Laboratory stress research in psychiatric and neurological populations: toward a consensus guideline

Research involving acute laboratory stress induction is essential to understanding the role of stress in human health and disease. However, participant-centered guidelines for stress research involving individuals with psychiatric or neurological disorders are lacking. Using the Delphi method, we established consensus on best practices for research employing stress induction paradigms in these populations. Our panel included up to 179 respondents. In the final round, 173 respondents completed the survey, comprising 22 researchers, 70 stress study participants (acute, chronic, or daily-life), 115 individuals with lived experience, 21 healthcare professionals, and 4 ethicists. In three anonymous online survey rounds, participants rated their agreement with 52 statements on a 5-point Likert scale. Consensus, defined as ≥ 70 % (dis)agreement, was reached for 38 statements (73.1 %). Our findings highlight the importance of carefully balancing effective stress induction with acceptable intensity in studies using stress induction paradigms in clinical populations. We provide recommendations spanning all phases of the research process, including protocol design, recruitment, informed consent procedures, stress induction procedures, debriefing and follow-up. These guidelines serve as a practical framework to support the design of future laboratory stress studies, with the aim of supporting both participant well-being and scientific validity and comparability.