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TAP reading note: Multi-systemic evaluation of biological and emotional responses to the Trier Social Stress Test: A meta-analysis and systematic review

Cortisol and negative mood were the most sensitive markers in the selected multi-system TSST literature. Sensitivity of other systems was less consistent or based on fewer studies. The result depends on the measure and time contrast.

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What the study found

Cortisol and negative mood were the most sensitive markers in the selected multi-system TSST literature. Sensitivity of other systems was less consistent or based on fewer studies. The result depends on the measure and time contrast.

Scope & limitations

61 studies in the review; 58 in meta-analyses, with 2,459 healthy participants aged 18–65.

Limited studies for several markers, selected healthy samples and differing time contrasts. Sensitive response markers are not universal personal recovery thresholds.

Population & sample

61 studies in the review; 58 in meta-analyses, with 2,459 healthy participants aged 18–65.

Exposure or intervention

TSST exposure with biological and emotional measurements.

Outcomes

Endocrine, physiological, inflammatory and emotional changes; separate time contrasts.

Time frame

Included publications spanned 2005–2020; review in the 2023 journal issue.

Research funding

Hong Kong Research Grants Council Collaborative Research Fund C7079-19GF (T. Lee); Greater Bay Area Centre for Brain Science and Brain-Inspired Intelligence Open Fund 2019007 (R. Shao).

Research conflicts of interest

The authors declare no competing interests.

Reading scope

University-repository full text: eligibility, study counts, outcome definitions, results and declarations. Supplementary analyses were not independently reproduced.

References

  1. Man ISC, Shao R, Hou WK, Xin Li S, Liu FY, Lee M, Wing YK, Yau SY, Lee TMC (2023). Multi-systemic evaluation of biological and emotional responses to the Trier Social Stress Test: A meta-analysis and systematic review. Frontiers in neuroendocrinology. https://doi.org/10.1016/j.yfrne.2022.101050

Publication record

TAP-RDN-0090 · v1.0 · English

Author: TAP Editorial Team ·

The Allostasis Project is founded and supported by Resilio.

Record for v1.0 · Updated

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Under the editorial responsibility of the TAP Editorial Team, this publication used AI assistance for content organization and editing.

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Captured: 2026-11-13T08:41:22.432Z

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Project informationPrivacy PolicyProject informationContactAssessmentTAP Load & Recovery ProfileMethodsLoad & Recovery Profile: Methods & DevelopmentExploreQuestions about Human AdaptationExploreMeasurement & InterpretationReading guide · Essential 35Load & Recovery: Six Research DirectionsReading guide · Essential 5Allostatic LoadReading guide · Essential 5Recovery ScienceReading guide · Essential 5Reserve & ResilienceReading guide · Essential 5MeasurementFoundationsLoadFoundationsWhat Is Allostasis? Predictive Regulation and HomeostasisFoundationsRecoveryFoundationsWhat Is Allostatic Load? Meaning and MeasurementFoundationsPhysiological ReserveFoundationsResilienceFeaturesHow Is Allostatic Load Measured? Biomarkers, Scores and LimitsFeaturesRecovery Is Not RestFeaturesWhat Is Resilience Nutrition?FeaturesModels of Adaptation: What Different Frameworks ExplainFeaturesTAP Human Adaptation FrameworkFeaturesAre Recovery and Resilience the Same Thing?FeaturesCan Physiological Reserve Be Improved? Ageing, Exercise and RecoveryFeaturesCan Underfueling Affect Recovery?FeaturesCan Weekend Catch-Up Sleep Make Up for a Week of Short Sleep?FeaturesCyclic Sighing, Slow Breathing or Box Breathing: What Does the Evidence Show?FeaturesDoes Recovery Always Mean Returning to the Same Baseline?FeaturesHow Does Nutrition Influence Recovery? What Human Studies Can Tell UsFeaturesHow Is Recovery from Stress Measured?FeaturesPerseverative Cognition: Why Can Stress Outlast an Event?FeaturesPhysiological Reserve: Meaning, Examples and ResilienceFeaturesProtein Intake vs Timing: Daily Amount, Meals and ExerciseFeaturesWhat Can HRV Tell Us About Recovery?FeaturesWhat Does Your Wearable’s Recovery Score Actually Tell You?FeaturesWhat Is Sleep Rebound? Sleep Debt, REM Rebound and RecoveryFeaturesWhat Is a Normal HRV? Personal Baselines, RMSSD and SDNNFeaturesWhy Can Stress Responses Continue After Work Ends?FeaturesWhy Does HRV Drop? How to Read a Low Value in ContextFeaturesWhy Feeling Better Doesn’t Always Mean Fully RecoveredMethods & projectEvidence grading & methodsMethods & projectEditorial & scientific standardsMethods & projectAbout the projectResearch · 1988Muscle glycogen synthesis after exercise: effect of time of carbohydrate ingestion.Research · 1993The 'Trier Social Stress Test'--a tool for investigating psychobiological stress responses in a laboratory settingResearch · 1993Stress and the individual. Mechanisms leading to diseaseResearch · 1998Protective and damaging effects of stress mediatorsResearch · 2001Frailty in older adults: evidence for a phenotypeResearch · 2003Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent changeResearch · 2003The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivationResearch · 2004Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory researchResearch · 2006The perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and healthResearch · 2006Psychosocial, hemostatic, and inflammatory correlates of delayed poststress blood pressure recoveryResearch · 2007The Recovery Experience Questionnaire: development and validation of a measure for assessing recuperation and unwinding from workResearch · 2009The Reactive Scope Model — A new model integrating homeostasis, allostasis, and stressResearch · 2009Go no-go performance under psychosocial stress: beneficial effects of implementation intentionsResearch · 2010Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recoveryResearch · 2010Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: a meta-analysis of prospective evidenceResearch · 2010Allostatic load biomarkers of chronic stress and impact on health and cognitionResearch · 2011Stress- and Allostasis-Induced Brain PlasticityResearch · 2012Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant dataResearch · 2012Enhanced emotional reactivity after selective REM sleep deprivation in humans: an fMRI studyResearch · 2012Allostasis: a model of predictive regulationResearch · 2012A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and healthResearch · 2012Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trialResearch · 2013Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesisResearch · 2013The LF/HF ratio does not accurately measure cardiac sympatho-vagal balanceResearch · 2013Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performanceResearch · 2013Sleep drives metabolite clearance from the adult brainResearch · 2014Monitoring training status with HR measures: do all roads lead to Rome?Research · 2014Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trialResearch · 2014Clarifying the roles of homeostasis and allostasis in physiological regulationResearch · 2014Resilience definitions, theory, and challenges: interdisciplinary perspectivesResearch · 2015Recovery from job stress: The stressor-detachment model as an integrative frameworkResearch · 2016Physiological concomitants of perseverative cognition: A systematic review and meta-analysisResearch · 2016The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisolResearch · 2016Successfully leaving work at work: The self-regulatory underpinnings of psychological detachmentResearch · 2016Blood Pressure and Fibrinogen Responses to Mental Stress as Predictors of Incident Hypertension over an 8-Year PeriodResearch · 2016Physical Resilience in Older Adults: Systematic Review and Development of an Emerging ConstructResearch · 2017Diurnal cortisol slopes and mental and physical health outcomes: A systematic review and meta-analysisResearch · 2017The Trier Social Stress Test: Principles and practiceResearch · 2017Evidence for a Large-Scale Brain System Supporting Allostasis and Interoception in HumansResearch · 2017Heart Rate Variability and Cardiac Vagal Tone in Psychophysiological Research - Recommendations for Experiment Planning, Data Analysis, and Data ReportingResearch · 2017Diurnal Variation and Twenty-Four Hour Sleep Deprivation Do Not Alter Supine Heart Rate Variability in Healthy Male Young Adults.Research · 2017The impact of reduced worktime on sleep and perceived stress - a group randomized intervention study using diary dataResearch · 2017A Meta-Analysis on Antecedents and Outcomes of Detachment from WorkResearch · 2017Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challengeResearch · 2018Recovery and Performance in Sport: Consensus StatementResearch · 2018A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adultsResearch · 2018Association between changes in heart rate variability during the anticipation of a stressful situation and the stress-induced cortisol responseResearch · 2018Quantifying resilience of humans and other animalsResearch · 2019Ad libitum Weekend Recovery Sleep Fails to Prevent Metabolic Dysregulation during a Repeating Pattern of Insufficient Sleep and Weekend Recovery SleepResearch · 2019Resilience in Clinical Care: Getting a Grip on the Recovery Potential of Older AdultsResearch · 2019An introductory guide to conducting the Trier Social Stress TestResearch · 2019The persistent effect of acute psychosocial stress on heart rate variabilityResearch · 2019Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trialResearch · 2020Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical TrialResearch · 2020Kinetics and Interrelations of the Renin Aldosterone Response to Acute Psychosocial Stress: A Neglected Stress SystemResearch · 2020The effects of acute work stress and appraisal on psychobiological stress responses in a group office environmentResearch · 2020A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable researchResearch · 2020Whitepaper: Defining and investigating cognitive reserve, brain reserve, and brain maintenanceResearch · 2021Health effects of psychological interventions for worry and rumination: A meta-analysisResearch · 2021Longitudinal analysis of blood markers reveals progressive loss of resilience and predicts human lifespan limitResearch · 2021Leaving Work at Work: A Meta-Analysis on Employee Recovery From WorkResearch · 2022"Give me a break!" A systematic review and meta-analysis on the efficacy of micro-breaks for increasing well-being and performanceResearch · 2022Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysisResearch · 2022Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood ResearchResearch · 2022Allostatic Load and Mortality: A Systematic Review and Meta-AnalysisResearch · 2022Recovery from Work: Advancing the Field Toward the FutureResearch · 2023Brief structured respiration practices enhance mood and reduce physiological arousalResearch · 2023Conceptualizing a resilience research framework at The National Institutes of HealthResearch · 2023Multi-systemic evaluation of biological and emotional responses to the Trier Social Stress Test: A meta-analysis and systematic reviewResearch · 2023Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysisResearch · 2023Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical TrialResearch · 20232023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)Research · 2023Low energy availability reduces myofibrillar and sarcoplasmic muscle protein synthesis in trained femalesResearch · 2023The anabolic response to protein ingestion during recovery from exercise has no upper limit in magnitude and duration in vivo in humansResearch · 2024Seven robust and easy to obtain biomarkers to measure acute stressResearch · 2024Low energy availability increases immune cell formation of reactive oxygen species and impairs exercise performance in female endurance athletesResearch · 2024Impact of baseline and longitudinal allostatic load changes on incident cardiovascular disease and all-cause mortality: A 7-year population-based cohort study in ChinaResearch · 2024Brain clearance is reduced during sleep and anesthesiaResearch · 2024Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort studyResearch · 2025Impact of Vegan Diets on Resistance Exercise-Mediated Myofibrillar Protein Synthesis in Healthy Young Males and Females: A Randomized Controlled TrialResearch · 2025Allostatic (over)Load Measurement: Workflow and repositoryResearch · 2025Systematic Review on HRV Reference ValuesResearch · 2025Does Protein Ingestion Timing Affect Exercise-Induced Adaptations? A Systematic Review with Meta-AnalysisResearch · 2025Validation of nocturnal resting heart rate and heart rate variability in consumer wearablesResearch · 2025Readiness, recovery, and strain: an evaluation of composite health scores in consumer wearablesResearch · 2025Physiological and psychological responses to acute stress: A meta-analysis of the 171 studies of Trier Social Stress Test including 8452 healthy adultsResearch · 2025Resilience phenotypes derived from an active inference account of allostasisResearch · 2025A meta-analysis of the influence of work connectivity behavior after-hours on employees: The mediating role of work autonomy and psychological detachmentResearch · 2025Comparing the Effects of Square, 4–7-8, and 6 Breaths-per-Minute Breathing Conditions on Heart Rate Variability, CO2 Levels, and MoodResearch · 2025The Effect of Protein Supplementation and Playing Time on Recovery Kinetics During a Congested Basketball Schedule.Research · 2025Inter- and Intrapersonal Associations Between Physiology and Mental Health: A Longitudinal Study Using Wearables and Mental Health SurveysResearch · 2025Cardiac vagal recovery following acute psychological stress in human adults: A scoping reviewResearch · 2026Allostatic (over) load measurement: Workflow and repositoryResearch · 2026Real-world effects of alcohol on heart rate, sleep, and physical activity by age and sex.Research · 2026A reporting checklist for human and animal heart rate variability researchResearch · 2026Acute effects of binge drinking following aerobic exercise on autonomic and hemodynamic recovery in young men: a randomized crossover trial.Research · 2026Acute sleep rebound following sleep restriction is associated with reduced mortality riskResearch · 2026Predicting acute stress recovery: A resilience index of physiological responses to Trier Social Stress TestResearch · 2026Perseverative cognition and vagally mediated heart rate variability in laboratory studies: A series of meta-analysesResearch · 2026How the Acute Psychosocial Stress Response Ends: A Post-Stressor Transition Model of Glucocorticoid Feedback, Vagal Re-Engagement, and Frontolimbic Context UpdatingResearch · 2026Building an ontology of resilience: Insights from the physical resilience literatureResearch · 2026Measuring the biological embedding of chronic stress: Allostatic load algorithms and cancer risk in a prospective cohort.Research · 2026Simply breathing anxiety away? A pilot, just-in-time ecological momentary intervention study of one-minute cyclic sighing versus box breathing as tools for acute anxiety reduction and attention promotion in real lifeResearch · 2026Pilot study of the impact of weekend sleep restriction and recovery sleep on metabolic and cardiovascular risk indicators: Results from a randomized crossover clinical trialResearch · 2026Protein supplementation and resistance training-induced strength gains in young adults: a meta-analysisTAP Record · TAP-CON-0001LoadTAP Record · TAP-CON-0002What Is Allostasis? Predictive Regulation and HomeostasisTAP Record · TAP-CON-0003RecoveryTAP Record · TAP-CON-0004What Is Allostatic Load? Meaning and MeasurementTAP Record · TAP-CON-0005Physiological ReserveTAP Record · TAP-CON-0006ResilienceTAP Record · TAP-FTR-0001How Is Allostatic Load Measured? 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What Human Studies Can Tell UsTAP Record · TAP-REV-0001How Is Recovery from Stress Measured?TAP Record · TAP-FTR-0016Perseverative Cognition: Why Can Stress Outlast an Event?TAP Record · TAP-FTR-0004Physiological Reserve: Meaning, Examples and ResilienceTAP Record · TAP-FTR-0020Protein Intake vs Timing: Daily Amount, Meals and ExerciseTAP Record · TAP-FTR-0005What Can HRV Tell Us About Recovery?TAP Record · TAP-FTR-0011What Does Your Wearable’s Recovery Score Actually Tell You?TAP Record · TAP-FTR-0019What Is Sleep Rebound? Sleep Debt, REM Rebound and RecoveryTAP Record · TAP-FTR-0021What Is a Normal HRV? Personal Baselines, RMSSD and SDNNTAP Record · TAP-FTR-0010Why Can Stress Responses Continue After Work Ends?TAP Record · TAP-FTR-0014Why Does HRV Drop? 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A systematic review and meta-analysis on the efficacy of micro-breaks for increasing well-being and performanceTAP Record · TAP-RDN-0077TAP reading note: Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysisTAP Record · TAP-RDN-0011TAP reading note: Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood ResearchTAP Record · TAP-RDN-0015TAP reading note: Allostatic Load and Mortality: A Systematic Review and Meta-AnalysisTAP Record · TAP-RDN-0021TAP reading note: Recovery from Work: Advancing the Field Toward the FutureTAP Record · TAP-RDN-0057TAP reading note: Brief structured respiration practices enhance mood and reduce physiological arousalTAP Record · TAP-RDN-0033TAP reading note: Conceptualizing a resilience research framework at The National Institutes of HealthTAP Record · TAP-RDN-0090TAP reading note: Multi-systemic evaluation of biological and emotional responses to the Trier Social Stress Test: A meta-analysis and systematic reviewTAP Record · TAP-RDN-0014TAP reading note: Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysisTAP Record · TAP-RDN-0065TAP reading note: Effect of Multimodal Prehabilitation on Reducing Postoperative Complications and Enhancing Functional Capacity Following Colorectal Cancer Surgery: The PREHAB Randomized Clinical TrialTAP Record · TAP-RDN-0047TAP reading note: 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)TAP Record · TAP-RDN-0045TAP reading note: Low energy availability reduces myofibrillar and sarcoplasmic muscle protein synthesis in trained femalesTAP Record · TAP-RDN-0083TAP reading note: The anabolic response to protein ingestion during recovery from exercise has no upper limit in magnitude and duration in vivo in humansTAP Record · TAP-RDN-0098TAP reading note: Seven robust and easy to obtain biomarkers to measure acute stressTAP Record · TAP-RDN-0046TAP reading note: Low energy availability increases immune cell formation of reactive oxygen species and impairs exercise performance in female endurance athletesTAP Record · TAP-RDN-0031TAP reading note: Impact of baseline and longitudinal allostatic load changes on incident cardiovascular disease and all-cause mortality: A 7-year population-based cohort study in ChinaTAP Record · TAP-RDN-0063TAP reading note: Brain clearance is reduced during sleep and anesthesiaTAP Record · TAP-RDN-0061TAP reading note: Sleep regularity is a stronger predictor of mortality risk than sleep duration: A prospective cohort studyTAP Record · TAP-RDN-0084TAP reading note: Impact of Vegan Diets on Resistance Exercise-Mediated Myofibrillar Protein Synthesis in Healthy Young Males and Females: A Randomized Controlled TrialTAP Record · TAP-RDN-0035TAP reading note: Allostatic (over)Load Measurement: Workflow and repositoryTAP Record · TAP-RDN-0086TAP reading note: Systematic Review on HRV Reference ValuesTAP Record · TAP-RDN-0082TAP reading note: Does Protein Ingestion Timing Affect Exercise-Induced Adaptations? A Systematic Review with Meta-AnalysisTAP Record · TAP-RDN-0055TAP reading note: Validation of nocturnal resting heart rate and heart rate variability in consumer wearablesTAP Record · TAP-RDN-0041TAP reading note: Readiness, recovery, and strain: an evaluation of composite health scores in consumer wearablesTAP Record · TAP-RDN-0091TAP reading note: Physiological and psychological responses to acute stress: A meta-analysis of the 171 studies of Trier Social Stress Test including 8452 healthy adultsTAP Record · TAP-RDN-0034TAP reading note: Resilience phenotypes derived from an active inference account of allostasisTAP Record · TAP-RDN-0058TAP reading note: A meta-analysis of the influence of work connectivity behavior after-hours on employees: The mediating role of work autonomy and psychological detachmentTAP Record · TAP-RDN-0080TAP reading note: Comparing the Effects of Square, 4–7-8, and 6 Breaths-per-Minute Breathing Conditions on Heart Rate Variability, CO2 Levels, and MoodTAP Record · TAP-RDN-0073TAP reading note: The Effect of Protein Supplementation and Playing Time on Recovery Kinetics During a Congested Basketball Schedule.TAP Record · TAP-RDN-0056TAP reading note: Inter- and Intrapersonal Associations Between Physiology and Mental Health: A Longitudinal Study Using Wearables and Mental Health SurveysTAP Record · TAP-RDN-0092TAP reading note: Cardiac vagal recovery following acute psychological stress in human adults: A scoping reviewTAP Record · TAP-RDN-0048TAP reading note: Allostatic (over) load measurement: Workflow and repositoryTAP Record · TAP-RDN-0069TAP reading note: Real-world effects of alcohol on heart rate, sleep, and physical activity by age and sex.TAP Record · TAP-RDN-0054TAP reading note: A reporting checklist for human and animal heart rate variability researchTAP Record · TAP-RDN-0070TAP reading note: Acute effects of binge drinking following aerobic exercise on autonomic and hemodynamic recovery in young men: a randomized crossover trial.TAP Record · TAP-RDN-0043TAP reading note: Acute sleep rebound following sleep restriction is associated with reduced mortality riskTAP Record · TAP-RDN-0097TAP reading note: Predicting acute stress recovery: A resilience index of physiological responses to Trier Social Stress TestTAP Record · TAP-RDN-0075TAP reading note: Perseverative cognition and vagally mediated heart rate variability in laboratory studies: A series of meta-analysesTAP Record · TAP-RDN-0102TAP reading note: How the Acute Psychosocial Stress Response Ends: A Post-Stressor Transition Model of Glucocorticoid Feedback, Vagal Re-Engagement, and Frontolimbic Context UpdatingTAP Record · TAP-RDN-0030TAP reading note: Building an ontology of resilience: Insights from the physical resilience literatureTAP Record · TAP-RDN-0068TAP reading note: Measuring the biological embedding of chronic stress: Allostatic load algorithms and cancer risk in a prospective cohort.TAP Record · TAP-RDN-0078TAP reading note: Simply breathing anxiety away? A pilot, just-in-time ecological momentary intervention study of one-minute cyclic sighing versus box breathing as tools for acute anxiety reduction and attention promotion in real lifeTAP Record · TAP-RDN-0042TAP reading note: Pilot study of the impact of weekend sleep restriction and recovery sleep on metabolic and cardiovascular risk indicators: Results from a randomized crossover clinical trialTAP Record · TAP-RDN-0085TAP reading note: Protein supplementation and resistance training-induced strength gains in young adults: a meta-analysisTAP Record · TAP-MTH-0002Same Biomarkers, Different ScoresTAP Record · TAP-ASM-0001TAP Load & Recovery ProfileTAP Record · TAP-MTH-0001Load & Recovery Profile: Methods & DevelopmentTAP Record · TAP-FIG-0001Human Adaptation MapTAP Record · TAP-FIG-0002Recovery trajectoriesTAP Record · TAP-STD-0001Citation & Reuse