The psychology of HPA axis activation: Examining subjective emotional distress and control in a phobic fear exposure model.

•We examined the impact of distress and control on HPA responses to phobic exposure.•Exposure elicited intense distress without a corresponding HPA axis response.•Our manipulation of control over the exposure of pace did not impact HPA responses.•Perceived control during exposure, moderated by actual control, buffered cortisol.•Our results challenge the notion that HPA axis activity reflects subjective distress.