Date: Thursday, March 19, 2026, 10:30h-11:30h UTC+2 (CEST)

Online

Speaker: Adrián Alacreu

Title: Physiological and emotional vulnerability to social stress of suicidal patients
Authors: Adrián Alacreu-Crespo 1 , Emma Sebti 2 , Myriam Benramdame 2 , Emilie Olié 2 y
Philippe Courtet 2
1 Area of Personality, Assessment and Psychological Treatment, Department of
Psychology and Sociology, University of Zaragoza, Teruel, Spain email:
aalacreu@unizar.es
2 IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France / Department of
Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier,
Montpellier, France

Abstract:
Individuals with a history of suicide attempt (SA) exhibit a particular sensitivity to social
stress. The literature suggests that stress response, which can be influenced by impulsivity,
is at the core of suicidal vulnerability. Particularly suicidal patients with high impulsivity have
greater cortisol response to social stress. However, emotional, cardiovascular (CV) and
inflammatory response is remains understudied. We performed two studies to investigate the
complete physiological and emotional response to social stress in individuals with a history of
SA or suicidal ideation. Participants were placed in a social stress situation using the virtual
Trier Social Stress Test (v-TSST) or the classic TSST. CV response was measured using
impedance cardiography throughout the TSST, and emotional response was assessed using
questionnaires at different time points. We also obtain blood and saliva samples to measure
cortisol, inflammatory markers and blood count. Impulsivity traits were evaluated using the
BIS-10. SA subjects showed a significant decrease in pre-ejection period (PEP) before the
TSST, suggesting an anticipation to stress. Cortisol response was blunted in SA patients.
Moreover, inflammatory markers show great variability in SA and SI patients compared to
affective controls. Impulsivity was able to separate participants with high responsiveness to
social stress vs low responsiveness in some of the studied variables. These results show a
pattern of vulnerability to stress in suicidal patients. Additionally, results with impulsivity show
two patterns to respond to stress in suicidal patients. This fact may have clinical implications
as it may help to create specific interventions to suicidal patients vulnerable to stress.

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