Physiological Markers Reveal Confounding Effects of Apprehension and Habituation During Stress Protocol

Studies of stress often assume that baseline periods, stressors, and neutral conditions elicit their intended responses. This assumption may not always hold. In this study, we use a comprehensive set of cardiovascular and respiratory markers to demonstrate that factors including habituation and apprehension can lead to unintended physiological responses. Re-analyzing the data from a previous investigation of traumatic stress, we studied N = 26 participants with history of prior trauma. These participants took part in a three-hour protocol involving repeated exposure to traumatic stressors and neutral conditions. Electrocardiogram, photoplethysmogram, seismocardiogram, and respiratory effort signals were collected. Unlike previous studies, we investigated the physiological responses to each neutral condition and traumatic stressor separately, rather than aggregating over repetitions. We find that habituation reduces the physiological responses to repeated traumatic stressors. We also observe transient stress responses during the first neutral conditions of the protocol. We attribute this stress to apprehension. Notably, the stress exhibited during the first neutral condition was on par with that of the second traumatic stressor. To our knowledge, the data herein are the first to quantitatively show that apprehension during a neutral condition can produce stress responses on par with trauma recall. These results advocate against classifying periods of data as "stress" or "no stress" based solely on the protocol. Instead, studies of stress should incorporate physiological sensing to assess whether the protocol's intended effects are consistent with observed changes in physiological markers.