Validity of the Trier Social Stress Test in studying discrimination stress

To test the validity of a modified Trier Social Stress Test (TSST) for studying stress reactivity in sexual minority women. Two hundred seventy-four female participants (66.4% Black American), half of whom identified as lesbian/gay or bisexual and half as heterosexual, completed the TSST with instructions to describe an experience of discrimination. Cortisol levels and negative emotion scores increased, and heart rate variability decreased in response to the TSST, and the magnitude of these responses varied as a function of sexual orientation and race. Women who discussed sexual orientation as a source of discrimination had greater increases in cortisol and negative mood following the TSST. The modified instructions did not compromise the validity of the TSST. Prompting participants to discuss specific sources of discrimination may be a useful adaptation of the TSST in studying minority stress reactivity. The goal of the present study was to adapt a widely used measure of stress reactivity to study the impact of experiences with discrimination on biological systems involved in regulating the stress response. The modification included asking women to discuss a time when they had been treated unfairly and to describe how they responded to that experience. The magnitude of response to the task varied as a function of sexual orientation and race, and the topics discussed, demonstrating usefulness of the modification for studying the impact of discrimination stress of physical health.