetic adrenomedullary system (SAM) (e.g heart rate), as well as the subjective psychological stress response measured via questionnaire represent important branches and variables of the stress response that should be captured in state-of-the-art research. While these axes are characterized by various complex feedback mechanisms and interactions, they may also respond quite independently, meaning that increases in one stress system do not necessarily lead to the same increases in all other stress systems—evident in the largely weak correlations between psychological and physiological stress responses [4]. It is the type of stressor that seems to modulate the three stress-response dimensions, with social evaluation being the key feature driving the cortisol stress response [5,6]. Moreover, several ‘features’ of the subject itself mediate the effectiveness of stressors regarding their varying levels of stress response. Gender, the menstrual cycle phase, or oral contraceptives, age or body weight [7,8] but also psychological variables such as personality traits or different psychopathological symptoms have exhibited an influence on all three stress levels [9–13]. One important situational variable affecting the stress response is ‘social evaluation’ [5]. This effect is dependent on one`s subjective appraisal and personal experiences, and is closely associated with social anxiety. Social evaluation is the feature of the TSST [14] or the Socially Evaluated Cold Pressor Test (SECPT) [6] that characterizes these paradigms as ‘social’ stress paradigms compared to non-social, physical stress paradigms like the Cold Pressor Test (CPT) [15], which lacks a social component. Manifold concepts from different decades and fields of sciences reveal the diversity of the concept ‘stress’ [16–20]. They attempt to provide a framework of mechanistic physiological action and behavioral consequences of stress. Although the fight-or-flight concept [21,22] represents for acute stress the dominant theoretical framework in both animal and human stress research, recent studies provide evidence that acute stressors can also lead to an increase in prosocial behavior [23–28]. They are derived from a theory called the tend-and-befriend concept [29,30]. The latter introduced the neuropeptide oxytocin and opioids as being involved in stress regulation and in the behavioral consequences of the stress response that may be affiliatory. These concepts highlight the diversity of behavioral findings in stress research, and reveal the ambiguity of research on the effects of stress on behavior. There is evidence supporting the fight-or-flight response to stress: e.g. Steinbeis and colleagues [31] report stressed participants as being less trusting. There is evidence that stress leads to less antisocial risk aversion in healthy subjects [32], and that stress reduced donations to a charitable organization [33]. With regard to moral decision-making, one study revealed no group differences between the stress and control group, but documented a positive correlation between the cortisol responses and egoistic decision-making in emotional dilemmas [34]. On the other hand, there are studies supporting the tend-and-befriend reaction to stress entailing higher levels of trust, trustworthiness, or sharing after acute stress [27], studies linking stress reactivity to better social cognition (already implying gender differences) [25,26,28], and studies indicating an association among stress induction, cortisol increase, and prosocial or affiliatory behaviors [23,35]. In the context of moral decision-making, a recent study reported higher levels of altruistic decisions in the stress than the control group [36].

This is the first study to investigate the effects of social stress, physical stress, and social anxiety on social behavior. Social stress increased subjective stress and tension, whereas physical stress increased physical symptoms, unpleasantness, and pain. There was no interaction between social and physical stress with regard to the subjective stress ratings. Participants high in social anxiety reported stronger increases in stress and tension on a trend level, but did not differ in their reported increases in unpleasantness, physical symptoms or pain. Cortisol was increased by physical stress, but there was no stronger effect for the interaction of social and physical stress and no effect of social stress alone. In terms of the cardiovascular response there were increases by physical stress and social stress over time, but again no interaction. Social anxiety revealed no association with the physical stress response. The level of depressive symptoms did not influence the psychobiological stress response significantly.




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