Social skills moderate pain sensitivity during acute psychosocial stress: an experimental study using the Trier Social Stress Test

Abstract Background This study examines whether acute psychosocial stress induced by the Trier Social Stress Test (TSST) alters pressure pain threshold (PPT) in healthy university students. Furthermore, we investigated how overall social skills and its subscales relate to stress-induced changes in PPT and whether trait anxiety moderates these relationships. Methods A total of 34 healthy university students (14 males, 20 females; mean age = 21.2 ± 1.0 years) participated in the study. TSST was used to induce acute psychosocial stress. PPT, subjective stress, and autonomic activity (pulse wave amplitude and length) were assessed at three time points: pre, post, and 10-min recovery. Social skills were measured using the Adult Social Skills Scale, and trait anxiety was assessed using the STAI. Linear mixed-effects and regression models were applied to examine time effects and anxiety’s moderating role. Results Subjective stress increased significantly immediately after TSST and returned to near baseline at the 10-min recovery. No significant changes were observed in pulse wave amplitude or length. A linear mixed-effects model revealed no significant main effect of time (F(2, 64) = 0.01, p = .99) or interaction between time and total social skills (F(2, 64) = 0.03, p = .97). A trend-level main effect of total social skills was observed (F(1, 31) = 3.28, p = .08), indicating that higher social skills were associated with greater PPT overall. Regression analyses of subscales revealed that only encoding skill exhibited a trend-level association with pre-to-post PPT change. A subsequent interaction model established a significant moderation by trait anxiety: the protective association of encoding skill with increased PPT was significant among low to average anxiety participants but not among high-anxiety participants. Conclusions Individuals with higher social skills, particularly those with effective encoding abilities and lower trait anxiety, exhibited greater pain tolerance under stress, although acute social stress did not produce an overall change in PPT. These findings suggest that social communication competence may serve as a resilience factor in stress-related pain modulation, although elevated anxiety levels may attenuate such benefits.