Psychother Psychosom Med Psychol 2010; 60(2): 64-72
DOI: 10.1055/s-0028-1103297
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Entwicklung des „Mannheimer Multikomponenten-Stress-Test” (MMST)

Development of the “Mannheim Multicomponent Stress Test” (MMST)Tatyana Kolotylova 1 [*] , Mandy Koschke 2 , 3 [*] , Karl-Jürgen Bär 2 , Ulrich Ebner-Priemer 1 , Nikolaus Kleindienst 1 , Martin Bohus 1 , Christian Schmahl 1
  • 1Zentralinstitut für Seelische Gesundheit Mannheim, Klinik für Psychosomatik und Psychotherapeutische Medizin
  • 2Klinik für Psychiatrie und Psychotherapie, Universität Jena
  • 3Institut für Psychosoziale Medizin und Psychotherapie, Universität Jena
Further Information

Publication History

eingereicht: 9. Juni 2008

akzeptiert: 27. Okt. 2008

Publication Date:
26 February 2009 (online)

Zusammenfassung

Ziel dieser Arbeit war die Entwicklung und Evaluation eines ökonomischen, standardisierten Stress- Paradigmas, das zur Untersuchung von individuellen Stressreaktionen unter Laborbedingungen eingesetzt werden kann. Hierzu wurde zunächst die Kombination verschiedener stressauslösender Reize hinsichtlich ihrer Wirkung auf Herzfrequenz und subjektives Stresserleben untersucht. Den höchsten Anstieg im objektiven und subjektiven Stresslevel zeigte eine Kombination aus Kopfrechenaufgaben, Lärm und emotional belastenden Bildern, welche während der Lösung der Kopfrechenaufgaben im Hintergrund präsentiert wurden. Diese Stresskombination wurde an einer unabhängigen Stichprobe mit 32 gesunden Probanden hinsichtlich physiologischer Reaktionsmuster evaluiert. Es zeigten sich rasche, signifikante Veränderungen der primären Untersuchungsparameter Herzratenvariabilität, Baroreflexsensitivität und Impedanzkardiografie. Der Mannheimer Multikomponenten-Stress-Test (MMST) ermöglicht eine standardisierte, starke Stressinduktion innerhalb kurzer Zeit und stellt somit einen effektiven und ökonomischen Stresstest zur Untersuchung von Stressreaktionen dar.

Abstract

The aim of the present study was to develop and evaluate an economical stress paradigm, which can be used for the investigation of stress reactions in a laboratory setting. Different stressors were combined to investigate the changes of heart frequency and subjective stress levels as response to stressful stimulation. A combination of mental stress, noise and emotional pictures presented in the background during performing a mental arithmetic task showed significant increases in heart rate and subjective stress levels. Furthermore we tested the stress combination in 32 healthy subjects to evaluate the physiological response. We found significant changes in the cardiovascular parameters such as heart rate variability, baroreflex sensitivity and cardiac output. We conclude that the Mannheim Multicomponent Stress Test (MMST) induces high levels of physiological and psychological stress and can serve as an economical method to investigate stress reactions in a laboratory setting.

Literatur

  • 1 Chrousos GP, Gold PW. The concepts of stress and stress system disorders. Overview of physical and behavioral homeostasis.  JAMA. 1992;  267 ((9)) 1244-1252
  • 2 Shalev AY, Peri T, Gelpin E. et al . Psychophysiologic assessment of mental imagery of stressful events in Israeli civilian posttraumatic stress disorder patients.  Compr Psychiatry. 1997;  38 269-273
  • 3 Liberzon I, Abelson JL, Flagel SB. et al . Neuroendocrine and psychophysiologic responses in PTSD: a symptom provocation study.  Neuropsychopharmacology. 1999;  21 40-50
  • 4 Lanius RA, Williamson PC, Densmore M. et al . Neural correlates of traumatic memories in posttraumatic stress disorder: a functional MRI investigation.  Am J Psychiatry. 2001;  158 1920-1922
  • 5 McNally RJ, Lasko NB, Clancy SA. et al . Psychophysiological responding during script-driven imagery in people reporting abduction by space aliens.  Psychol Sci. 2004;  15 ((7)) 493-497
  • 6 Gronwall DM. Paced auditory serial-addition task: a measure of recovery from concussion.  Percept Mot Skills. 1977;  44 ((2)) 367-373
  • 7 Ellenbogen MA, Schwartzman AE, Stewart J. et al . Stress and selective attention: the interplay of mood, cortisol levels, and emotional information processing.  Psychophysiology. 2002;  39 ((6)) 723-732
  • 8 Uchino BN, Cacioppo JT, Malarkey W. et al . Individual differences in cardiac sympathetic control predict endocrine and immune responses to acute psychological stress.  J Pers Soc Psychol. 1995;  69 ((4)) 736-743
  • 9 Zakowski SG, McAllister CG, Deal M. et al . Stress, reactivity, and immune function in healthy men.  Health Psychol. 1992;  11 ((4)) 223-232
  • 10 McCleery JM, Bhagwagar Z, Smith KA. et al . Modelling a loss event: effect of imagined bereavement on the hypothalamic-pituitary-adrenal axis.  Psychol Med. 2000;  30 ((1)) 219-223
  • 11 Buchanan TW, al’Absi M, Lovallo WR. Cortisol fluctuates with increases and decreases in negative affect.  Psychoneuroendocrinology. 1999;  24 ((2)) 227-241
  • 12 Dickerson SS, Mycek PJ, Zaldivar F. Negative social evaluation, but not mere social presence, elicits cortisol responses to a laboratory stressor task.  Health Psychol. 2008;  27 ((1)) 116-121
  • 13 Patil PG, Apfelbaum JL, Zacny JP. Effects of a cold-water stressor on psychomotor and cognitive functioning in humans.  Physiol Behav. 1995;  58 ((6)) 1281-1286
  • 14 Ishizuka K, Hillier A, Beversdorf DQ. Effect of the cold pressor test on memory and cognitive flexibility.  Neurocase. 2007;  13 ((3)) 154-157
  • 15 Grassi G, Seravalle G, Bolla G. et al . Heart rate as a sympathetic marker during acute adrenergic challenge.  J Hypertens. 2008;  26 ((1)) 70-75
  • 16 Waldstein SR, Bachen E A, Manuck SB. Active coping and cardiovascular reactivity: A multiplicity of influences.  Psychosom Med. 1997;  59 620-625
  • 17 Mathias CW, Stanford MS, Houston RJ. The physiological experience of the Paced Auditory Serial Addition Task (PASAT): Does the PASAT induce autonomic arousal?.  Arch Clin Neuropsychol. 2004;  19 543-554
  • 18 Holdwick DJ, Wingenfeld SA. The subjective experience of PASAT testing: Does the PASAT induce negative mood?.  Arch Clin Neuropsychol. 1999;  14 ((3)) 273-284
  • 19 Martin M. On the induction of mood.  Clin Psychol Rev. 1999;  10 669-697
  • 20 Gross JJ, Levenson RW. Emotion elicitation using films.  Cogn & Emot. 1995;  9 87-108
  • 21 Meagher MW, Randolph C, Arnau RC. et al . Pain and Emotions: Effects of Affective Picture Modulation.  Psychosom Med. 2001;  63 ((1)) 79-90
  • 22 Ehrly AM, Langdraf H, Hessler J. et al . Influence of videofilm- induced emotional stress on the flow properties of blood.  Angiology. 1988;  39 ((4)) 341-344
  • 23 Kudielka BM, Schommer NC, Hellhammer DH. et al . Acute HPA axis responses, heart rate, and mood changes to psychosocial stress (TSST) in humans at different times of day.  Psychoneuroendocrinology. 2004;  29 ((8)) 983-992
  • 24 Blackhart GC, Eckel LA, Tice DM. Salivary cortisol in response to acute social rejection and acceptance by peers.  Biol Psychol. 2007;  75 ((3)) 267-276
  • 25 Stroud LR, Tanofsky-Kraff M, Wilfley DE. et al . The Yale Interpersonal Stressor (YIPS): affective, physiological, and behavioral responses to a novel interpersonal rejection paradigm.  Ann Behav Med. 2000;  22 ((3)) 204-213
  • 26 Kirschbaum C, Pirke KM, Hellhammer DH. The „Trier Social Stress Test” – a tool for investigating psychobiological stress responses in a laboratory setting.  Neuropsychobiology. 1993;  28 76-81
  • 27 Lackschewitz H, Hüther G, Kröner-Herwig B. Physiological and psychological stress responses in adults with attention-deficit/hyperactivity disorder (ADHD).  Psychoneuroendocrinology. 2008;  , [Epub ahead of print]
  • 28 Kudielka BM, Schommer NC, Hellhammer DH. et al . Acute HPA axis responses, heart rate, and mood changes to psychosocial stress (TSST) in humans at different times of day.  Psychoneuroendocrinology. 2004;  29 ((8)) 983-992
  • 29 Dedovic K, Renwick R, Mahani NK. et al . The Montreal Imaging Stress Task: using functional imaging to investigate the effects of perceiving and processing psychosocial stress in the human brain.  J Psychiatry Neurosci. 2005;  30 ((5)) 319-325
  • 30 Tafalla RJ, Evans GW. Noise, physiology, and human performance: the potential role of effort.  J. Occup. Health Psychol. 1997;  2 148-155
  • 31 Buczynski A, Kedziora J. The effect of acoustic stimulus of different continuity pattern on plasma concentration of catecholamines in humans during submaximal exercise.  Acta Physiol. 1983;  34 596-500
  • 32 Yamamura K, Maehara N, Harabuchi I. et al . The effects of intermittent (trapezoidal) noise on man.  Tohoku J Exp Med. 1981;  135 ((2)) 179-186
  • 33 Patil PG, Apfelbaum JL, Zacny JP. Effects of a cold-water stressor on psychomotor and cognitive functioning in humans.  Physiol Behav. 1995;  58 ((6)) 1281-1286
  • 34 Casey DP, Braith RW, Pierce GL. Changes in central artery blood pressure and wave reflection during a cold pressor test in young adults.  Eur J Appl Physiol. 2008;  , [Epub ahead of print]
  • 35 Dickerson S, Kemeny M. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research.  Psychological Bulletin. 2004;  130 ((3)) 355-391
  • 36 Mason JW. A review of psychoendocrine research on the pituitary-adrenal cortical system.  Psychosomatic Medicine. 1968;  30 576-607
  • 37 Kirschbaum C, Prussner JC, Stone AA. et al . Persistent high cortisol responses to repeated psychological stress in a subpopulation of healthy men.  Psychosom Med. 1995;  57 ((5)) 468-474
  • 38 Grossman P, Beek J van, Wientjes C. A comparison of three quantification methods for estimation of respiratory sinus arrhythmia.  Psychophysiology. 1990;  27 ((6)) 702-714
  • 39 Houtveen JH, Molenaar PC. Comparison between the Fourier and Wavelet methods of spectral analysis applied to stationary and nonstationary heart period data.  Psychophysiology. 2001;  38 ((5)) 729-735
  • 40 Bertinieri G, Rienzo M Di, Cavallazzi A. et al . A new approach to analysis of the arterial baroreflex.  J Hypertens Suppl. 1985;  3 79-81
  • 41 Kubicek WG, Karnegis JN, Patterson RP. et al . Development and evaluation of an impedance cardiac output system.  Aerosp Med. 1966;  37 ((12)) 1208-1212
  • 42 Bär KJ, Boettger MK, Neubauer R. et al . Heart rate variability and sympathetic skin response in male patients undergoing acute alcohol withdrawal syndrome.  Alcohol Clin Exp Res. 2006;  30 ((9)) 1305-1312
  • 43 Kirschbaum C, Hellhammner DH. Salivary cortisol in psychoneuroendocrine research: recent developments and applications.  Psychoneuroendocrinology. 1994;  19 313-333
  • 44 Davis M. The Role of the Amygdala in Fear and Anxiety.  Annu Rev Neurosci. 1992;  15 353-375
  • 45 Herman JP, Cullinan WE. Neurocircuitry of stress: central control of the hypothalamo-pituitary-adrenocortical axis.  Trends Neurosci. 1997;  20 ((2)) 78-84
  • 46 Herman JP, Ostrander MM, Mueller NK. et al . Limbic system mechanisms of stress regulation: Hypothalamo-pituitary-adrenocortical axis.  Prog Neuropsychopharmacol Biol Psychiatry. 2005;  29 ((8)) 1201-1213
  • 47 Wang J, Rao H, Wetmore GS. et al . Perfusion functional MRI reveals cerebral blood flow pattern under psychological stress.  Proc Natl Acad Sci USA. 2005;  102 ((49)) 17804-17809
  • 48 Miki K, Kawamorita K, Araga Y. et al . Urinary and salivary stress hormone levels while perfoming arithmetic calculation in a noisy environment.  Industrial Health. 1998;  36 66-69
  • 49 Flor H, Grüsser SM. Conditioned stress-induced analgesia in humans.  Eur J Pain. 1999;  3 317-324
  • 50 Wittchen HU, Wunderlich U, Gruschwitz S. et al .SKID-1 und SKID-2. Strukturiertes klinisches Interview für DSM-IV. Achse 1: Psychische Störungen/Achse 2: Persönlichkeitsstörungen. Weinheim: Beltz 1997
  • 51 Loranger AW. International Personality Disorder Examination (IPDE): DSM-IV and ICD-10 modules. Odessa FL: Psychological Assessment Resources 1999
  • 52 Lejuez CW, Kahler CW, Brown RA. A modified computer version of the paced auditry serial addition task (PASAT) as a laboratory-based stressor: Implications for behavioural assessment.  Behavior Terapist. 2002;  26 290-292
  • 53 Blokland GA, McMahon KL, Hoffman J. et al . Quantifying the heritability of task-related brain activation and performance during the N-back working memory task: A twin fMRI study.  Biol Psychol. 2008;  , [Epub ahead of print]
  • 54 Hirano Y, Obata T, Kashikura K. et al . Effects of chewing in working memory processing.  Neurosci Lett. 2008;  436 ((2)) 189-192
  • 55 Audenaert K, Lahorte P, Brans B. et al . The classical stroop interference task as a prefrontal activation probe: a validation study using 99Tcm-ECD brain SPECT.  Nucl Med Commun. 2001;  22 ((2)) 135-143
  • 56 Harrison BJ, Shaw M, Yücel M. et al . Functional connectivity during Stroop task performance.  Neuroimage. 2005;  24 ((1)) 181-191
  • 57 Center for the Study of Emotion and Attention (CSEA) .The International Affective Picture System: Digitized photographs. The Center for Research in Psychophysiology University of Florida, Gainesville, Florida 2005
  • 58 Rhudy JL, Meagher MW. Noise stress and human pain thresholds: divergent effects in men and women.  J Pain. 2001;  2 ((1)) 57-64
  • 59 Gow AJ, Dearly IJ. Is the PASAT Past it? Testing attention and concentration without numbers.  J Clin Exp Neuropsychol. 2004 Sep;  26 ((6)) 723-736
  • 60 Schmahl C, Meinzer M, Zeuch A. et al . Pain sensitivity is reduced in borderline personality disorder, but not in posttraumatic stress disorder and bulimia nervosa.  W J Biol Psychiatrie (in Begutachtung).
  • 61 Ludäscher P, Bohus M, Lieb K. et al . Elevated pain thresholds correlate with dissociation and aversive arousal in patients with borderline personality disorder.  Psychiatry Res. 2007;  149 ((1–3)) 291-296
  • 62 Schulz P, Schlotz W, Becker P. Trierer Inventar zum chronischen Stress (TICS). Göttingen: Hogrefe 2004
  • 63 Birkhofer A, Schmidt G, Forstl H. Herz und Hirn – Die Auswirkungen psychischer Erkrankungen und ihrer Therapie auf die Herzfrequenzvariabilität.  Fortschr Neurol Psychiatr. 2005;  73 192-205
  • 64 Bär KJ, Greiner W. Pain perception is not influenced by altered autonomic function in major depression.  Psychiatr Prax. 2007;  3 309-313
  • 65 Bär KJ, Boettger MK, Koschke M. et al . Increased QT interval variability index in acute alcohol withdrawal.  Drug Alcohol Depend. 2007;  89 ((2–3)) 259-266
  • 66 Kirschbaum C, Kudielka BM, Gaab J. et al . Impact of gender, menstrual cycle phase and oral contraceptives on the activity of the hypothalamus-pituitary- adrenal axis.  Psychosom Med. 1999;  61 154-162
  • 67 Kirschbaum C, Hellhammer DH. Salivary cortisol in psychoneuroendocrine research: recent developments and applications.  Psychoneuroendocrinology. 1994;  19 ((4)) 313-333

1 beide Autoren haben zu gleichen Teilen bei der Erstellung des Manuskriptes mitgewirkt.

Korrespondenzadresse

PD Dr. med. Christian Schmahl

Klinik für Psychosomatik und Psychotherapeutische Medizin

Zentralinstitut für Seelische Gesundheit Mannheim J 5

68159 Mannheim

Email: christian.schmahl@zi-mannheim.de

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