An exploratory multivariate study examining correlates of trait mental and physical fatigue and energy

Depression, Anxiety, Energy, and Fatigue Among Nurses Who Cared for Patients During the COVID-19 Pandemic: A Cross-Sectional Study

Purpose of Study: Nurses around the world have faced challenges during the coronavirus disease 2019 (COVID-19) pandemic. This study examined the association between depression and anxiety and trait energy and trait fatigue, and baseline health status and work characteristics. Design of Study: A cross-sectional study. Methods: A survey was conducted to collect self-reported data from nurses involved in patient care in Northern Virginia. Depression and anxiety were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) depression and anxiety scales. To measure trait energy and trait fatigue, the Mental and Physical State and Trait Energy and Fatigue Scale (MPSTEFS) was used. Findings: There was a significant association between depression and energy (b=-0.46, t = -1.78, p < .001) and loneliness (b=1.38, t = 4.00, p < .001) and increased alcohol use (b=2.11, t = 2.04, p = .045). We also found that nurses with depression were significantly more likely to seek mental health counseling (b=-2.91, t = 2.54, p = 0.013), which was also the case for anxiety (b=3.13, t = 2.14, p = .036). Conclusions: Our study highlights the mental health burden among nurses who worked in the early phase of the COVID-19 pandemic and its association with increased alcohol use and loneliness. The findings may help healthcare leaders identify early signals of deterioration in nurses' well-being.

Correlates of depressive mood among graduate-level allied health students: An exploratory study examining trait energy and fatigue

Objective: The objective of this study was to identify factors associated with the occurrence and severity of depressive mood states among graduate-level allied health students. Participants: Students (N = 77) completed this study. Methods: Participants completed a series of self-reported surveys measuring moods, lifestyle behaviors, trait mental and physical energy and fatigue, and objective assessments of Trail-Making Test Part-B, and muscle oxygen consumption. Multiple backwards linear regression models were fitted to identify factors associated with depressive mood states. Results: When accounting for all subjects, increased severity of depressive mood states was associated with worse sleep quality (SQ), increased sitting time (ST), and trait physical fatigue (TPF). When examining subjects reporting depressive mood states, increased severity of depressive mood states was associated with worse SQ, increased ST, decreased mental workload on non-school days, and trait physical energy (TPE). Conclusion: Adjustments in lifestyle factors such as sleep, mental workload, and ST, may ameliorate depressive mood states.

The contribution of gut-brain axis to development of neurological symptoms in COVID-19 recovered patients: A hypothesis and review of literature

The gut microbiota undergoes significant alterations in response to viral infections, particularly the novel SARS-CoV-2. As impaired gut microbiota can trigger numerous neurological disorders, we suggest that the long-term neurological symptoms of COVID-19 may be related to intestinal microbiota disorders in these patients. Thus, we have gathered available information on how the virus can affect the microbiota of gastrointestinal systems, both in the acute and the recovery phase of the disease, and described several mechanisms through which this gut dysbiosis can lead to long-term neurological disorders, such as Guillain-Barre syndrome, chronic fatigue, psychiatric disorders such as depression and anxiety, and even neurodegenerative diseases such as Alzheimer's and Parkinson's disease. These mechanisms may be mediated by inflammatory cytokines, as well as certain chemicals such as gastrointestinal hormones (e.g., CCK), neurotransmitters (e.g., 5-HT), etc. (e.g., short-chain fatty acids), and the autonomic nervous system. In addition to the direct influences of the virus, repurposed medications used for COVID-19 patients can also play a role in gut dysbiosis. In conclusion, although there are many dark spots in our current knowledge of the mechanism of COVID-19-related gut-brain axis disturbance, based on available evidence, we can hypothesize that these two phenomena are more than just a coincidence and highly recommend large-scale epidemiologic studies in the future.

Preventive Medicine via Lifestyle Medicine Implementation Practices Should Consider Individuals' Complex Psychosocial Profile

Noncommunicable chronic diseases are associated with lifestyle behaviors. Psychological and social factors may influence the adoption of such behaviors. Being mentally and physically energized or fatigued may influence the intention-behavior gap of healthy lifestyle adoption accordingly. We investigated the associations of age, sex, lifestyle behaviors, mood, and mental and physical energy and fatigue at both the trait and state levels. The participants (N = 670) completed questionnaires assessing their sleep, mood, mental and physical state energy and fatigue, physical activity, mental workload, and diet. The ordinary least squares regression models revealed an overlap between the mental state and trait energy levels for males who consume polyphenols, have a high mental workload, and sleep well. Being younger, having a high stress level, bad sleep habits, and being confused and depressed were associated with high mental fatigue. Physical energy and fatigue shared the same commonalities with the previous results, with greater discrepancies observed between the state and trait indicators compared to that between mental energy and fatigue. Diet and stress management seem to be predictors of high physical energy, and females report higher physical fatigue levels. Health care professionals should consider this psychosocial complex profiling in their differential diagnosis and when one is implementing lifestyle behavioral changes to address the facets of preventive medicine, wellness, and health promotion.

Trait Energy and Fatigue Modify Acute Ingestion of an Adaptogenic-Rich Beverage on Neurocognitive Performance

Background: Psychological research considers traits as a long-standing pre-disposition to an individual’s mood, whereas short-term feelings are categorized as states. We previously reported similar overall acute mental performance benefits between an adaptogen-rich, caffeine-containing energy shot (e+Energy Shot–e+Shot; Isagenix International, LLC) and a caffeine-matched placebo Since the publication of that study, multiple studies have reported that trait mental and physical energy (TME/TPE), and trait mental and physical fatigue (TMF/TPF) status modify the effect of various interventions on neurocognitive performance. Therefore, we reevaluated our previously published work and accounted for the four traits. Methods: Participants (n = 30) completed a series of questionnaires to determine baseline trait energy and fatigue measures. Then, participants performed a 27 min battery of neurocognitive tasks before and three times after consuming the study beverages with 10 min breaks between each post-consumption battery of tests. Data from the previous study were re-analyzed using linear mixed-effects models. Results: We now report that the adaptogen product significantly improved mood and cognitive test responses in individuals stratified by initial TME, TPE, TMF, and TPF status. Moreover, this reevaluation also indicated that the caffeine placebo significantly increased heart rate and blood pressure in those subjects initially characterized by low physical and mental energy. Conclusions: In summary, a post-hoc re-analysis of our initial study suggests that consumption of the adaptogen-rich, caffeine-containing product preferentially benefited individuals with initial low TME/TPE and high TMF status when compared to caffeine alone. These findings also support our previous study suggesting that adaptogens may promote mental and physical performance benefits while modulating potentially negatively associated responses to caffeine.

Using Machine Learning to Identify Feelings of Energy and Fatigue in Single-Task Walking Gait: An Exploratory Study

The objective of this study was to use machine learning to identify feelings of energy and fatigue using single-task walking gait. Participants (n = 126) were recruited from a university community and completed a single protocol where current feelings of energy and fatigue were measured using the Profile of Moods Survey–Short Form approximately 2 min prior to participants completing a two-minute walk around a 6 m track wearing APDM mobility monitors. Gait parameters for upper and lower extremity, neck, lumbar and trunk movement were collected. Gradient boosting classifiers were the most accurate classifiers for both feelings of energy (74.3%) and fatigue (74.2%) and Random Forest Regressors were the most accurate regressors for both energy (0.005) and fatigue (0.007). ANCOVA analyses of gait parameters comparing individuals who were high or low energy or fatigue suggest that individuals who are low energy have significantly greater errors in walking gait compared to those who are high energy. Individuals who are high fatigue have more symmetrical gait patterns and have trouble turning when compared to their low fatigue counterparts. Furthermore, these findings support the need to assess energy and fatigue as two distinct unipolar moods as the signals used by the algorithms were unique to each mood.

Trait Energy and Fatigue May Be Connected to Gut Bacteria among Young Physically Active Adults: An Exploratory Study

Recent scientific evidence suggests that traits energy and fatigue are two unique unipolar moods with distinct mental and physical components. This exploratory study investigated the correlation between mental energy (ME), mental fatigue (MF), physical energy (PE), physical fatigue (PF), and the gut microbiome. The four moods were assessed by survey, and the gut microbiome and metabolome were determined from 16 S rRNA analysis and untargeted metabolomics analysis, respectively. Twenty subjects who were 31 ± 5 y, physically active, and not obese (26.4 ± 4.4 kg/m2) participated. Bacteroidetes (45%), the most prominent phyla, was only negatively correlated with PF. The second most predominant and butyrate-producing phyla, Firmicutes (43%), had members that correlated with each trait. However, the bacteria Anaerostipes was positively correlated with ME (0.048, p = 0.032) and negatively with MF (−0.532, p = 0.016) and PF (−0.448, p = 0.048), respectively. Diet influences the gut microbiota composition, and only one food group, processed meat, was correlated with the four moods—positively with MF (0.538, p = 0.014) and PF (0.513, p = 0.021) and negatively with ME (−0.790, p < 0.001) and PE (−0.478, p = 0.021). Only the Firmicutes genus Holdemania was correlated with processed meat (r = 0.488, p = 0.029). Distinct metabolic profiles were observed, yet these profiles were not significantly correlated with the traits. Study findings suggest that energy and fatigue are unique traits that could be defined by distinct bacterial communities not driven by diet. Larger studies are needed to confirm these exploratory findings.

Development and Initial Validation of an Acute Readiness Monitoring Scale in Military Personnel

Personnel in many professions must remain “ready” to perform diverse activities. Managing individual and collective capability is a common concern for leadership and decision makers. Typical existing approaches for monitoring readiness involve keeping detailed records of training, health and equipment maintenance, or – less commonly – data from wearable devices that can be difficult to interpret as well as raising privacy concerns. A widely applicable, simple psychometric measure of perceived readiness would be invaluable in generating rapid evaluations of current capability directly from personnel. To develop this measure, we conducted exploratory factor analysis and confirmatory factor analysis with a sample of 770 Australian military personnel. The 32-item Acute Readiness Monitoring Scale (ARMS) demonstrated good model fit, and comprised nine factors: overall readiness; physical readiness; physical fatigue; cognitive readiness; cognitive fatigue; threat-challenge (i.e., emotional/coping) readiness; skills-and-training readiness; group-team readiness, and equipment readiness. Readiness factors were negatively correlated with recent stress, current negative affect and distress, and positively correlated with resilience, wellbeing, current positive affect and a supervisor’s rating of solider readiness. The development of the ARMS facilitates a range of new research opportunities: enabling quick, simple and easily interpreted assessment of individual and group readiness.

Deriving Mental Energy From Task Completion

Many tasks in everyday life (e.g., making an accurate decision, completing job tasks, and searching for product information) are extrinsically motivated (i.e., the task is performed to gain a benefit) and require mental effort. Prior research shows that the cognitive resources needed to perform an extrinsically motivated task are allocated pre-task. The pre-task allocation of mental resources tends to be conservative, because mental effort is costly. Consequently, there are mental energy deficits when the use of mental resources exceeds the allocated amount. This research provides evidence for post-task mental energy replenishment. The amount of resource replenishment is a function of the size of the mental energy deficit and the favorability of the cost-benefit trade-off experienced at the completion of the task (i.e., the value of the reward given the energy investment). The findings have implications for how cognitive resources management influences the availability of mental energy on a moment-to-moment basis.

Declining energy predicts incident mobility disability and mortality risk in healthy older adults

BACKGROUND

The purpose was to examine whether longitudinal changes in self-reported energy predict incident mobility disability and mortality. We further explored whether changes in energy-related behaviors (physical activity, appetite, or sleep quality) would explain these associations.

METHODS

N = 2021 participants from the Health, Aging and Body Composition Study free from mobility disability and with at least three energy assessments from years 2 to 10.

MEASUREMENTS

The outcomes were time to first self-reported inability to walk a quarter of a mile (mobility disability) and death. Self-reported energy level (SEL) was a single-item indicator over the prior month, ranging from 0 to 10; person-specific slopes measured whether individuals increased or decreased in SEL across the total follow-up time (mean 7.09 years, +1.72, range 2-8 years). Potential energy-related mediators were baseline and change in self-reported physical activity, appetite, and sleep quality. Covariates were baseline levels and change in demographics, health characteristics and behaviors, tiredness, cognition, mood, and gait speed.

RESULTS

A total of 947 developed disability and 567 died over the study follow-up. A one-point change in SEL over the follow-up (or an average 0.125 points/year) was inversely associated with a 35% risk of incident mobility disability (hazard ratio = 0.65, 95% confidence interval [CI] = 0.55, 0.76, p < 0.001) and 35% risk of death (hazard ratio = 0.67, 95% CI = 0.42, 0.87, p = 0.003), independent of covariates. Potential energy-related mediators did not attenuate this association.

CONCLUSIONS

In this longitudinal analysis of community-dwelling older adults, energy decline was common and a significant independent predictor of disability risk and mortality.

Trait Energy and Fatigue Modify the Effects of Caffeine on Mood, Cognitive and Fine-Motor Task Performance: A Post-Hoc Study

Multiple studies suggest that genetic polymorphisms influence the neurocognitive effects of caffeine. Using data collected from a double-blinded, within-participants, randomized, cross-over design, this study examined the effects of trait (long-standing pre-disposition) mental and physical energy and fatigue to changes in moods (Profile of Mood Survey-Short Form (POMS-SF), state mental and physical energy and fatigue survey), cognitive (serial subtractions of 3 (SS3) and 7 (SS7)), and fine-motor task (nine-hole peg test) performance after consuming a caffeinated beverage and a non-caffeinated placebo. Results indicate that trait mental and physical fatigue and mental energy modified the effects of caffeine on vigor, tension-anxiety, physical, and mental fatigue. Additionally, we report that those who were high trait physical and mental fatigue and low-trait mental energy reported the greatest benefit of caffeine on the SS3 and SS7, while those who were high trait mental and physical fatigue reported the greatest benefit of consuming caffeine on fine-motor task performance. The results of our study suggest that trait mental and physical fatigue and mental energy modify the acute effects of caffeine among a group of healthy, young adults and should be measured and controlled for by researchers who choose to study the effects of caffeine on acute moods and cognitive and fine-motor task performance.

The Factorial Validity of the Norwegian Version of the Multicomponent Training Distress Scale (MTDS-N)

BACKGROUND

Athlete self-report measures (ASRM) are methods of athlete monitoring, which have gained considerable popularity in recent years. The Multicomponent Training Distress Scale (MTDS), consisting of 22 items, is a promising self-report measure to assess training distress among athletes. The present study aimed to investigate the factorial validity of the Norwegian version of MTDS (MTDS-N) among student-athletes (n = 632) attending the optional program subject "Top-Level Sports" in upper secondary schools in Norway.

METHODS

A confirmatory factor analysis (CFA) was conducted to assess the six-factor model proposed by Main and Grove (2009). McDonald's omega (ω) along with confidence intervals (CIs) were used to estimate scale reliability. After examining the fit of the CFA model in the total sample, covariates were included to investigate group differences in latent variables of MTDS-N, resulting in the multiple indicators multiple causes (MIMIC) model. Further, direct paths between the covariates and the factor indicators were included in an extended MIMIC model to investigate whether responses to items differed between groups, resulting in differential item functioning (DIF).

RESULTS

When modification indices (MIs) were taken into consideration, the alternative CFA model revealed that MTDS-N is an acceptable psychometric tool with a good fit index. The factors in MTDS-N all constituted high scale reliability with McDonald's ω ranging from 0.725-0.862. The results indicated statistically significant group differences in factor scores for gender, type of sport, hours of training per week, school program, and school level. Further, results showed that DIF occurred in 13 of the MTDS-N items. The student-athletes' reports of training distress were moderate.

CONCLUSION

The MTDS-N may be suitable for use in a Norwegian population to assess student-athletes' training distress in a reliable manner. The indications of group effects suggest that caution should be used if one is interested in making group comparisons when the MTDS-N is used among student-athletes in Norway until further research is conducted.

Caffeine-Containing, Adaptogenic-Rich Drink Modulates the Effects of Caffeine on Mental Performance and Cognitive Parameters: A Double-Blinded, Placebo-Controlled, Randomized Trial

Using a placebo-controlled, double-blinded, within-participants, randomized, cross-over design, we examined the neurocognitive effects of a: (a) caffeine-containing, adaptogenic herbal-rich natural energy shot (e+ shot), (b) a matched caffeine-containing shot (caffeine), and, (c) a placebo. Participants (n = 30) were low consumers of caffeine without elevated feelings of energy. Before and three times after beverage consumption, a 27-min battery was used to assess motivation to perform cognitive tasks, mood, attention ((serial subtractions of 3 (SS3) and 7 (SS7), the continuous performance task (CPT), and the rapid visual input processing tasks)), heart rate (HR), blood pressure (BP), and motor coordination (nine-hole peg test) with a 10-min break between each post-consumption battery. The procedure was repeated for each beverage for each participant at least 48 h apart and within 30 min the same time of day using a random group assignment with blinding of researchers and subjects. To evaluate for changes in outcomes, a Treatment × Time analysis of covariance controlling for hours of prior night's sleep was used. Analysis of all outcomes and all treatment comparisons indicated that compared to placebo, both e+ shot ( Δ ¯   = 2.60; η2 = 0.098) and caffeine ( Δ ¯   = 5.30, η2 = 0.098) increased systolic BP 30 min post consumption (still within normal healthy ranges). The caffeine beverage also led to an improvement in most cognitive measures and moods 30-min post-consumption with improvements tapering at 69 and 108 min, while e+ shot noted more steady improvements with no significant differences between beverages on most cognitive and mood measures at 69 and 108 min. However, compared to caffeine, e+ shot noted a significant increase in reaction time at 108 min, while caffeine noted a small change in the opposite direction. No side-effects were reported by any intervention. These results suggest that the specific blend of adaptogens in e+ shot may modulate the neurocognitive effects of caffeine on mood, and cognition.