title: The reaction to social stress in social phobia: discordance between physiological and subjective parameters.
abstract: BACKGROUND
  Research on the biopsychological background of social phobia (SP) is scarce and inconsistent. We investigated endocrine and autonomic markers along with subjective responses to a standardized stress situation (Trier Social Stress Test, TSST) in SP patients and healthy controls (HC).
  
  
  METHODS
  We examined 88 patients with the primary diagnosis of SP as well as 78 age and sex comparable HCs with the TSST. Blood and saliva samples were obtained before and after the TSST for the assessment of salivary cortisol, plasma cortisol, salivary alpha-amylase (sAA), and prolactin. Heart rate (HR) and heart rate variability (HRV) were recorded continuously. Scalp-near hair samples were collected for the assessment of long-term cortisol secretion. The self-reported stress response was measured with different state and trait scales.
  
  
  RESULTS
  While self-reported anxiety was elevated in SP before, during, immediately after, and one week after the TSST, no significant differences in biological stress responses were observed between SP and HC. There was a trend for SP to show higher baseline stress markers. Also long-term cortisol deposition in hair remained unaltered.
  
  
  CONCLUSIONS
  Our results suggest that the excessive self-reported stress in SP is not reflected by a respective biological stress response. Patients with SP apparently show neither an extreme form of focused fear reactivity nor excessive defensive impairment.
authors.affiliation: Institute of Biopsychology, Technische Universitaet Dresden, Dresden, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Klumbies
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Braeuer
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Dresden, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Hoyer
authors.affiliation: Institute of Biopsychology, Technische Universitaet Dresden, Dresden, Germany.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006197:Hair / Q000737:chemistry; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis* / Q000097:blood; D008297:Male; D010698:Phobic Disorders / Q000097:blood / Q000503:physiopathology* / Q000523:psychology; D011388:Prolactin / Q000032:analysis / Q000097:blood; D012463:Saliva / Q000737:chemistry; D055291:Salivary alpha-Amylases / Q000032:analysis; D057566:Self Report; D013315:Stress, Psychological / Q000097:blood / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
chemical_list: D011388:Prolactin; D055291:Salivary alpha-Amylases; D006854:Hydrocortisone