ArticlePsychopharmacology2026
Development of the Yale pain stress test to elicit a multi-level stress response and assess stress adaptability.
Article in Psychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Assessing Autonomic Regulation Under Stress with the Yale Pain Stress Test in Social Drinking and Alcohol Use Disorder.Behavioral sciences (Basel, Switzerland) · 2025Article
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5 authors.
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Abstract
rationaleHigh levels of stress and acute stress responses are significant predictors of chronic illnesses; however, specific stress response components of resilience and healthy coping are not well understood.
objectivesTo develop and assess a pain stress test (Yale Pain Stress Test - YPST) involving three uncontrollable and unpredictable consecutive 3-minute trials of pain-stress (0 °C ice + water) or no pain-stress control (37 °C warm water) hand immersion conditions, adapted from the Cold Pressor Task (CPT).
methodsFifty men and women participated in a within-subjects experiment. Repeated autonomic [pulse, systolic and diastolic blood pressure (SBP/DBP)], hypothalamic pituitary adrenal (HPA) axis (cortisol, ACTH) and subjective stress (self-reported pain, anxiety) measures during the pre-stress baseline, acute reactivity and return to homeostasis/recovery time periods were collected. Behavioral pain tolerance per trial (in seconds) was also assessed.
resultsRobust multi-level stress responses were observed (p's < 0.009), with sex-specific interactions only for SBP, DBP and pain ratings. Greater reactivity in SBP, DBP, cortisol, and Cortisol/ACTH ratio predicted higher behavioral pain tolerance (p's < 0.038), and higher DBP predicted lower pain during recovery in the pain-stress condition (p < .028). Higher SBP, DBP, Cortisol, and ACTH reactivity in pain-stress but not control predicted lower basal anxiety during recovery (p's < 0.004).
conclusionThese findings indicate robust multi-level stress responses with YPST provocation, that were also significantly related to behavioral pain tolerance and subjective distress and recovery. The results suggest that acute physiological stress responses play a role in stress adaptability and resilient coping, but replication in larger samples and in individuals suffering from stress-related illnesses is warranted.
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