Acute Stress Potentiates Anxiety in Humans

Background: Stress is an important factor in the development and maintenance of anxiety disorders. Stress also potentiates anxiety-like response in animals, but empirical evidence for a similar effect in humans is still lacking. Methods: To test whether stress increases anxiety in humans, we examined the ability of a social stressor (speech and a counting task) to potentiate the facilitation of startle in the dark. Measures of subjective distress and of hypothalamic-pituitary-adrenal axis and autonomic nervous system activity (e.g., salivary cortisol, α-amylase, blood pressure, and heart rate) were also taken to confirm the effectiveness of the stress manipulation. Results: Startle was significantly facilitated in the dark. This effect was potentiated by prior exposure to the social stressor. The social stressor induced increases in salivary cortisol and α amylase as well as increases in blood pressure, heart rate, and subjective distress. Conclusion: The findings indicate that stress potentiates anxiety. Animal studies suggest that such an effect might be mediated by glucocorticoid effects on corticotropin-releasing hormone in limbic structures.