Benjamin Zenke

Benjamin Zenke

Master's Thesis

stress+ – Development and Evaluation of a Web Application for Remote, Internet-based Induction of Acute Psychosocial Stress

Robert Richer (M.Sc.), Markus Wirth (M.Sc.), Prof. Dr. Nicolas Rohleder, Prof. Dr. Björn Eskofier

09/2021 – 02/2022

Chronic stress and its consequences for individual health, but also for the economy, are becoming one of the most important social problems in industrialized countries. The economic impact of stress is enormous: An estimated $42 billion is already spent in the U.S. on absenteeism and treatment for stress-related diseases [1]. But there is not only an impact on the economy, but also on the individual body. Chronic stress not only limits well-being, but it also has measurable effects on health and performance. To understand chronic stress, and its potential negative health outcomes, it is crucial to observe the response of the human body to stress. One way is to observe repeated acute stress responses: When the body is exposed to acute stress, two major stress pathways are activated: the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. The result is an increase in heart rate and the secretion of alpha-amylase and cortisol [2]. The “wear and tear” of these stress pathways is assumed to be responsible for the transition from acute to chronic stress [3]. These biological stress responses are, however, usually measured by complex, often invasive laboratory procedures, which limit biopsychological research. Thus, there is a need for novel methods for inducing acute psychosocial stress that are easy to conduct (repeatedly), easy to reproduce and cost-efficient.

One possibility is to move away from laboratory procedures and transfer existing stress protocols into virtual or remote settings. Previous work has shown that this can be done by, for example, replicating the laboratory environment in virtual reality or simply using videoconferencing systems that allow participants and staff to be remote from each other [4,5]. It has been shown that these remote protocols can induce stress in a way that is comparable to laboratory testing. However, most of these methods are limited by the fact that they still require specialized hardware such as head-mounted VR displays and typically only address one specific stress protocol which cannot be adapted.

The goal of this master thesis is, therefore, to address these limitations and develop a web application for acute psychosocial stress induction that allows to create stress protocols in a flexible and modular way. This master thesis builds on the already existing framework of the web application “stress+” for acute stress induction. At first, research will be first conducted on possible methods to replicate the induction of psychosocial stress assessment “in presence” by equivalent digital stressors. Afterwards, these different stressors will be implemented as additional modules in the web application. Finally, we will evaluate the developed approach by comparing neuroendocrine and cardiovascular stress responses with stress responses induced by an established laboratory-based acute stress protocol.


Full Thesis


[1] Kalia, M. (2002). Assessing the economic impact of stress—The modern day hidden epidemic. Metabolism: Clinical and Experimental, 51 (6 SUPPL. 1), 49–53.
[2] Ulrich-Lai, Y. M., & Herman, J. P. (2009). Neural regulation of endocrine and autonomic stress responses.
Nature Reviews Neuroscience (6), 397–409.
[3] McEwen, B. S. (1998). Protective and Damaging Effects of Stress Mediators.
New England Journal of Medicine (3), 171–179.
[4] Zimmer, P., Buttlar, B., Halbeisen, G., Walther, E., & Domes, G. (2019). Virtually stressed? A refined virtual reality adaptation of the Trier Social Stress Test (TSST) induces robust endocrine responses. Psychoneuroendocrinology, 101 (August 2018), 186–192.
[5] Eagle, D. E., Rash, J. A., Tice, L., & Proeschold-Bell, R. J. (2021). Evaluation of a remote, internet-delivered version of the Trier Social Stress Test. International Journal of Psychophysiology, 165, 137–144.
[6] Helminen, E. C., Morton, M. L., Wang, Q., & Felver, J. C. (2019). A meta-analysis of cortisol reactivity to the Trier Social Stress Test in virtual environments. Psychoneuroendocrinology, 110 (February), 104437.