An ecological approach for investigations of the anticipatory cortisol stress response.

Real-world anticipatory stressors account for rising rates of chronic psychophysiological stress and adverse health outcomes, yet the literature lacks an effective approach to study the anticipatory cortisol stress response. An extended pre-stressor period to capture peak anticipatory cortisol is not conducive to laboratory stress manipulations but is inherent to naturalistic stressors. Naturalistic approaches have been frequently utilized, but few studies included valid baseline and temporally proximate pre-post cortisol measures to operationalize the anticipatory cortisol stress response, and none have differentiated anticipatory from reactive response types. To address these gaps, this study sought to establish an effective and easy-to-implement protocol to investigate the anticipatory cortisol stress response. Saliva was sampled from 78 healthy college students (69 % female) before and after a 50-minute class period on a day of a lecture (baseline) and day of a scheduled written exam (stressor). The overall sample displayed an anticipatory stress response, operationalized as peak pre-exam cortisol and post-exam levels that returned to baseline, while individual response patterns were also detected and subsequently differentiated into anticipatory (37 %), reactive (9 %), anticipatory-reactive (13 %), and non- (41 %) response groups. These responses are consistent with those previously differentiated in a controlled laboratory setting with an exhaustive sampling schedule; yet this study captured a larger number of pre-stressor (anticipatory) cortisol peaks. Subjective measures of psychological stress were also examined. Findings demonstrate the effectiveness of a college written exam and validity of a baseline-pre-post sampling design for operationalizing the anticipatory cortisol stress response and differentiating within-sample response variability.