Abstract
While a substantial body of research has demonstrated robust relationships between social status and health, the exact mechanisms involved remain unclear. Maladaptive hypothalamus-pituitary-adrenal (HPA) axis stress responses have been implicated in the pathogenesis of a variety of disorders, and subjective social status (SSS) has been found associated with HPA reactivity. Since no studies have addressed exposure to repeated stress, we set out here to test cognitive appraisal and SSS as predictors of cortisol reactivity to repeated psychosocial stress.\r Twenty-six participants (14 women; mean age=21.96 yrs.) were exposed to the Trier Social Stress Test (TSST) twice on consecutive days. Appraisal processes were assessed immediately prior to each TSST. Salivary cortisol was measured 1 minute prior, and 1, 10, 30, 60, and 120 minutes post TSST. SSS relative to US and community was assessed using MacArthur ladders. \r Both TSSTs induced marked HPA activation (p<.001), with lower responses to second exposure (p=.002). Community SSS was inversely related with HPA axis stress responses (TSST1: trend, r=-.35, p=.08; TSST2: r=-.59, p=.002). Further regression analyses revealed a significant interaction of threat appraisals and SSS predicting HPA responses to the second, but not the first, TSST (beta=-.478; p=.011). \r In summary, in low but not high SSS individuals, threat appraisals were positively related with cortisol reactivity upon repeated exposure. Future research should investigate possible long-term health consequences associated with these relationships.