Abstract # 1828 Acute stress reactivity is differentially moderated by perceived stress and anxiety in adults with chronic idiopathic urticaria

Background Chronic idiopathic urticaria (hives) (CIU) is a common, often debilitating, disorder with no known cause. Existing research suggests that increased stress and anxiety are associated with CIU. This study examines the relationship between HPA reactivity (ACTH and cortisol), perceived stress, and anxiety in adults with CIU. Methods The Trier Social Stress Test (TSST) was used to elicit an acute stress response in adults with CIU ( n = 36) and healthy controls ( n = 37). Repeated blood samples were assayed for ACTH and cortisol to determine Area Under the Curve (AUCi), Task Reactivity, and Peak Response. Stress appraisal and anxiety were assessed with the Perceived Stress Scale (PSS) and Beck Anxiety Inventory (BAI), respectively. Groups were compared on ACTH, Cortisol, PSS, and BAI via t-tests. Linear regression models assessed diagnostic group with PSS and BAI separately in predicting ACTH and cortisol AUCi, Task Reactivity, and Peak Response. Results There were no significant group differences in ACTH, cortisol, PSS or BAI. CIU significantly moderated the relationship between (a) BAI with both ACTH and Cortisol Task Reactivity ( B = .414, p = .021; B = .221, p = .042), and (b) PSS with ACTH AUCi ( B = .428, p = .002), and Cortisol Task Reactivity ( B = .029, p = .041). Conclusions Adults with CIU who have higher anxiety and/or who appraise life as more stressful may be at increased risk for alterations in HPA acute stress responses, thereby also increasing risk of sustained dermal inflammation.