Name: enactive phenomenological approach to the trier social stress test: a mixed methods point of view
Uploaded: 2019-01-07T14:00:00
Description: Watch this Scientific Journal Video about Enactive Phenomenological Approach to the Trier Social Stress Test: A Mixed Methods Point of View at JoVE.com

The authors thank Perrine Labeaume and Fanny Vieu for their help.

The Institutional Review Board of the University approved this research.
NOTE: An example of mixed methods using the enactive phenomenological protocol.
1. Exclusion Criteria
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	<li>Use a questionnaire before the experiment in order to exclude some participants, as necessary, on the following criteria: smoking (over five cigarettes per day), drinking (over two glasses of alcohol per day), taking medication, using drugs, having an endocrine problem, exp...

In this article, we present an original mixed methods approach combining an experimental protocol with the enactive phenomenological approach. This kind of mixed methods is helpful to access experience, to understand participants&#39; points of view, and to analyze in depth the dynamics of cognitive processes like intentions, perceptions, enacted knowledge, and emotions.
Mixed methods can be used in different ways. Green et al.6 present five functions: triangul...

Mixed methods give various advantages when trying to understand a phenomenon1,2,3,4,5. Greene et al.6 define them as protocols that include a quantitative method to analyze numbers and a qualitative method to analyze words. This approach aims to move beyond paradigm wars or conflicts between qualitative and quantitative research. The goal is to increase the strengths of studies and diminish the weaknesses of single studies3; thus, it functions as a third research paradigm. Combining different kinds of analyses on the same object makes it possible to have different points of view. This paper presents a particular form of mixed methods, combining an experimental protocol with experiential data using the single TSST7and the TSST-G8. The TSST is the most used protocol to experimentally perform psychosocial stress investigations9,10. These tests are based on uncontrollability and social-evaluative threat, linked with physiological and psychological consequences. Different empirical, theoretical, or meta-analysis studies11 have shown that the TSST and the TSST-G elicit psychological effects and activate the HPA axis, leading, for example, to negative emotional states, self-reported anxiety, and cortisol rise. Many experimental studies investigated these markers of stress, their relations, and their influences12. However, only one qualitative approach has been conducted13 to understand the participants&#39; lived experiences during these tests.
The present protocol develops the original mixed methods approach mainly used in an earlier publication13. The originality of this mixed methods research lies in the qualitative approach based on an enactive phenomenological framework13,14,15,16 to examine accurately participants&#39; experiences when confronted with the TSST and the TSST-G. Qualitative investigations can be heuristic because they make it possible to characterize and analyze what is happening psychologically for participants in a particular situation17. Last, the enactive phenomenological approach allows researchers to understand the participants&#39; points of view and, thus, to analyze stress and emotion18,19,20. Following this approach, participants can describe, comment on, and show their lived experience step-by-step. This enactive phenomenological framework has two main assumptions16,21. First, action and situation are coupled22,23 (i.e., the dynamics of the action emerge within a specific context). This assumption provides access to the dynamics of the participant&#39;s experience confronted with the TSST and the TSST-G and to identify particular components of the context for the actor. Secondly, every action carries significations for the actor23,24. This approach provides access to the actor&#39;s signification construction of the experience during the action, thanks to a rigorous method originating from phenomenological interviews and named enactive interviews16,25. The actor&#39;s experience can be characterized in its emotional, perceptional, and situational dimensions26. Different kinds of mixed methods are based on this enactive phenomenological approach, which has already produced heuristic results in different areas, namely sport14,15,18,27, doping28, work29, and education30,31,32.
The mixed methods presented here aim to give confirmation and comprehension to findings in the TSST literature: confirmation through a comparison of the effect of the TSST and the TSST-G on physiological indicators (like cortisol), on self-reported indicators (like anxiety and emotional states), and on experiential indicators (like participants&#39; voices) and comprehension through the qualitative method accessing participants&#39; dynamics of action as they emerge in these stressful protocols. This is an original way to access in-depth the dynamics of psychosocial stress and to understand the participants&#39; voices about the stressful moment of the TSST and the TSST-G. This protocol is, thus, an example of mixed methodology, showing the added value of using the enactive phenomenological approach to analyze the experimental protocol more deeply.

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			<td height="21" style="height:21px;width:281px;">Enzyme-linked immunosorbent assay (ELISA)</td>
			<td style="width:167px;">Salimetrics, UK</td>
			<td style="width:128px;">Kit-- N&#176; No. 1-3002</td>
			<td style="width:427px;">Expanded Range High Sensitivity Salivary Cortisol Enzyme Immunoassay</td>
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			<td height="22" style="height:22px;width:281px;">Spectrophotometer</td>
			<td>Thermo Fisher, Germany</td>
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			<td>Multiska FC Microplate Photometer</td>
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enactive phenomenological approach to the trier social stress test: a mixed methods point of view

The single Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) are the most used protocols to experimentally induce psychosocial stress. These tests are based on uncontrollability and social-evaluative threat, inducing psychological and physiological consequences (e.g., anxiety, emotional states, salivary cortisol increases). Many quantitative experimental studies have investigated these stress inducers and these consequences. But, as far as we know, this study is the first to provide a qualitative analysis to access the participants' voices so as to understand the dynamics of their experience throughout the TSST and the TSST-G. This paper outlines a mixed methods approach to the TSST. This approach can help to maximize the information that can be gained from the TSST, which researchers often use without looking more closely at what is qualitatively happening psychologically for participants during the stressor itself. In this way, this protocol is an example of mixed methods, showing the added value of using the enactive phenomenological approach to analyze experimental protocols more deeply. This kind of mixed methods is helpful to access the experience, to understand the actor's point of view, and to analyze in-depth the dynamics of cognitive processes like intentions, perceptions, enacted knowledge, and emotion. The discussion section shows the different uses of a mixed methods protocol, exploiting the enactive phenomenological approach to analyze a protocol or to give a cross vision of the same research subject. This section deals with different existing applications, pointing out some critical steps in this mixed methods approach.

The results shown here come from a review of literature (for the cortisol)8 and two studies on stress done in our lab (for the state anxiety, the affective reaction, and the qualitative approach)13,41. The results presented here are representative of what can be found, using the protocol, about (1) salivary cortisol levels, (2) state anxiety, (3) pleasure, arousal, and dominance, and (4) meaningful experien...

Watch this Scientific Journal Video about Enactive Phenomenological Approach to the Trier Social Stress Test: A Mixed Methods Point of View at JoVE.com

Enactive Phenomenological Approach to the Trier Social Stress Test: A Mixed Methods Point of View

Here, we present an original mixed method combining a quantitative and a qualitative approach to examine accurately participants&#39; experiences during the Trier Social Stress Test and the Trier Social Stress Test for groups.

The single Trier Social Stress Test (TSST) and the TSST for groups (TSST-G) are the most used protocols to experimentally induce psychosocial stress. ...

This protocol combines qualitive and quantitative approach to examine accurately participants'experience during the Trier Social Stress Test, and the TSST for Groups. This makes me thoughts shows the added value of using the enactive phenomenological approach to analyze experimental protocols more deeply. To begin, instruct the participant to tilt their head forward, allow saliva to pool in their mouth, and release the saliva into a small tube.Then, freeze the tube immediately, at negative 20 degrees Celsius. After this, measure the participant's anxiety with the State-Trait Anxiety Inventory questionnaire. Then, measure the participant's emotional state with the Self-Assessment Manikin questionnaire.After bringing the participant to the TSST room, and explaining their actions will be filmed, ask the participant to imagine a job of their choice. After three minutes of preparation time, give the participant five minutes in front of a committee to explain why they are the best candidate for the job. If the participant stops talking during this time, remind them that they still have time remaining.If the participant stops talking for a second time, remain silent for 20 seconds. Then, ask some standardized job interview questions if the participant does not resume speaking. Begin the mental arithmetic task by instructing the participant to count backwards from 2, 023 in steps of 17, as quickly and correctly as possible.When the participant makes an error, point out the mistake, and instruct the participant to start over. Collect saliva from the participant as previously described. Then, measure the participant's anxiety by having them fill out an STAI questionnaire.After this, explain that the participant must try to relive past activities, helped by their own audio-visual record of the TSST. While the participant watches the video, ask the participant directive questions to aid in the re-emergence of the experience. Enactive interviews are difficult to conduct due to the structuring effects of language.The writer must question the participants about action, and avoid global discourse, post-analysis, or discretion out of the precise moment. Next, allow the participant to describe, comment on, and show their lived experiences step by step. Investigate these components of the experience, as intentions and perceptions, by asking the participant about their intentions.Finally, ask the participant follow-up questions based upon their responses to the previous questions. In this protocol, quantitative and qualitative methods were used to examine participants'experiences during the Trier Social Stress Test. Salivary cortisol was used as a physiological marker of stress.In the TSST and the TSST for Groups, salivary cortisol significantly increased compared to the control group. The STAI scale was used as a psychological marker of stress. The TSST and the TSST for Groups demonstrated increased stress over the course of the procedure, compared to the control group.The SAM scale was also employed as a psychological measure of stress. The TSST and the TSST for Groups displayed different dynamics of pleasure, arousal, and dominance during the procedure, compared to the control group. Combining quantitative and qualitative methods of measuring stress, allows for the comprehension of stress manifestations during the TSST and other similar tests.The originality of our approach is the use of mixed methods, with physiological indicators, self-reported indicators, and experiential indicators. This procedure provides a new way to use mixed methods with an enactive phenomenological approach to improve a protocol, evaluate a device, or give a cross-vision of the same research subject. The enactive phenomenological approach provides a foundation for future research to understand the participants'point of view analyzing the dynamic of stress and emotion.

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