The Maastricht Acute Stress Test (MAST): Physiological and Subjective Responses in Anticipation, and Post-stress
Open accessAbstract
The Maastricht Acute Stress Test (MAST) is designed to be a simple, quick, and non-invasive procedure aimed at activating the human stress system. The MAST has been developed by combining elements from two of the most common experimental paradigms measuring stress, the Trier Social Stress Test and the Cold Pressor Test. The aim of this study was to use the MAST procedure to elicit strong autonomic and subjective stress responses that can be quantified in terms of (systolic and diastolic) blood pressure, pulse rate (PR), and state anxiety ratings. In healthy individuals, the MAST induced a significant elevation of systolic blood pressure (SBP) from baseline for up to 30 min post-MAST, while diastolic blood pressure (DBP) dropped to baseline within 10 min post-MAST. Interestingly, the presentation of instructions alerting participants to the procedure resulted in significant elevation of both SBP and DBP above baseline. However, BP measurements prior to test initiation were not as high as those measured immediately after the MAST procedure. PR data showed limited variability across time points. Self-reported state anxiety increased dramatically from baseline to immediately following the MAST procedure. Further, individuals who reported higher levels of depression and stress were more likely to demonstrate larger increases in SBP in response to the MAST. Together, these results support the use of the MAST as a useful tool to activate both acute physiological and subjective measures of the stress response in healthy adults lasting up to 30 min.
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The Trier Social Stress Test and the Maastricht Acute Stress Test activate the autonomic nervous system and the HPA axis.
“Both of these stressors activate the autonomic nervous system and the HPA axis (e.g., Dickerson & Kemeny, 2004; Shilton et al., 2017; Smeets et al., 2012).”
From The effects of acute stress on eyewitness memory: An integrative review for eyewitness researchers (2021) · cites this paper as Shilton et al., 2017
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Stress-induced brain responses are associated with BMI in women
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“[33] have reported that combining measures of autonomic activity (i.”
BackgroundSmet, S. D., Baeken, C., Raedt, R. D., Pulopulos, M. M., Razza, L. B., Damme, S. V., Witte, S. D., Brunoni, A. R., & Vanderhasselt, M. (2021) · Clinical Neurophysiology · doi:10.1016/j.clinph.2021.01.025 · Cited by 13 · see citing works
“In general, the MAST is an effective stress induction paradigm (Shilton et al., 2017) which has been shown to repeatedly generate a robust psychological and physiological stress response, without participants showing any habituation or sensitization in response to the paradigm (Quaedflieg et al.”
BackgroundTahsin, C. T., Michopoulos, V., Powers, A. D., Park, J., Ahmed, Z., Cullen, K. R., Jenkins, N. D. M., Keller‐Ross, M. L., & Fonkoue, I. T. (2023) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00169.2023 · Cited by 13 · see citing works
Torre, D. L., Dalile, B., de Loor, H., Oudenhove, L. V., & Verbeke, K. (2021) · Stress · doi:10.1080/10253890.2021.1959546 · Cited by 12 · see citing works
“The MAST has been validated and serves to elicit a strong autonomic and glucocorticoid stress response (Shilton et al., 2017; Smeets et al., 2012).”
Chang, Y., Gill, D. L., Creswell, J. D., Chen, D.-T., Lin, C., Chu, C., & Nien, J. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107175 · Cited by 12 · see citing works
Ahmed, T., Powner, M. B., Qassem, M., & Kyriacou, P. (2024) · Scientific Reports · doi:10.1038/s41598-024-69466-5 · Cited by 11 · see citing works
Stressing out! Effects of acute stress on prepulse inhibition and working memory
Santos‐Carrasco, D., & la Casa, L. G. D. (2024) · Psychophysiology · doi:10.1111/psyp.14599 · Cited by 11 · see citing works
Controlling intrusive thoughts of future fears under stress
Ashton, S. M., Smeets, T., & Quaedflieg, C. W. E. M. (2023) · Neurobiology of Stress · doi:10.1016/j.ynstr.2023.100582 · Cited by 11 · see citing works
“The MAST successfully induced acute stress (Smeets et al., 2012; Quaedflieg et al., 2017; Shilton et al., 2017) by increasing cortisol in the placebo-stress and propranolol-stress groups compared to the placebo-control condition.”
Pouchieu, C., Pourtau, L., Brossaud, J., Gaudout, D., Corcuff, J., Capuron, L., Castanon, N., & Philip, P. (2023) · Nutrients · doi:10.3390/nu15132921 · Cited by 9 · see citing works
“The MAST is a validated experimental stress procedure that has been widely used as a safe and reliable measure to activate both acute physiological and subjective measures of the stress response in healthy adults [24,25].”
MethodStress Assessment for Augmented Reality Applications Based on Head Movement Features
Ferrarotti, A., Baldoni, S., Carli, M., & Battisti, F. (2024) · IEEE Transactions on Visualization and Computer Graphics · doi:10.1109/tvcg.2024.3385637 · Cited by 10 · see citing works
Chatzaki, C., & Tsiknakis, M. (2025) · Sensors · doi:10.3390/s25237108 · Cited by 17 · see citing works
Tervonen, J., Närväinen, J., Mäntyjärvi, J., & Pettersson, K. (2023) · Frontiers in Neuroergonomics · doi:10.3389/fnrgo.2023.1294286 · Cited by 9 · see citing works
“However, HR evidenced no group level effect between pre-MAST and post-MAST phases (Shilton et al., 2017).”
BackgroundEpstein, R., Aceret, J., Giordani, C., Zankich, V. R., & Zhang, L. (2024) · Scientific Reports · doi:10.1038/s41598-024-68328-4 · Cited by 8 · see citing works
“Levels of stress can also be measured 78–83 , and so can stress-management proficiency 17,18,21,24,27,28,30,84–87 .”
BackgroundNeurotransmitters in Neural Circuits and Neurological Diseases
Gholami, A., & Mortezaee, K. (2025) · ACS Chemical Neuroscience · doi:10.1021/acschemneuro.5c00426 · Cited by 8 · see citing works
Hot metacognition: poorer metacognitive efficiency following acute but not traumatic stress
Smith, A., Bisby, J. A., Dercon, Q., Bevan, A., Kigar, S. L., Lynall, M.-E., Dalgleish, T., Hitchcock, C., & Nord, C. L. (2024) · Translational Psychiatry · doi:10.1038/s41398-024-02840-z · Cited by 9 · see citing works
“There are well-known individual differences in sensitivity to the stress induction [56].”
BackgroundNey, L. J., Felmingham, K. L., Nichols, D. S., & Matthews, A. J. (2020) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2020.107308 · Cited by 7 · see citing works
Khundrakpam, B. S., Segado, M., Pazdera, J. K., Shaigetz, V. G., Granek, J. A., & Choudhury, N. (2025) · JMIR Formative Research · doi:10.2196/64492 · Cited by 6 · see citing works
“Traditionally, the impact of stress on biological measures such as HRV and brain activity is investigated after inducing a specific stressor (mainly in live scenarios) using psychological, performance, or social tests [21,22].”
Exploring metabolomic dynamics in acute stress disorder: amino acids, lipids, and carbohydrates
Gary, N. C., Misganaw, B., Hammamieh, R., & Gautam, A. (2024) · Frontiers in Genetics · doi:10.3389/fgene.2024.1394630 · Cited by 7 · see citing works
“Concentrations of Kynurenine were signi fi cantly lower after stress induction compared to pre-stress induction in a study that used Maastricht Acute Stress Test (MAST) (Shilton et al., 2017) in a cohort of 56 male participants (La Torre et al., 2021).”
MethodThomson, C., Lesser, I., & Hatfield, G. (2024) · Journal of American College Health · doi:10.1080/07448481.2024.2308267 · Cited by 5 · see citing works
“An acute psychological stressor such as a simulated exam may result in psychological changes such as increased state anxiety, 26 and physiological changes including increased blood pressure, heart rate, etc., 27 and these responses are often dependent on the individual’s trait anxiety.”
Examining the Effects of Nature and Animal Videos on Stress
Lavan, S., Ein, N., & Vickers, K. (2023) · Anthrozoos · doi:10.1080/08927936.2023.2210439 · Cited by 4 · see citing works
“Research shows that selfreported stress can be influenced by demographic characteristics and pre-existing stress, social anxiety, and depression (Crişan et al., 2016; Shilton et al., 2017).”
BackgroundSpinella, T. C., Burdeyny, V. V., Oprea, A., Perrot, T. S., & Barrett, S. P. (2023) · Cannabis and Cannabinoid Research · doi:10.1089/can.2022.0326 · Cited by 5 · see citing works
Mitigating the negative effects of retrieval stress on memory: an arousal reappraisal intervention
Marr, C., Sauerland, M., Otgaar, H., Quaedflieg, C. W. E. M., & Hope, L. (2021) · Memory · doi:10.1080/09658211.2021.1893750 · Cited by 5 · see citing works
“Effects of retrieval stress on memory performance As expected and in line with previous research (e.g., Shilton et al., 2017; Smeets et al., 2012), negative affect and blood pressure increased in both stress conditions after experiencing the stressor, but did not increase in the control condition.”
ResultMason, N. L., Szabó, A., Kuypers, K. P. C., Mallaroni, P., de la Torre, R., Reckweg, J. T., Tse, D. H. Y., Hutten, N. R. P. W., Feilding, A., & Ramaekers, J. G. (2022) · medRxiv · doi:10.1101/2022.10.31.22281688 · Cited by 5 · see citing works
“Such findings are in line with previous studies utilizing the MAST in a healthy population[40, 88-92].”
ResultBogaard, G., Dimopoulos, R., & Quaedflieg, C. W. E. M. (2025) · Applied Cognitive Psychology · doi:10.1002/acp.70018 · Cited by 5 · see citing works
Disentangling the effects of acute stress on affiliation and prosociality
Stahlecker, C., & Häusser, J. A. (2025) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2025.107441 · Cited by 4 · see citing works
“After participants experience a stressor in the laboratory, a subsequent non-stressed condition could be biased by anticipatory stress (Monat et al., 1972; Starcke et al., 2008; cf. also Shilton et al., 2017); hence, the order of experimental conditions cannot be easily counterbalanced.”
Investigation of different ML approaches in classification of emotions induced by acute stress
Sourkatti, H., Pettersson, K., van der Sanden, B. P. G. H., Lindholm, M., Plomp, J., Määttänen, I., Henttonen, P., & Närväinen, J. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e23611 · Cited by 4 · see citing works
“The difference is not unexpected, as MAST is a designed and validated stress induction paradigm and shown to arouse the ANS system and brain [70,65].”
BackgroundXi, W. (2023) · International Journal of Systems Assurance Engineering and Management · doi:10.1007/s13198-023-02145-2 · Cited by 3 · see citing works
Examining the effect of stress on the flexible updating of avoidance responses
Lemmens, A., Quaedflieg, C. W. E. M., Dibbets, P., Rijkeboer, M. M., & Smeets, T. (2021) · European Journal of Neuroscience · doi:10.1111/ejn.15155 · Cited by 2 · see citing works
Trapero‐Asenjo, S., Fernández‐Guinea, S., Guillot, A., García‐Domínguez, J. J., & Núñez-Nagy, S. (2024) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.14716 · Cited by 2 · see citing works
Santos‐Carrasco, D., & la Casa, L. G. D. (2025) · The Spanish Journal of Psychology · doi:10.1017/sjp.2025.4 · Cited by 2 · see citing works
“…reactivity to the TSST in different cultures, reporting that Spanish people exhibited different levels of stress reactivity than other cultures, such as the Dutch and Australian population, where the MAST has already been validated (Smeets et al., 2012 and Shilton et al., 2017, respectively).”
InfluentialOptimizing Heart Rate Variability Detection: An Algorithm for Enhanced ECG and PPG Measurements
Kwon, H.-J., Baek, J., Seo, C., Lee, S.-R., Lee, J., Lee, Y., Joo, S., Kim, H. K., & Lee, C. (2025) · Journal of Electrical Engineering and Technology · doi:10.1007/s42835-025-02283-6 · Cited by 2 · see citing works
“The second session introduced psychological and physical stressors through the Maastricht Acute Stress Test (MAST) Protocol to induce varying stress levels [ 27].”
Zhang, X., Peng, L., Lv, J., & Mao, S. (2025) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2025.06.032 · Cited by 2 · see citing works
Daily Consumption of Kombucha Influences the Urinary and Plasma Metabolome in a Healthy Human Cohort
Lloyd, A. J., Nash, R. J., Taylor, A. N. W., Warren‐Walker, A., Davies, C., Martin, P. M., Moron‐Garcia, O. M., Watson, A., Lyons, L., Pavey, M. J., et al. (2025) · Food Science & Nutrition · doi:10.1002/fsn3.71020 · Cited by 3 · see citing works
“Additionally, the Maastricht Acute Stress Test (MAST) was conducted together with cortisol measurements in saliva (Shilton et al. 2017; Smeets et al. 2012).”
Chen, D.-T., Nien, J., Chen, H., Gill, D. L., Yang, Y.-R., Hsieh, W.-L., Hung, T., & Chang, Y. (2026) · Mindfulness · doi:10.1007/s12671-026-02842-6 · Cited by 2 · see citing works
“Moreover, although MAST incorporated physical and psychological distress and induced negative emotions (Shilton et al., 2017), these might not fully reflect the emotional responses during endurance tasks.”
Garcés-Arilla, S., Hidalgo, V., Fidalgo, C., Salvador, A., Juan, M. ‐., & Méndez-López, M. (2025) · Behavioural Brain Research · doi:10.1016/j.bbr.2025.115525 · Cited by 2 · see citing works
“Typically, the MAST has assessed salivary cortisol responses [20,24 – 27], but we are unaware of any studies assessing the DHEA response to this stressor.”
InfluentialScott, T. M., & Dickson, J. M. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.100917 · Cited by 1 · see citing works
Stress-driven shifts in sensory desire and food appetite
Lee, S.-H., & Hong, J.-H. (2025) · Food Quality and Preference · doi:10.1016/j.foodqual.2025.105816 · Cited by 2 · see citing works
Evidence for a behaviourally measurable perseverance traitPreprint
Määttänen, I., Makkonen, E., Jokela, M. M., Närväinen, J., Väliaho, J., Seppälä, V., Kylmälä, J., & Henttonen, P. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.05.05.079509 · Cited by 1 · see citing works
Lemmens, A. (2022) · doi:10.26481/dis.20221222al
Physiological Assessment of the State of Mental Stress at Work
Fauquet-Alekhine, P., & Granry, J.-C. (2023) · Springer eBooks · doi:10.1007/978-3-031-27349-0_5
Ashton, S. M. (2024) · doi:10.26481/dis.20240321sa
Hamzah, K. A. (2024) · Queensland University of Technology · doi:10.5204/thesis.eprints.254327
Xu, L., Peng, Z., Lian, J., & Shao, Y. (2025) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2498422
“…nervous system responses, or cortisol alterations, the Maastricht Acute Stress Test (MAST) paradigm has been widely shown to be effective in inducing stress responses in participants (Bali & Jaggi, 2015; O’Connor et al., 2020; Quaedflieg et al., 2017; Shilton et al., 2017; Smeets et al., 2012).”
Deep Learning Based Method to Electrocardiogram Reconstruction via Photoplethysmography
Seo, C., Kwon, H.-J., Baek, J., Lee, S.-R., Lee, J., Lee, Y., Joo, S., Kim, H. K., & Lee, C. (2025) · Journal of Electrical Engineering and Technology · doi:10.1007/s42835-025-02328-w
“One factor that fluctuates human heart rate is various stress - ful situations [27, 28].”
Fensterseifer, F. J., Teixeira, I. G., Oracz, W., Filipini, R. E., Stein, F. S., & Speretta, G. F. F. (2026) · Physiological Reports · doi:10.14814/phy2.70803
“Interestingly, in stressors involving mental stress, there is an anticipation of stress, that is, an activation of response systems, preparing the organism even before the onset of the stressful event (Shilton et al., 2017).”
Individual dynamics in stress-related pain responses
Vyverman, J., Timmers, I., Meeuwis, S. H., Smeets, T., & Hilger, K. (2026) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2026.107974
Grimm, E., & Agrigoroaei, S. (2026) · Psychophysiology · doi:10.1111/psyp.70388
“Nonetheless, Dickerson and Kemeny (2004) listed social-evaluative threat, novelty, uncontrollability, and motivated performance as key ingredients for laboratory stressors to elicit strong cortisol responses, all of which are characteristics of the MAST (Shilton et al. 2017; Smeets et al. 2012).”
Ørsted, N., Sikorska, K., Ballegaard, S., & Qvortrup, K. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1923282
Ahmed, M. H., Weerasinghe, Y., Michael, G., Nielsen, I. E., Taebi, A., Thibbotuwawa, A., Kaya, M., & Gamage, P. T. (2026) · Cognitive Neurodynamics · doi:10.1007/s11571-026-10571-8
“This split-task structure was adapted in part from the Maas-tricht Acute Stress Test (Shilton et al. 2017).”
- Authors
- Shilton, A. L., Laycock, R., & Crewther, S. G.
- Affiliations
- La Trobe University (AU)
- Corresponding author
- Laycock, Robin
- Crewther, Sheila G.
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2017-04-19
- Volume
- 8
- Pages
- 567-567
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC5395611
- OpenAlex
- W2606007667
- Cited by
- 76
- References
- 37
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 12 · 2023: 14 · 2022: 6 · 2021: 13 · 2020: 5 · 2019: 3 · 2018: 2
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RMIT Research Repository (RMIT University Library) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- Maastricht Acute Stress Test, acute stress response, autonomic stress response, blood pressure, heart rate, state anxiety, Trier Social Stress Test, cold pressor test, depression, healthy adults
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