Predicting acute stress recovery: A resilience index of physiological responses to Trier Social Stress Test

Previous theoretical and empirical research has highlighted the predictive utility of different physiological reactivity and recovery patterns during acute stress for long-term mental health outcomes. Timely identification of mental health risk can be achieved by integrating these multiple temporal responses to characterize adaptive, dynamic resilience factors and then generating a resilience index. This study aimed to generate a resilience index to characterize the adaptive and dynamic resilient physiological responses and identify the predictors of these responses from a wide array of candidate predictors of psychological resilience in previous studies. Trier Social Stress Test (TSST) was used to induce acute stress responses in a sample of 248 participants (56.0 % female). Principal component analyses (PCA) were employed to integrate cortisol and cardiovascular responses to the TSST. The resilience index, comprising of the PCA reactivity and recovery scores, was related to better mental health. Using the least absolute shrinkage and selection operator regression, 25 of the 48 predictors were identified as critical ones, including baseline physiological activity, coping and emotion regulation strategies (e.g., positive reappraisal and instrumental support seeking), positive affective style and emotional reactivity, cognitive functions (e.g., interference inhibition), and demographic factors (e.g., minor medical conditions) (absolute magnitude of coefficients=0.402-3.865). These findings highlighted the importance of considering stress reactivity and recovery and physiological stress responses to understand the resilience factors, offering significant insight into developing wearable cognitive behavioral adjustment protocols to promote recovery from stress and hence mental well-being.