Salivary alpha-amylase response following repeated psychosocial stress in patients with panic disorder

Research output: Contribution to journalResearch articleContributedpeer-review



BACKGROUND: This study examined autonomic responses (salivary alpha-amylase, sAA; heart rate, HR) to repeated psychosocial stress as a candidate mechanism linking autonomic hyper-arousal and sensitization to the occurrence of panic disorder (PD).

METHODS: Thirty-three patients with PD and 34 healthy controls were exposed to the Trier Social Stress Test (TSST) twice on consecutive days.

RESULTS: sAA changes were comparable between PD and controls on both testing days with overall decreasing sAA responses (delta) on day two. In contrast, HR delta increased on day two in both groups. This sensitization was driven by female controls while male PD showed most pronounced HR changes to the first TSST.

CONCLUSIONS: Overall, a general autonomic hyper-arousal in PD could not be confirmed. In contrast, sAA responses slightly habituated to repeated stress. Whether sAA findings mirror assumed habituation effects of repeated stress exposure on normalizing autonomic reactivity remains to be investigated in longitudinal studies.


Original languageEnglish
Pages (from-to)54-63
Number of pages10
JournalJournal of Anxiety Disorders
Publication statusPublished - Jan 2016

External IDs

researchoutputwizard legacy.publication#71344
researchoutputwizard legacy.publication#73364
PubMed 26625098
Scopus 84947996407



  • Adolescent, Adult, Analysis of Variance, Arousal/physiology, Autonomic Nervous System/physiology, Biomarkers/metabolism, Case-Control Studies, Female, Heart Rate/physiology, Humans, Hydrocortisone/metabolism, Male, Middle Aged, Panic Disorder/metabolism, Saliva/enzymology, Salivary alpha-Amylases/metabolism, Stress, Psychological/metabolism, Young Adult, TSST