{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:09:18Z","timestamp":1767892158753,"version":"3.49.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Fear and horror induce autonomic protective responses, acting as \u201csurvival intelligence.\u201d Pupillometry is an innovative method that captures real-time autonomic nervous system reactions to stress.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To evaluate the feasibility of pupillometry to assess the acute response to a passive real-life stressor\u2014viewing a truthful war scene.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Thirteen medical students (10 women) with an average age of 20.4 years were enrolled in a nonrandomized controlled crossover trial. Selected clips from two different audiovisual stimuli (M1: <jats:italic toggle=\"yes\">Saving Private Ryan<\/jats:italic> as a fear and horror inducer and M2: <jats:italic toggle=\"yes\">Life Is Beautiful<\/jats:italic> as a control) were watched for 15 minutes, separated by a washout period of 48\u201372 hours. The differences in pupillometry parameters between the exposure movie and the assessment time (T0 and T1 for M1 and T0 and T1 for M2) were evaluated using a Wilcoxon test. The Wilcoxon test was also used to assess the difference between M1 and M2 within each assessment time point (T0 and T1).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>A significant difference in response to acute fear and horror-induced stress was observed in pupillometry parameters {baseline [6.90 (5.95; 7.40) vs. 6.60 (5.55; 7.10), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.030] and final pupil diameter [4.50 (3.90; 5.20) vs. 4.10 (3.50; 4.60), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.012]} between M1 and M2 in T1, suggesting the acute increase in sympathetic parameters. Although not significant, there was also a difference in pupillometry parameters (final pupil diameter [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.060], average constriction velocity [<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.059]) after watching M1 compared with T0.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Our proof-of-concept study suggests that pupillometry may be used to evaluate changes in the activity of the autonomic nervous system induced by an acute passive stress stimulus.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/j.pbj.0000000000000279","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T12:00:28Z","timestamp":1738065628000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Assessing response to stressful emotions: a controlled crossover study using pupillometry"],"prefix":"10.1097","volume":"10","author":[{"given":"Ana Carolina","family":"Noronha","sequence":"first","affiliation":[{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Francisca","family":"Castro Mendes","sequence":"additional","affiliation":[{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal"}]},{"given":"Pedro","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Mafalda","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"In\u00eas","family":"Paci\u00eancia","sequence":"additional","affiliation":[{"name":"Center for Environmental and Respiratory Health Research (CERH), Population Health, University of Oulu, Oulu, Finland"}]},{"given":"Andr\u00e9","family":"Moreira","sequence":"additional","affiliation":[{"name":"Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"EPIUnit\u2014Institute of Public Health, University of Porto, Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal"},{"name":"Center for Environmental and Respiratory Health Research (CERH), Population Health, University of Oulu, Oulu, Finland"},{"name":"Servi\u00e7o de Imunoalergologia, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, 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