Stress and decision-making in humans: performance is related to cortisol reactivity, albeit differently in men and women.

Acutely elevated levels of cortisol are associated with euphoria and reward-like properties related to sensation-seeking behaviour. Thus, acute stress and elevated levels of cortisol may promote risk-taking behaviour. High cortisol responders are more sensitive to immediate rewards than low cortisol responders. In this study we therefore tested whether acute stress in male and female subjects, induced by the Trier Social Stress Test (TSST), affects decision-making as measured by the Iowa Gambling Task (IGT) and to what extent this is related to cortisol reactivity. Control subjects did not receive the stress manipulation. We specifically predict that high responders show risk-taking behaviour in the IGT compared to low responders and controls. The data show that the more (salivary) cortisol levels are elevated after the TSST the poorer the subsequent performance in the IGT in male subjects. In female subjects an inverse relationship between cortisol levels and IGT performance is observed: slightly elevated levels of cortisol after the TSST improve IGT performance, while highly elevated levels decrease IGT performance. Thus, acute stress as induced by the TSST affects decision-making behaviour of men and women differently and cortisol reactivity is associated with decision-making performance.