Randomized controlled evaluation of the effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects.

Psychosocial stress is a potent activator of the hypothalamus-pituitary-adrenal (HPA) axis. While neuroendocrine stress responses are essential for the maintenance of homeostasis, evidence suggests that excessive activation of the HPA axis constitutes a risk for disease and psychopathology. The purpose of the present study was to assess the effect of cognitive-behavioral stress management training on endocrine stress responses and cognitive appraisal under acute psychosocial stress among healthy young subjects. Forty-eight healthy, non-smoking male students without acute or chronic medical or psychiatric disorder on self report were randomly assigned to receive group-based cognitive-behavioral stress management training either before or after a standardized psychosocial stress test (Trier Social Stress Test, TSST). Endocrine and psychological stress responses were assessed with salivary free cortisol response and cognitive appraisal processes to the TSST. In comparison with the control group, subjects in the treatment group showed an attenuated endocrine response (F (2.55/117.41) = 3.81; P = 0.02; effect size f(2) = 0.35) to the TSST. In addition, subjects in the SIT group had lower stress appraisal and higher control expectancies (F (2/45) = 6.56; P = 0.003, effect size f(2) = 0.29) compared to controls. Short group-based cognitive-behavioral stress management training reduces the neuroendocrine stress response to an acute stressor in healthy subjects. Therefore, stress management training may prove useful in preventing detrimental effects of stress-induced neuroendocrine activation