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Cited by 142Stress Responses and CortisolHeart Rate Variability and Autonomic ControlAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Cortisol Response to Stress: The Role of Expectancy and Anticipatory Stress Regulation

Open access
Pulopulos, Matias M., Baeken, Chris, De Raedt, Rudi·2020·Hormones and Behavior
DOI 10.1016/j.yhbeh.2019.104587
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Abstract

An exacerbated physiological response to stress is associated with the development of stress-related disorders (e.g., depression and anxiety disorders). Recently, it has been proposed that individuals with high expectancies of being able to deal with stressful situations will activate regulatory mechanisms during the anticipation of the stressful event that would improve stress regulation. To test this hypothesis, 52 women in young adulthood (M = 21.06; SD = 2.58) anticipated and performed a laboratory-based stress task after receiving positive or negative feedback on their abilities to deal with stressful events. Heart rate variability and salivary cortisol were assessed throughout the experimental protocol. Participants receiving positive feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress. Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response. Our results indicate that people with positive expectancy initiate mechanisms of anticipatory stress regulation that enhance the regulation of the physiological stress response. Expectancy and anticipatory stress regulation may be key mechanisms in the development and treatment of stress-related disorders.

Verified 2026-10-09 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

In a laboratory stress study with 52 young women, positive expectancy feedback led to more positive anticipatory cognitive appraisal and, after controlling for reflection, lower cortisol response to stress than negative expectancy feedback. Mediation suggested that more negative appraisal predicted worse anticipatory HRV regulation, which in turn predicted higher cortisol reactivity.

Key findings

  • The Low Expectancy group showed higher primary appraisal (t(50)=2.25, p=0.029, d=0.31), lower secondary appraisal (t(50)=-2.04, p=0.047, d=0.28), and more negative global anticipatory cognitive stress appraisal (t(50)=-2.46, p=0.017, d=0.34) than the High Expectancy group.
  • In unadjusted t-tests, the Low Expectancy group had higher cortisol AUCi (mean=-1.31, SD=111.25 vs. High mean=-42.77, SD=71.15) and cortisol reactivity (mean=0.550, SD=0.49 vs. High mean=-0.375, SD=0.29), but these differences were not statistically significant (AUCi: t(44.39)=1.61, p=0.114, d=0.22; reactivity: t(50)=1.48, p=0.141, d=0.21). After controlling for reflection, the Low Expectancy group showed significantly higher AUCi (F(1,49)=4.87, p=0.032, ηp²=0.09) and cortisol reactivity (F(1,49)=4.42, p=0.041, ηp²=0.08).
  • No significant group differences were found for HRV response: Group F(1,49)=0.54, p=0.468, ηp²=0.01; Time × Group F(2.03,99.42)=0.79, p=0.460, ηp²=0.02. Mood changes over time were significant for several VAS scales, but Time × Group interactions were not significant for the nine VASs (ps>0.115).
  • Mediation: more negative anticipatory cognitive stress appraisal was associated with larger HRV decreases during anticipation (b=0.370, p=0.004), and larger HRV decreases were associated with higher cortisol reactivity (b=-0.357, p=0.030). The indirect effect was significant for cortisol reactivity (Indirect effect=-0.133, SE=0.071) but not for AUCi in the main analysis (Indirect effect=-0.124, SE=0.072, 95% CI=-0.280 to 0.006); supplementary analyses including participants who suspected the manipulation reported significant indirect effects for both cortisol reactivity and AUCi.

Methods

  • Experimental study with healthy female undergraduates from Ghent University, all taking hormonal contraceptives. Sixty-seven women participated; final main analyses included 52 participants (High Expectancy n=25, Low Expectancy n=27) after exclusions.
  • Expectancy was manipulated by giving positive or negative feedback about participants’ ability to deal with socially stressful situations. Participants then completed a modified Trier Social Stress Test with a 15-min anticipatory phase followed by a free speech and arithmetic task.
  • Measures included salivary cortisol at six time points, HRV (RMSSD) at baseline, anticipation, stress, and recovery, the Primary Appraisal Secondary Appraisal scale for anticipatory cognitive stress appraisal, and Visual Analogue Scales for mood. Analyses used t-tests, mixed ANOVAs, ANCOVAs controlling for general self-efficacy and reflection, and PROCESS mediation models.

Limitations

  • The paper states that only women taking hormonal contraceptives were included, which may reduce generalizability, and that the groups were not assessed for similar levels of social anxiety.
  • The authors note that hormonal contraceptives reduce the cortisol response to stress and that the TSST version used had moderate-low stress severity, which may have contributed to the blunted cortisol response in the High Expectancy group.
  • Evident from the text: the final sample was small (52), seven participants who disbelieved the expectancy feedback were excluded from the main analyses, and the main unadjusted cortisol group differences were non-significant, only emerging after covarying reflection.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.yhbeh.2019.104587

Cites

95 of 96 references verified0 citation errors · 0 not checkable

Statistics

54 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

0 of 59 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    A more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation, indexed as less decrease in heart rate variability.

    “Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response.”
    Quote in the paperSubstantial claim
  • Findingown data

    There were no significant differences between the High Expectancy and Low Expectancy groups in HRV response (anticipatory HRV response and HRV response to stress).

    “The factor Group (High Expectancy vs Low Expectancy) (F(1,49)=0.54,p=0.468, hp 2 =0.01), and the interaction between Time and Group were not statistically significant (F(2.03,99.42)=0.79,p=0.460, hp 2 =0.02).”
    Quote in the paperNot a substantial claim
  • Findingown data

    No significant relationships were observed between anticipatory HRV response and brooding, reflection, perceived stress, self-esteem, and depression.

    “No significant relationships were observed between the anticipatory HRV response and brooding (r=-0.052,p=0.716), reflection (r=-0.047,p=0.739), perceived stress (r=-0.217,p=0.122), self-esteem (r=-0.032,p=0.822), and depression (r=-0.236,p=0.092) 5 .”
    Quote in the paperSubstantial claim
  • Findingown data

    After controlling for general self-efficacy, the Low Expectancy group did not show a significantly larger decrease in HRV from baseline to anticipation than the High Expectancy group.

    “Although the Low expectancy group showed a larger decrease in HRV from baseline to anticipation (Low Expectancy: mean=-0.104,SEM=0.039,High Expectancy: mean=-0.58,SEM=0.041), the differences between groups were not statistically significant (F(1,49)=0.66,p=0.419, hp 2 =0.01).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Participants receiving positive feedback (High Expectancy group) showed a lower cortisol response to stress than participants receiving negative feedback (Low Expectancy group).

    “Participants receiving positive feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress.”
    Quote in the paperSubstantial claim
  • May combine two claims. 28
  • Classified as probably not a substantial claim. 26

  • May combine two claims.

    Findingown data

    No significant differences were observed between the High Expectancy and Low Expectancy groups in age, body mass index, subjective socioeconomic status, smoking, depression symptoms, reflection, brooding, perceived stress in the past month, self-esteem, and general self-efficacy (all ps>0.102).

    “No significant differences were observed between the High Expectancy and Low Expectancy groups in age, body mass index, subjective socioeconomic status (assessed using the subjective socioeconomic status scale: Adler et al., 2000), and smoking, and their scores in depression symptoms, reflection, brooding, perceived stress in the past month, self-esteem, and general self-efficacy (all ps>0.102).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The final sample included 25 participants in the High Expectancy group and 27 in the Low Expectancy group.

    “The final sample included in the analyses was composed of 25 participants in the High Expectancy group, and 27 in the Low Expectancy group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    After controlling for reflection, the Low Expectancy group showed higher AUCi and cortisol reactivity than the High Expectancy group.

    “Importantly, the Low Expectancy group show higher AUCi (F(1,49)=4.87,p=0.032, hp 2 =0.09; Figure 3B), and cortisol reactivity (F(1,49)=4.42,p=0.041, hp 2 =0.08; Figure 3C), than the High Expectancy group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In unadjusted analyses, the Low Expectancy group showed higher AUCi and cortisol reactivity than the High Expectancy group, but the differences were not statistically significant.

    “For the analyses with AUCi and cortisol reactivity, the Low Expectancy group showed higher values than the High Expectancy group (for AUCi, Low Expectancy: mean=-1.31,SD=111.25,High Expectancy: mean=-42.77,SD=71.15; for cortisol Reactivity, Low Expectancy: mean=0.550,SD=0.49,High Expectancy: mean=-0.375,SD=0.29), however, the differences were not statistically significant (AUCi: t(44.39)=1.61,p=0.”
    Quote in the paperNot a substantial claim

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    Findingown data

    Reflection was significantly associated with both AUCi and cortisol reactivity.

    “and that reflection was significantly associated with both AUCi (r=-0.274,p=0.049) and cortisol reactivity (r=-0.281,p=0.044).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Seven participants indicated that they did not believe the feedback used to manipulate expectancy.

    “Finally, seven participants indicated that they did not believe the feedback used to manipulate expectancy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The Low Expectancy group showed higher primary appraisal, lower secondary appraisal, and more negative anticipatory cognitive stress appraisal than the High Expectancy group.

    “The Low Expectancy group showed higher primary appraisal (t(50)=2.25,p=0.029, d=0.31) lower secondary appraisal (t(50)=-2.04,p=0.047,d=0.28),and more negative anticipatory cognitive stress appraisal, (t(50)=-2.46,p=0.017, d=0.34)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Worse anticipatory stress regulation was associated with higher cortisol reactivity and higher AUCi.

    “Moreover, worse anticipatory stress regulation was associated with a higher cortisol reactivity and (in the supplementary material) to higher AUCi.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The stress task provoked changes in self-reported negative and positive affect, but both groups showed a similar psychological stress response.

    “For the whole sample, the stress task provoked changes in self-reported negative and positive affect; however, both groups showed a similar psychological stress response.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The stress task moderately activated the HPA axis in the Low Expectancy group but not in the High Expectancy group.

    “Although the stress task provoked a psychological and cardiovascular response in both groups, it moderately activated the HPA axis in the Low Expectancy, but not in the High Expectancy group.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The total and direct effects of cognitive stress appraisal on AUCi were not significant.

    “The total effect (i.e., effect of cognitive stress appraisal on cortisol reactivity without taking into account the anticipatory HRV response), and the direct effect (i.e., effect of cognitive stress appraisal on cortisol reactivity controlling for the anticipatory HRV response) were not significant (Total effect=-0.054,SE=0.144, 95% CI=-0.322 to 0.235; Direct effect=0.070,SE=0.151, 95% CI=-0.234”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Under stressful conditions, the HPA axis is activated, resulting in an increase in cortisol secretion that peaks between 20 and 40 min after initiation of the stressful event.

    “Under stressful conditions, the hypothalamuspituitary-adrenal (HPA) axis is activated, resulting in an increase in cortisol secretion that peaks between 20 and 40 min after initiation of the stressful event (Dickerson et al., 2004).”
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    Premisecitation

    A proactive anticipation of the stressful situation is associated with a sustained anticipatory activity of the DLPFC.

    “De Raedt and Hooley (2016) suggest that a proactive anticipation of the stressful situation (e.g., using effective strategies of emotion regulation during stress anticipation) will be associated with a sustained anticipatory activity of the DLPFC.”
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    • cites De Raedt and Hooley (2016)

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    Premisecitation

    Inability to handle everyday stress leads to exacerbated physiological responses and is associated with the development and course of adverse long-term health outcomes, including major depression, substance abuse, and anxiety disorders.

    “Inability to handle everyday stress leads to exacerbated physiological responses and is associated with the development and course of adverse long-term health outcomes, including a wide range of psychological disorders such as major depression, substance abuse, and anxiety disorders (Duffing et al., 2014;McEwen, 2008;Sinha, 2001).”
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    • cites Duffing et al., 2014

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    Premisecitation

    When a stressful situation is anticipated, individuals make behavioral, cognitive, and physiological adjustments that facilitate the process of coping with the upcoming stressor.

    “Indeed, it has been proposed that, when a stressful situation is anticipated, individuals make behavioral, cognitive, and physiological adjustments that facilitate the process of coping with the upcoming stressor (Pulopulos et al., 2018a;Schulkin, 2011;Schulkin et al., 1994;Turan et al., 2015).”
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    • cites Pulopulos et al., 2018a

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    • cites Schulkin, 2011 source

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    • cites Schulkin et al., 1994 source

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    Premisecitation

    The Neurocognitive framework for Regulation Expectation (NFRE) proposes that when a stressful event is anticipated, individuals with high expectancies of being able to deal with the future situation successfully will engage in proactive stress anticipation (anticipatory stress regulation).

    “The NFRE proposes that, when a stressful event is anticipated, individuals with high expectancies of being able to deal with the future situation successfully will engage in a proactive stress anticipation (i.e., anticipatory stress regulation).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites De Raedt and Hooley (2016)

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    Premisecitation

    Cortisol and the activity of the HPA axis play a central role in the onset and maintenance of stress-related psychological illnesses such as depression and anxiety disorders.

    “There are large inter-individual differences in the cortisol response to stress, and it has been proposed that cortisol and the activity of the HPA axis play a central role in the onset and maintenance of stress-related psychological illnesses such as depression and anxiety disorders (Faravelli et al., 2012;Herbert, 2013;Morris et al., 2012).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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    • cites Herbert, 2013 source

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    Premisecitation

    High levels of cortisol are associated with decreased dorsolateral prefrontal cortex (DLPFC) activity and prolonged activation of the amygdala, a deregulation that may lead to reduced abilities to regulate emotion, sustained negative mood, and may hyperactivate the HPA axis during confrontation with future stressful events.

    “High levels of cortisol have been associated with a decreased dorsolateral prefrontal cortex (DLPFC) activity, and a prolonged activation of the amygdala, a deregulation which may lead to reduced abilities to regulate emotion, sustained negative mood and may (hyper)activate the HPA axis during the confrontation with future stressful events (De Raedt and Koster, 2010).”
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    • cites De Raedt and Koster, 2010 source

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    Premisecitation

    An increase in DLPFC activity may reduce the HPA axis response to stress through indirect and inhibitory connections with the amygdala.

    “As proposed by several authors, an increase in DLPFC activity may reduce the HPA axis response to stress through indirect and inhibitory connections with the amygdala (Baeken et al., 2010(Baeken et al., , 2014;;Herman et al., 2005).”
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    Study design and conductown data

    Experimental session starting time was counterbalanced, and there were no significant differences between groups in the time when they started the session.

    “The starting time was counterbalanced, and there were no significant differences between groups in the time when they started the session (χ 2 =0.265, p=0.876,Phi=0.07).”
    Quote in the paperSubstantial claim

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    Study design and conductnone given

    The conclusions of the study are the same if pNN50 is used in the analyses instead of RMSSD.

    “The conclusions of the study are the same if pNN50 is used in the analyses.”
    Quote in the paperNot a substantial claim

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    Study design and conductnone given

    Participants were selected to exclude those using medication that may affect cortisol levels, cognitive and cardiovascular activity; those with current or history of neurological or psychiatric illness; and those smoking ten or more cigarettes per day.

    “Participants were selected according to the following criteria: no use of medication that may affect cortisol levels, cognitive and cardiovascular activity; no current (or history of) neurological or psychiatric illness; and smoking less than ten cigarettes per day.”
    Quote in the paperSubstantial claim

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    Study design and conductnone given

    Participants were instructed to abstain from alcohol and heavy physical exercise for 24 hours before the session and from eating, smoking, brushing teeth, or taking stimulants two hours before the session.

    “Participants were asked to sleep as usual and to abstain from alcohol and heavy physical exercise for 24 hours before the session.Additionally, they were instructed to drink only water, not eat, smoke, brush their teeth or take any stimulants (such as coffee, cola, caffeine, tea or chocolate) two hours before the session.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Depression symptoms, rumination, trait self-efficacy, self-esteem, and perceived stress may affect the HRV and cortisol response to stress.

    “Importantly, in previous studies it has been demonstrated that depression symptoms, rumination, trait self-efficacy, self-esteem, and perceived stress may affect the HRV and cortisol response to stress (e.g., Chopra et al., 2009;Kemp et al., 2010;Key et al., 2008;O'Donnell et al., 2008;Pruessner et al., 2005;Puig-Perez et al., 2016;Salvador and Costa, 2009;Schönfeld et al., 2007;Schull et al., 201”
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    • cites Chopra et al., 2009 source

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    Interpretationown data

    The Low Expectancy group perceived the stressful situation as more threatening and challenging and perceived having fewer resources to deal with it than the High Expectancy group.

    “indicating that the Low Expectancy group perceived the situation as more threatening and challenging, and they perceived that they have fewer resources to deal with the stressful situation than the High Expectancy group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Greenhouse-Geisser correction was applied when necessary to ensure the assumption of sphericity.

    “When necessary, we applied the Greenhouse-Geisser correction to ensure the assumption of sphericity.”
    Quote in the paperNot a substantial claim

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    Premisecitation

    High HRV is considered a marker of emotion regulation and stress adaptability, and it has been associated with increased PFC activity.

    “High HRV is considered a marker of emotion regulation and stress adaptability, and it has been associated with increased PFC activity (Makovac et al., 2017;Park et al., 2014;Thayer et al., 2012;Vanderhasselt et al., 2015).”
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    • cites Makovac et al., 2017 source

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    • cites Park et al., 2014 source

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    • cites Thayer et al., 2012 source

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    Premisecitation

    Primary and secondary appraisal are interdependent, have a mutual influence, and are parts of a common process known as anticipatory cognitive stress appraisal.

    “As proposed by Lazarus (2001), primary and secondary appraisal are interdependent, they have a mutual influence (e.g., a low secondary appraisal can only be interpreted if scores in primary appraisal are taken into account), and they are parts of a common process known as anticipatory cognitive stress appraisal.”
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    Premisecitation

    Participants who had performed a similar stress task in previous experiments were excluded because of the well-known habituation of the HPA axis response to the TSST.

    “We decided to exclude participants who performed a similar stress task in previous experiments because of the well-known habituation of the HPA axis response to the TSST (Schommer et al., 2003).”
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    • cites Schommer et al., 2003 source

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    Study design and conductown data

    The analyses were repeated including participants who suspected the feedback was part of the manipulation, with 29 in the High Expectancy group and 30 in the Low Expectancy group.

    “Afterwards, the analyses were repeated including the participants who suspected that the feedback used to manipulate expectancy was part of the manipulation of the study (High Expectancy group=29, Low Expectancy group=30) (see supplementary material) 4 .”
    Quote in the paperNot a substantial claim

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    Study design and conductnone given

    Participants were randomly assigned to the High Expectancy or Low Expectancy group independently of their responses to the online questionnaire.

    “Before coming to the lab and independently of their response to the questionnaire, participants were randomly assigned to the High Expectancy or Low Expectancy group.”
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    Study design and conductnone given

    The study was approved by the faculty ethical committee at Ghent University.

    “The participants provided written informed consent, and the study was approved by the faculty ethical committee at Ghent University.”
    Quote in the paperNot a substantial claim

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    Interpretationown data

    People with negative expectancies concerning future stressful events may become more sensitive to stressful events, reflected in an exacerbated HPA axis response, which in the long term may contribute to the development of stress-related disorders.

    “Our results suggest that people with negative expectancies concerning future stressful events may become more sensitive to stressful events (i.e., reflected in an exacerbated HPA axis response to stress), what in a long-term may contribute to the development of stress-related disorders.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Less decrease in HRV during stress anticipation was associated with lower cortisol reactivity in a large sample of healthy individuals.

    “These results are in line with our recent study showing in a large sample of healthy individuals that less decrease in HRV during stress anticipation was associated with lower cortisol reactivity (Pulopulos et al., 2018a).”
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    • cites Pulopulos et al., 2018a

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    Premisecitation

    High HRV is associated with successful emotion and stress regulation and with high prefrontal cortex activity.

    “Importantly, high HRV has been associated with successful emotion and stress regulation (Park et al., 2014;Thayer et al., 2012;Vanderhasselt et al., 2015), and with high prefrontal cortex activity (for meta-analyses see: Makovac et al., 2017;Thayer et al., 2012).”
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    • cites Park et al., 2014 source

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    Interpretationcitation

    Individuals with less ability to deal with minor stressors would experience more frequent HPA reactivity and higher exposure to high cortisol levels, leading to dysregulation of the HPA-axis and reduced ability to regulate emotions.

    “As proposed by Vrshek-Schallhorn et al. (2018), given that minor stressors are more common in daily life, individuals with less ability to deal with this kind of stressful events (e.g., persons with low expectancy) would experience more frequent HPA reactivity and higher exposure to high cortisol levels, what in long-run will lead to a dysregulation of the HPA-axis (McEwen, 2003) and a reduced”
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    • cites McEwen, 2003

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    • cites De Raedt and Koster, 2010 source

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    Premisecitation

    It is more difficult to detect rapid changes in emotional states compared to the slow endocrine response.

    “As a possible explanation, it has been proposed that in comparison to the slow endocrine response, it is more difficult to detect the rapid changes in emotional states (Campbell and Ehlert, 2012;Schlotz et al., 2008).”
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    Premisecitation

    Stress-related disorders such as depression and anxiety are more common in women than in men.

    “Although this may reduce the generalizability of our results, it is important to note that stressrelated disorders such as depression and anxiety are more common in women than in men (Bandelow and Michaelis, 2015;Kessler et al., 1994).”
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    • cites Bandelow and Michaelis, 2015 source

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    Interpretationown data

    Expectancy is a key factor to understanding interindividual differences in HPA-axis activation under stressful situations and explains to some extent how expectancy might be linked to the development of stress-related disorders.

    “Together, these results demonstrate that expectancy is a key factor to understanding the interindividual differences in the activation of the HPA-axis under stressful situations and explain to some extent how expectancy might be linked to the development of stress-related disorders.”
    Quote in the paperSubstantial claim

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    Study design and conductown data

    No significant differences were observed between the High expectancy and Low expectancy groups in age, body mass index, subjective socioeconomic status, smoking, depression symptoms, brooding, perceived stress in the past month, and general self-efficacy.

    “No significant differences were observed between the High expectancy and Low expectancy groups in age (p=0.428),body mass index (p=0.743),subjective socioeconomic status (p=0.929),smoking (p=0.143),depression symptoms (p=0.633),brooding (p=0.388),perceived stress in the past month (p=0.498), and general self-efficacy (p=0.440).”
    Quote in the paperSubstantial claim

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    Study design and conductown data

    Participants in the Low expectancy group reported slightly higher levels of reflection (p=0.055) and self-esteem (p=0.077) than the High expectancy group.

    “Participants in the Low expectancy group reported slightly higher levels of reflection (p=0.055) and self-esteem (p=0.077).”
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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Expectancy and anticipation play a central role in the placebo effect, and expectations about treatment success are the most prominent predictor of outcome in psychopharmacological and psychological interventions.

    “Previous studies have demonstrated that expectancy and anticipation play a central role in the placebo effect (Rief and Glombiewski, 2017), and it has been proposed that expectations about treatment success are the most prominent predictor of outcome in psychopharmacological and psychological interventions (Schedlowski et al., 2015).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Rief and Glombiewski, 2017

      Not checked in the free run.

    • cites Schedlowski et al., 2015 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    A lack of cortisol increase, as observed in the High Expectancy group, might be a maladaptive response to stress.

    “Given that one of the functions of the hormone cortisol is to mobilize resources to deal with stressful situations, one could also consider that a lack of cortisol increase, as it is observed in the High Expectancy group, might be a maladaptive response to stress.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: One of the functions of the hormone cortisol is to mobilize resources to deal with stressful situations.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The two groups may differ in social anxiety because it was not assessed.

    “Another limitation is that, although we assessed several psychological factors that may affect the stress response (i.e., perceived stress in the past month, self-efficacy, self-esteem, rumination and depression symptoms), we do not know whether the two groups have similar levels of social anxiety.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Individuals with high expectancy successfully initiate mechanisms of anticipatory stress regulation, allowing them to prepare for and confront the stressful event, resulting in a lower cortisol response to stress in the long run.

    “Taken all together, these findings support the idea that individuals with high expectancy will successfully initiate mechanisms of anticipatory stress regulation (reflected in less decrease in HRV during stress anticipation), allowing them to prepare for the confrontation with the upcoming situation, and facilitating the confrontation with the stressful event, what in a long-run would be reflected”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The scale was translated into Dutch and back-translated into English, and the final English version was approved by the author of the scale.

    “The scale was translated into Dutch and back translated into English.The final English version was approved by the author of the scale.”
    Quote in the paperNot a substantial claim
46 of 46

  • The paper relies on this without support.

    It is not well understood how psychological and physiological processes that occur during stress anticipation affect the regulation of the cortisol response to stress.

    “However, it is still not well understood how psychological and physiological processes that occur during stress anticipation affect the regulation of the cortisol response to stress.”

  • The paper relies on this without support.

    There are large inter-individual differences in the cortisol response to stress.

    “There are large inter-individual differences in the cortisol response to stress, and it has been proposed that cortisol and the activity of the HPA axis play a central role in the onset and maintenance of stress-related psychological illnesses such as depression and anxiety disorders (Faravelli et al., 2012;Herbert, 2013;Morris et al., 2012).”

  • The paper relies on this without support.

    The mechanism by which expectancy affects the cortisol response to stress has never been investigated.

    “However, this mechanism has never been investigated; and research using an experimental manipulation is needed to establish such a causal pathway.”

  • The paper relies on this without support.

    The expectancy manipulation (positive/negative feedback) was effective in changing expectancy in the analyzed participants.

    “Finally, seven participants indicated that they did not believe the feedback used to manipulate expectancy.”

  • The paper relies on this without support.

    The version of the TSST used in this study had moderate-low stress severity.

    “Second, the stress severity of the version of the TSST used in this study was moderate-low.”

  • The paper relies on this without support.

    One of the functions of the hormone cortisol is to mobilize resources to deal with stressful situations.

    “Given that one of the functions of the hormone cortisol is to mobilize resources to deal with stressful situations”

  • The paper relies on this without support.

    The anticipatory cognitive stress appraisal index validly measures perceived threat, challenge, and coping resources.

    “The result of anticipatory cognitive stress appraisal indicates that the Low expectancy group perceived the situation as more threatening and challenging, and that they perceived that they have fewer resources to deal with the stressful situation than the High expectancy group.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: F(1,48)=4.03,p = .470

    Minor

    The paper reports p = .47 here; recomputing from the test statistic and its degrees of freedom gives p = .050. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .47 · recomputed p = .050

  • Inconsistent p-value: F(1,56)=0.32,p = .858

    Minor

    The paper reports p = .858 here; recomputing from the test statistic and its degrees of freedom gives p = .574. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .858 · recomputed p = .574

  • Inconsistent p-value: F(3.30,135.35)=0.64, p = .640

    Minor

    The paper reports p = .64 here; recomputing from the test statistic and its degrees of freedom gives p = .605. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .64 · recomputed p = .605

  • Inconsistent p-value: F(3.53,137.46)=0.36, p = .807

    Minor

    The paper reports p = .807 here; recomputing from the test statistic and its degrees of freedom gives p = .814. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .807 · recomputed p = .814

  • Inconsistent p-value: F(1,56)=2.31,p = .633

    Minor

    The paper reports p = .633 here; recomputing from the test statistic and its degrees of freedom gives p = .134. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .633 · recomputed p = .134

  • Inconsistent p-value: F(3.73,152.93)=0.96, p = .418

    Minor

    The paper reports p = .418 here; recomputing from the test statistic and its degrees of freedom gives p = .427. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .418 · recomputed p = .427

  • Inconsistent p-value: F(1,41)=2.93, p = .093

    Minor

    The paper reports p = .093 here; recomputing from the test statistic and its degrees of freedom gives p = .095. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .093 · recomputed p = .095

  • Inconsistent p-value: t(50)=1.48,p = .141

    Minor

    The paper reports p = .141 here; recomputing from the test statistic and its degrees of freedom gives p = .145 (two-tailed). The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .141 · recomputed p = .145

8 of 8

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upt(50) = 1.48reported p = .141 · recomputed p = .145

    “t(50)=1.48,p = .141”

  • Doesn’t add upF(1, 48) = 4.03reported p = .47 · recomputed p = .050

    “F(1,48)=4.03,p = .470”

  • Doesn’t add upF(1, 56) = 2.31reported p = .633 · recomputed p = .134

    “F(1,56)=2.31,p = .633”

  • Doesn’t add upF(1, 56) = 0.32reported p = .858 · recomputed p = .574

    “F(1,56)=0.32,p = .858”

  • Doesn’t add upF(3.3, 135.35) = 0.64reported p = .64 · recomputed p = .605

    “F(3.30,135.35)=0.64, p = .640”

  • Doesn’t add upF(1, 41) = 2.93reported p = .093 · recomputed p = .095

    “F(1,41)=2.93, p = .093”

  • Doesn’t add upF(3.73, 152.93) = 0.96reported p = .418 · recomputed p = .427

    “F(3.73,152.93)=0.96, p = .418”

  • Doesn’t add upF(3.53, 137.46) = 0.36reported p = .807 · recomputed p = .814

    “F(3.53,137.46)=0.36, p = .807”

  • Consistentt(50) = 2.25reported p = .029 · recomputed p = .029

    “t(50)=2.25,p = .029”

  • Consistentt(50) = -2.04reported p = .047 · recomputed p = .047

    “t(50)=-2.04,p = .047”

  • Consistentt(50) = -2.46reported p = .017 · recomputed p = .017

    “t(50)=-2.46,p = .017”

  • ConsistentF(2.03, 99.42) = 57.97reported p < .001 · recomputed p < .001

    “F(2.03,99.42)=57.97,p < .001”

  • ConsistentF(1, 49) = 0.54reported p = .468 · recomputed p = .466

    “F(1,49)=0.54,p = .468”

  • ConsistentF(2.03, 99.42) = 0.79reported p = .46 · recomputed p = .458

    “F(2.03,99.42)=0.79,p = .460”

  • Consistentt(44.39) = 1.61reported p = .114 · recomputed p = .115

    “t(44.39)=1.61,p = .114”

  • ConsistentF(1, 49) = 5.92reported p = .019 · recomputed p = .019

    “F(1,49)=5.92,p = .019”

  • ConsistentF(1, 49) = 0.66reported p = .419 · recomputed p = .420

    “F(1,49)=0.66,p = .419”

  • ConsistentF(1, 49) = 6.46reported p = .014 · recomputed p = .014

    “F(1,49)=6.46,p = .014”

  • ConsistentF(1, 49) = 6.57reported p = .014 · recomputed p = .013

    “F(1,49)=6.57,p = .014”

  • ConsistentF(1, 49) = 4.87reported p = .032 · recomputed p = .032

    “F(1,49)=4.87,p = .032”

  • ConsistentF(1, 49) = 4.42reported p = .041 · recomputed p = .041

    “F(1,49)=4.42,p = .041”

  • ConsistentF(1, 48) = 4.79reported p = .033 · recomputed p = .034

    “F(1,48)=4.79,p = .033”

  • ConsistentF(1, 48) = 1.78reported p = .188 · recomputed p = .188

    “F(1,48)=1.78,p = .188”

  • ConsistentF(1, 48) = 4.03reported p = .05 · recomputed p = .050

    “F(1,48)=4.03,p = .050”

  • ConsistentF(1, 48) = 5.29reported p = .026 · recomputed p = .026

    “F(1,48)=5.29,p = .026”

  • ConsistentF(1, 48) = 2.23reported p = .142 · recomputed p = .142

    “F(1,48)=2.23,p = .142”

  • ConsistentF(1, 49) = 5.45reported p = .024 · recomputed p = .024

    “F(1,49)=5.45,p = .024”

  • ConsistentF(2.08, 116.54) = 69.8reported p < .001 · recomputed p < .001

    “F(2.08,116.54)=69.80,p < .001”

  • ConsistentF(2.08, 116.54) = 0.42reported p = .665 · recomputed p = .666

    “F(2.08,116.54)=0.42,p = .665”

  • ConsistentF(1, 56) = 9.73reported p = .003 · recomputed p = .003

    “F(1,56)=9.73,p = .003”

  • ConsistentF(1, 56) = 4.83reported p = .032 · recomputed p = .032

    “F(1,56)=4.83,p = .032”

  • ConsistentF(1, 56) = 5.44reported p = .023 · recomputed p = .023

    “F(1,56)=5.44,p = .023”

  • ConsistentF(1, 56) = 4.81reported p = .032 · recomputed p = .032

    “F(1,56)=4.81,p = .032”

  • ConsistentF(2.74, 112.4) = 3.78reported p = .015 · recomputed p = .015

    “F(2.74,112.40)=3.78, p = .015”

  • ConsistentF(1, 41) = 0.23reported p = .634 · recomputed p = .634

    “F(1,41)=0.23, p = .634”

  • ConsistentF(2.74, 112.4) = 0.81reported p = .483 · recomputed p = .481

    “F(2.74,112.40)=0.81, p = .483”

  • ConsistentF(2.64, 108.2) = 7.02reported p < .001 · recomputed p < .001

    “F(2.64,108.20)=7.02, p < .001”

  • ConsistentF(1, 41) = 2.36reported p = .132 · recomputed p = .132

    “F(1,41)=2.36, p = .132”

  • ConsistentF(2.64, 108.2) = 2.08reported p = .115 · recomputed p = .115

    “F(2.64,108.20)=2.08, p = .115”

  • ConsistentF(2.53, 103.6) = 4.34reported p = .01 · recomputed p = .010

    “F(2.53,103.60)=4.34, p = .010”

  • ConsistentF(1, 41) = 0.46reported p = .5 · recomputed p = .501

    “F(1,41)=0.46, p = .500”

  • ConsistentF(2.53, 103.6) = 1.45reported p = .238 · recomputed p = .236

    “F(2.53,103.60)=1.45, p = .238”

  • ConsistentF(3.85, 157.67) = 22.75reported p < .001 · recomputed p < .001

    “F(3.85,157.67)=22.75, p < .001”

  • ConsistentF(1, 41) = 0.666reported p = .419 · recomputed p = .419

    “F(1,41)=0.666, p = .419”

  • ConsistentF(3.85, 157.67) = 0.43reported p = .778 · recomputed p = .780

    “F(3.85,157.67)=0.43, p = .778”

  • ConsistentF(3.3, 135.35) = 1.34reported p = .262 · recomputed p = .264

    “F(3.30,135.35)=1.34, p = .262”

  • ConsistentF(1, 41) = 5.39reported p = .025 · recomputed p = .025

    “F(1,41)=5.39, p = .025”

  • ConsistentF(3.87, 158.63) = 29.74reported p < .001 · recomputed p < .001

    “F(3.87,158.63)=29.74, p < .001”

  • ConsistentF(1, 41) = 0.23reported p = .635 · recomputed p = .634

    “F(1,41)=0.23, p = .635”

  • ConsistentF(3.87, 158.63) = 0.92reported p = .451 · recomputed p = .454

    “F(3.87,158.63)=0.92, p = .451”

  • ConsistentF(3.73, 152.93) = 10.7reported p < .001 · recomputed p < .001

    “F(3.73,152.93)=10.70, p < .001”

  • ConsistentF(3.53, 137.46) = 10.35reported p < .001 · recomputed p < .001

    “F(3.53,137.46)=10.35, p < .001”

  • ConsistentF(1, 41) = 0.52reported p = .474 · recomputed p = .475

    “F(1,41)=0.52, p = .474”

  • ConsistentF(1, 41) = 1.04reported p = .314 · recomputed p = .314

    “F(1,41)=1.04, p = .314”

54 of 54

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Cortisol-reactivity group summaries conflict with the reported t-test

    Major

    With 27 Low Expectancy and 25 High Expectancy participants, the stated means and SDs imply an unadjusted two-sample t statistic of roughly 8.2, not 1.48. The reported nonsignificant test is therefore inconsistent with the group summaries.

  • Group age means are assigned to opposite groups

    Minor

    The Methods assign mean ages 20.52 and 21.00 to the High and Low Expectancy groups, respectively. Table 1 assigns those same means to the Low and High groups, respectively.

  • The stated direction of the anticipatory HRV difference is reversed

    Minor

    The text says the Low Expectancy group had the larger decrease, but its reported mean change (-0.104) is less negative than the High Expectancy group's (-0.58). By the paper's definition of change from baseline to anticipation, the reported means show the larger decrease in the High Expectancy group.

  • Abstract age mean exceeds both reported group means

    Minor

    The abstract gives a mean age of 21.06 for the 52 participants, whereas the Methods give group means of 20.52 and 21.00 for those 52 participants. Their combined mean cannot exceed both group means.

  • VAS participant count conflicts with group counts

    Minor

    The reported VAS group counts total 43, not 42. Table 2's Group degrees of freedom, F(1,41), also imply 43 participants.

  • The reported indirect effect falls outside its confidence interval

    Minor

    The indirect effect is negative (-0.133), but its reported 95% confidence interval is entirely positive (0.285 to 0.009). The interval therefore cannot describe the reported effect.

6 of 6

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Raes, 2003, De Nederlandstalige versie van de ruminative response scale en de rumination on sadness scale (the Dutch version of the rumination response scale and the rumination on sadness scale), Gedragstherapie, 36, 97

Cited by

Sorted by citations

Related

Authors
Pulopulos, M. M., Baeken, C., & De Raedt, R.
Affiliations
Ghent University (BE)
ORCID
Venue
Hormones and Behavior
Publisher
Elsevier BV
Published
2020-01
Volume
117
Pages
104587
ISSN
0018-506X (ISSN-L)
DOI
10.1016/j.yhbeh.2019.104587
OpenAlex
W2981475429
Semantic Scholar
b70afe40549c9c1cc5a5954ecd73edbf9b304e34
Cited by
142
References
93
Citations by year
2026: 15 · 2025: 28 · 2024: 37 · 2023: 20 · 2022: 18 · 2021: 18 · 2020: 6
FWCI
6.88
Type
journal article
Language
en
Open access
Licence
Locations
  • Hormones and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
Funders
  • Universiteit Gent
  • Fonds Wetenschappelijk Onderzoek
Topics
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
expectancy, heart rate variability, salivary cortisol, stress-related disorders, depression, anxiety disorders, young women
MeSH terms
Adolescent, Adult, Female, Heart Rate, Humans, Hydrocortisone, Male, Motivation, Psychological Tests, Surveys and Questionnaires, Saliva, Stress, Psychological, Young Adult, Anticipation, Psychological

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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