The cortisol response to social stress in social anxiety disorder

• Evaluated CSR following TSST in SAD and control participants.
• Examined influence of study group, CT & interaction on CSR with linear regression.
• Significant result when predicting AUC with study group, EA, & their interaction.
• Highly significant study group by EA interaction predicting AUC.
• Need to measure dimensional characteristics in social stress studies.

This study evaluated the cortisol stress response (CSR) following the Trier Social Stress Test in Social Anxiety Disorder (SAD) and control participants, to determine whether individual differences in CSR associate more with SAD diagnosis or dimensional characteristics [i.e. childhood trauma (CT)]. Twenty-one participants (11 with SAD) had full data available for both CT-scores and cortisol area-under-the-curve (AUC). Linear regression produced significant results: predicting AUCG with study group, emotional abuse (EA) scores and their interaction (F = 3.14, df = 5,15; p = .039); of note, the study group by EA interaction was significant at p = .015, driven by a strong positive association between EA and cortisol AUCG in the control group, and a negative association between these variables in the SAD group (standardized-beta = 1.56, t = 2.75, p = .015). This suggests that EA in SAD patients is associated with altered CSR, highlighting need to measure dimensional characteristics.