Stress and health: psychological, behavioral, and biological determinants

Psychological resilience, cardiovascular disease, and mortality - Insights from the German Gutenberg Health Study

OBJECTIVE

Psychological distress is associated with a higher risk of cardiovascular disease (CVD) and mortality, whereas psychological resilience may confer a protective effect. However, evidence on these relationships remains limited. This study aimed to examine the associations between psychological resilience, CVD, and all-cause mortality within a large general population cohort.

METHODS

Data from 12,675 participants in the German Gutenberg Health Study were analyzed. Psychological resilience was assessed using the Brief Resilient Coping Scale (BRCS). CVD prevalence and mortality data were obtained from medical records and registry updates. Logistic and Cox regression analyses examined the associations between resilience, CVD, and mortality, with adjustments for socio-demographics, lifestyle, and clinical factors.

RESULTS

Cross-sectionally, lower resilience was linked to higher odds of any CVD (odds ratio (OR) 1.030, 95 % confidence interval [CI] 1.009-1.051). Participants with low resilience had 38 % higher odds of CVD and 61 % higher odds of peripheral artery disease compared to those with high resilience. Longitudinally, low resilience was associated with the highest all-cause mortality risk (log-rank test, p < 0.0001). This association remained significant in Cox models after adjusting for confounders (hazard ratio (HR) 1.362, 95 % CI 1.002-1.852).

CONCLUSIONS

Lower psychological resilience is associated with increased CVD prevalence and all-cause mortality. These findings highlight resilience as a potential target for cardiovascular risk assessment and intervention. Incorporating resilience measures in clinical practice may help identify vulnerable individuals who could benefit from strategies to enhance adaptive coping, improving cardiovascular and overall health outcomes.

The influence of intergenerational relationships on depressive symptoms in elderly patients with multiple chronic conditions: the mediating roles of self-rated health and well-being

BACKGROUND

The superimposition of multiple chronic conditions places a heavy physical burden and life pressure on older adults, making them more prone to psychological distress and significantly increasing their risk of depression, which has become an urgent public health issue. Intergenerational relationships, as the main source of social support for older adults, have a profound effect on their mental health. This study aims to explore the potential mediating mechanisms by which intergenerational relationships influence depressive symptoms among older adults within the context of the Chinese "filial piety" culture, providing a theoretical foundation for optimizing intergenerational support and improving the psychological well-being of older adults.

METHODS

Data from the 2020 China Family Panel Study (CFPS) were used, and 739 elderly patients with multiple chronic conditions were selected as the study subjects. Data on intergenerational relationships, self-rated health, well-being, and depressive symptoms were also obtained. A chain mediation model was developed using SPSS PROCESS macro model 6, and one-way ANOVA, Pearson correlation analysis, and mediation effect tests were performed to investigate the effects of intergenerational relationships, self-rated health, and well-being on depressive symptoms in elderly patients with multiple chronic conditions.

RESULTS

Intergenerational relationships, self-rated health, and well-being were found to be significantly correlated with depressive symptoms (P < 0.05). Intergenerational relationships negatively predicted depressive symptoms (β = -0.610, P < 0.01). Self-rated health (β = -1.115, P < 0.001) and well-being (β = -0.653, P < 0.001) mediated the effect of intergenerational relationships on depressive symptoms. Additionally, self-rated health and well-being were identified as chain mediators in this relationship for elderly patients with multiple chronic conditions (β = -1.118, P < 0.001).

CONCLUSION

Intergenerational relationships can reduce depressive symptoms among elderly patients with multiple chronic conditions by enhancing self-rated health and well-being. These findings highlight the importance of family support and emotional communication in mental health interventions for older adults. Therefore, healthcare professionals should incorporate family support and encourage positive intergenerational relationships when designing interventions to foster a supportive environment and improve quality of life.

Stress mindset predicts psychophysiological responses to stress and eating behaviors and moderates the stress-eating relationship in women

Individuals tend to shift their preferences towards comfort foods following acute stressors, but do not ubiquitously increase the amount of food consumed. Many individuals overeat in response to stressors, yet others decrease or do not change their food intake. Individual differences in factors related to stress and eating, such as stress mindset (i.e., perceptions regarding the nature of stress), may explain this variability in stress-eating. To investigate, we conducted the present pre-registered study, where we investigated whether stress mindset, 1) predicted psychophysiological stress responses, 2) predicted snack intake post-stress, and 3) moderated the stress-eating relationship. Participants were 86 women (34 % non-White) between 18 and 22 years old, with a mean body mass index of 24 kg/m2, who completed two visits. Participants completed an assessment of stress mindset during a preliminary screening and, on a subsequent laboratory visit, underwent a stress mindset manipulation followed by an acute social stress task (i.e., TSST) and a snack food taste test. Greater stress-is-enhancing mindsets during screening predicted more adaptive stress responses (greater ratio of sympathetic markers to cortisol levels) and healthier post-stress eating behaviors. Furthermore, the moderation model (PROCESS model 1) was significant: greater post-stress negative affect was associated with more M&M intake only for women with greater stress-is-debilitating mindsets at screening, and greater heart rate was associated with less chip and veggie straw intake only for women with greater stress-is-enhancing mindsets at screening. Thus, stronger stress-is-enhancing mindsets may reduce the impact of psychophysiological stress responses on snack food intake for women. Replications in larger and more diverse samples may elucidate the mechanisms underlying the moderation and inform eating- and obesity-related treatments targeting stress mindset.

Plant hormone jasmonic acid reduces anxiety behavior in mice

Anxiety disorders are a leading cause of disability worldwide and major contributors to the global disease burden. In this study, we investigated the anxiolytic-like effects of plant-derived molecules in mice. Jasmonic acid (JA), a major plant hormone, has been identified as an injury response-related hormone in higher plants. We found that the oral, intraperitoneal, and intraventricular administration of JA in mice demonstrated anxiolytic-like effects in an elevated plus maze test. Additionally, JA exhibited anxiolytic-like effects in mice undergoing open field and novel environment feeding suppression tests. In addition, we found that the anxiolytic-like effects of JA were mediated by serotonin 5-HT1A receptors and central dopamine D1 receptor systems. Our findings reveal a novel role of JA in exerting anxiolytic-like effects in animals and suggest that plant hormones, such as JA, could serve as potential compounds for treating anxiety disorders.

Glucocorticoids and HPA axis regulation in the stress-obesity connection: A comprehensive overview of biological, physiological and behavioural dimensions

Chronic stress, characterized by increased long-term exposure to the glucocorticoid hormone cortisol, is increasingly linked to obesity development. Still, various knowledge gaps persist, including on underlying pathophysiological mechanisms. The aim of the current review is to provide the latest insights on the connection between stress and obesity. We discuss three biological stress systems-the autonomic nervous system, the hypothalamus-pituitary-adrenal (HPA) axis and the immune system-and their link with obesity, with a particular focus on the HPA axis. The role of cortisol and its regulatory variations (including glucocorticoid rhythmicity and altered sensitivity) in adipose tissue biology and obesity development is discussed. Moreover, we highlight the physiological, affective, cognitive and behavioural dimensions of the stress response offering a deeper understanding of how stress contributes to obesity development and vice versa. Finally, stress as a treatment target for obesity is discussed. We conclude that the link between stress and obesity is complex and multifaceted, influenced by physiological, affective, cognitive and behavioural stress response mechanisms, which especially when chronically present, play a key role in the development of obesity and associated cardiometabolic diseases. This necessitates integrated approaches tailored to individual needs, including lifestyle modifications, behavioural interventions, psychosocial support and possible additional pharmacological interventions.

Abnormal response to chronic social defeat stress and fear extinction in a mouse model of Lynx2-based cholinergic dysregulation

Nicotinic receptor signaling is influential in modulating appropriate responses to salient stimuli within a complex environment. The cholinergic neurotransmitter system drives attention to salient stimuli such as stressors, and aids in orchestrating the proper neural and behavioral responses. Dysregulation of this system, however, has been implicated in altered anxiety regulation and mood disorders. Among the multiple layers of regulation are protein modulators such as Lynx2/Lypd1, which provides negative nicotinic acetylcholine receptor regulation within anxiety-related circuits, such as the amygdala and medial prefrontal cortex, among other brain regions. Mice null for Lynx2/Lypd1 (Lynx2 KO) show elevated basal anxiety-like behavior in tests such as elevated plus maze, light-dark box and social interaction assays. Here, we queried how a line predisposed to basal anxiety-like behavior would respond to specific stressors, using validated models of experiential-based affective disorders such as fear extinction, acute and chronic social defeat stress assays. We discovered that Lynx2 KO mice demonstrate an inability to extinguish learned fear during fear extinction tests even during milder stress conditions. In social defeat studies, contrary to our predictions, the Lynx2 KO mice switched from a socially avoidant phenotype (which could be considered susceptible) before defeat to a social approach/resilient phenotype after defeat. Consistent with reports of the inverse relationship between resilience and BDNF levels, we observed reduced BDNF levels in the VTA of Lynx2 KO mice. Furthermore, we provide evidence for the functional role of α7 nicotinic receptor subtypes by phenotypic rescue of fear extinction and social defeat phenotypes by MLA antagonism of α7 nicotinic acetylcholine receptors, or by crossing with α7 nicotinic acetylcholine receptor null mutant mice. A stable physical interaction between LYNX2 and α7 nAChRs was observed by co-immunoprecipitation of complexes from mouse amygdalae extracts. Together, these data indicate that responses to specific stressors can become aberrant when baseline genetic factors predispose animals to anxiety dysregulation. These studies underscore the critical nature of well-regulated nicotinic receptor function in the adaptive response to environmental stressors.

Unethical Work Polyvictimisation, Employee Well-Being, and Work Stress

Unethical behaviours have a wide-ranging negative influence in the workplace, including adverse effects on individuals who witness or are subjected to such acts. While research has explored the effects of various misbehaviours on employee well-being, this study draws from ethical impact theory and utilizes data from a panel sample of business professionals to examine the relationship between unethical work polyvictimisation, encompassing varied misbehaviours, and aggregated individual well-being and work stress. Most of the hypotheses were supported, with results indicating that unethical work polyvictimisation was negatively related to two conceptualisations of well-being. Unethical work polyvictimisation was also positively related to work stress, which functioned as a mediator and was negatively related to well-being. The findings suggest that organisations should reduce incidences of polyvictimisation to improve employee well-being and decrease their work stress.

Combatting Election Stress: Anticipatory Coping and Daily Self-Reported Physical Health

This study's purpose is to evaluate the effectiveness of anticipatory coping as a possible mechanism to reduce daily self-reported physical health consequences of forecasting election-related stress. Elections are often stressful for people. However, the research on possible physical consequences of anticipated election-related stress and ways to counter its impact is limited. We used data from the 2018 U.S. Midterm Election Stress Coping and Prevention Every Day (ESCAPED) study, which provided daily diary responses from 140 participants across the U.S. and American Samoa, ages 19-86. Participants were recruited using Amazon's Mechanical Turk (mTurk) and were asked to fill out an online survey each day for 22 days before, the day of, and 7 days after the 2018 U.S. midterm election, which fell on November 6, 2018. Questions involved forecasting election-related stress, four forms of anticipatory coping, and daily self-reported physical health. Results from multilevel models suggested that on days when participants experienced an increase in their forecasting of election-related stressors and also experienced a decrease in their anticipatory coping related to problem analysis, their daily self-reported physical health decreased. These results highlight the role that future-oriented tactics could play in managing the physical consequences of election-related stress.

PTSD screening using a ten-item checklist of psychological symptoms: a large-scale military veteran sample and a civilian comparison group

PURPOSE

The aim was to explore if self-rated psychological symptoms in military veterans covary strong enough with established PTSD scales to make a symptom checklist a useful screening tool.

METHODOLOGY

A Swedish sample of military veterans (n = 1,859) responded to a questionnaire which contained a checklist of ten psychological symptoms and a test of PTSD indication. The items measured the situation during the last month. All symptoms had the following response choices: 1 (Never), 2 (Seldom), 3 (Sometimes), 4 (Often) and 5 (Very often). The choices Often and Very often were combined and form the basis of the analysis.

FINDINGS

The majority of individuals in the military sample reported that they had not experienced any of the ten psychological symptoms often or very often during the last month. Approximately 5% of the men and 9% of the women scored five symptoms or more. Among the men who reported five symptoms or more, about one third scored above a higher established PTSD cut-off value (PCL-4 > 44).

ORIGINALITY

The psychological symptom checklist represents a new approach to PTSD indication screening and identification of individuals who may need further support.

RESEARCH LIMITATIONS AND STRENGTHS

Clinical assessment of PTSD would be a necessary complement for those that indicate further need. Study strengths include a large sample, use of established scales and a straightforward and simple statistical analysis.

PRACTICAL IMPLICATIONS

The checklist is easy to administer and score. After a brief introduction, it takes about two minutes to complete.

Association between a history of mental illness and the risk of systemic autoimmune rheumatic diseases: a nationwide, population-based case-control study

OBJECTIVE

Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), systemic sclerosis (SSc), dermatomyositis (DM)/polymyositis (PM), are still unknown. Therefore, we aim to address the association between a history of mental illnesses and the risk of SARD using a population-based database.

METHODS

We used the 2000-2020 Taiwanese National Health Insurance Research Database in this case-control study. Multivariable logistic regression was conducted to estimate the adjusted odds ratios (aORs) with 95% confidence interval (CIs). Sensitivity analyses were conducted using distinct definitions of mental illnesses and wash-out periods.

RESULTS

A total of 77,848 SARD cases and 313,392 age- and sex-matched non-SARD controls (1:4) were included for analyses. Patients with SARD were more likely to have history of mental illness (39.8% vs. 27.0%, p < 0.001). After adjusting for potential confounders, we found significant associations of between a history of mental illnesses with SARD (aOR, 1.65, 95%CI, 1.62-1.68), RA (aOR, 1.28, 95% CI, 1.24-1.32), SLE (aOR, 1.62, 95% CI, 1.54-1.71), SS (aOR, 2.35, 95% CI, 2.28-2.42), SSc (aOR, 1.40, 95% CI, 1.24-1.58), and DM/PM (aOR, 1.18, 95% CI, 1.05-1.32). The results remained robust after using various definitions of mental illnesses and wash-out periods.

CONCLUSION

We found that a history of mental illnesses was significantly associated with incident SARD, and the strength of association tended to be strong in patients with SS, followed by SLE. More studies are warranted to clarify the underlying mechanism. Key Points • Patients with systemic autoimmune rheumatic diseases (SARD) are at risk of mental illness, but whether mental illnesses are risk factors for SARD are still unknown. • We used a population-based database to demonstrate that mental illness was associated with the risk of SARD, particularly Sjögren's syndrome and systemic lupus erythematosus. • These findings underscore the importance of integrated care approaches, including surveys for autoimmune diseases, among patients with mental illness.

Sex-based differences in the prevention of stress-induced anxiety by Resolvin D5 and its precursor docosahexaenoic acid: A comparative study

Acute stress can cause emotional dysregulation and trigger various molecular changes, including increased neuroinflammation in limbic regions. These changes have the potential to induce anxiety by disrupting brain physiology and functional connectivity. In this study, we investigated whether an 8-day treatment with inflammation-resolving compounds, specifically Resolvin D5 (RvD5) and its precursor, the omega-3 fatty acid docosahexaenoic acid (DHA), could alleviate anxiety induced by acute restraint stress (ARS) in male and female rats. Additionally, we assessed whether these effects persisted one week after treatment cessation. Serum corticosterone levels and proinflammatory cytokine levels in the hippocampus (HIP) were also assessed. Our results confirmed that ARS induced significant anxiety-like behavior in both the short and long term, with females displaying greater exploratory activity than males. Both RvD5 and DHA prevented the development of pronounced anxiety-like behavior in stressed rats, without affecting anxiety levels in non-stressed rats. Notably, the effect persisted for at least one-week post-treatment in females. The treatments also prevented the elevation of TNF alpha and interleukin-1 beta levels in the HIP and serum corticosterone levels in stressed animals. In conclusion, our findings confirm the neuroprotective profile of these compounds and indicate that the continuous use of DHA or RvD5 may have promising effects in preventing anxiety responses triggered by acute stressful event, regardless of sex. Furthermore, this study is the first to demonstrate that RvD5 can downregulate corticosterone levels in stressed animals.

Stress Among Research Scholars: Causes, Coping Strategies and Implications for Policy Reform

Background

Stress is a major concern among research scholars as it has a detrimental effect on mental health, productivity and overall well-being. Several stressors, including academic pressure, financial issues, lack of resources and guide-student relationships, significantly contribute to the increased risk of lower physical and mental well-being in the long term. It is important to understand how stressors contribute to increased stress levels.

Summary

This study aimed to investigate the causes and consequences of stress, coping strategies in research scholars and policy implications of stress management. A literature search was performed using Google Scholar and PUBMED. This study included original research and review articles that were published in English. This study highlights academic pressure, lack of resources, guide-student relationships, future uncertainty, financial issues and work-life imbalance as major stressors for research scholars. Chronic stress decreases physical, mental, academic and professional outcomes.

Key Message

We propose adapting the 'AAA strategy (approach, assessment and administration)' by universities and institutes for stress management in research scholars. Policy changes in academic research are needed to improve research scholars' overall productivity and quality of life.

Is there anything good about conspiracy beliefs? Belief in COVID-19 conspiracy theories is associated with benefits to well-being

Recent theorizing suggests that people gravitate toward conspiracy theories during difficult times because such beliefs promise to alleviate threats to psychological motives. Surprisingly, however, previous research has largely failed to find beneficial intrapersonal effects of endorsing an event conspiracy theory for outcomes like well-being. The current research provides correlational evidence for a link between well-being and an event conspiracy belief by teasing apart this relation from (1) the influence of experiencing turmoil that nudges people toward believing the event conspiracy theory in the first place and (2) conspiracist ideation-the general tendency to engage in conspiratorial thinking. Across two studies we find that, when statistically accounting for the degree of economic turmoil recently experienced and conspiracist ideation, greater belief in COVID-19 conspiracy theories concurrently predicts less stress and longitudinally predicts greater contentment. However, the relation between COVID-19 conspiracy belief and contentment diminishes in size over time. These findings suggest that despite their numerous negative consequences, event conspiracy beliefs are associated with at least temporary intrapersonal benefits.

Predictors of Expectations for the Future Among Young Korean Adults

This study explored psychosocial factors related to young adults' expectations for the future and verified a model that can predict these expectations using psychosocial factors and demographic profiles to provide useful information for further studies and interventions. The participants were 371 Korean adults aged 20-39 years. The predictive models were examined using stepwise regression and decision tree analyses. The results revealed that stress, depression, gratitude, hardiness, interpersonal competence, and social support were significantly correlated with expectations for the future among young adults. Stepwise regression analysis revealed that commitment, reflecting a sense of purpose, and engagement in life accounted for the greatest variance in expectations for the future. Commitment, gratitude, self-directedness, depression, and the presence of disease accounted for approximately 66.7% of the variance in expectations for the future in young adulthood. The decision tree analysis identified commitment as the most important predictor, followed by gratitude, stress, self-directedness, empathy, perceived health, and marital status, showing how these factors are associated with shaping future expectations. These findings suggest that psychological variables such as commitment and gratitude may play a more important role in young adults' expectations of their future than health or marital status.

The impact of smartphone addiction on mental health and its relationship with life satisfaction in the post-COVID-19 era

Following the COVID-19 outbreak, smartphone usage among quarantined Chinese college students surged significantly, leading to a growing dependency on their devices and adversely impacting their emotional well-being. Consequently, the negative emotions associated with smartphone addiction have emerged as critical factors influencing students' life satisfaction. However, the psychological mechanisms linking these emotional effects to life satisfaction, as well as potential sustainable educational interventions, remain insufficiently explored. This study assessed a sample of 322 undergraduates (51.6% male) using the Mobile Phone Addiction Index (MPAI), the Depression, Anxiety, and Stress Scale (DASS-21), and the Satisfaction With Life Scale (SWLS) to construct a mediation model. The aim was to examine the relationships between smartphone addiction, negative emotions, and life satisfaction. Results revealed that smartphone addiction was significantly positively correlated with negative emotions (r = 0.332, p < 0.01), while negative emotions were significantly negatively correlated with life satisfaction (r = -0.391, p < 0.01). Among these negative emotions, depression emerged as a key factor, intensifying smartphone dependence and detrimentally affecting overall life satisfaction. The mediation analysis demonstrated that smartphone addiction contributes to the development of negative emotions, which in turn reduce life satisfaction. Students with higher levels of smartphone addiction reported heightened negative emotions, leading to more pessimistic coping strategies and, ultimately, a decline in mental health and life satisfaction. This study provides valuable insights into the impact of smartphone addiction on college students' life satisfaction and offers actionable educational recommendations to mitigate its harmful effects, promoting healthier and more sustainable lifestyles for students.

The relationship between work requirements and mental distress in hospital staff: the chain mediating effects of rumination and work recovery classes

BACKGROUND

Heavy work requirements can lead to significant increases in depression anxiety and stress among hospital staff. However, there is limited research considering the role of work recovery (WR) and rumination in this relationship, particularly how poor WR can create a vicious cycle of negative psychological outcomes for medical staff.

OBJECTIVE

In this cross-sectional observational study, the aim is to explore high-risk WR classes among hospital staff. By constructing chain mediation models according to the WR classes, the study seeks to identify which class of medical staff is most affected by work requirements in terms of mental distress, and to examine the chain mediation effects of rumination and WR classes.

METHODS

The cross-sectional observational study utilized Latent Profile Analysis (LPA) and Structural Equation Modeling (SEM) to investigate the relationships among various constructs. It employed the Work Requirements Scale (WRS), the Recovery - Stress Questionnaire (RESTQ), the Depression Anxiety Stress Scales (DASS), and the Revised Emotion Control Questionnaire (RECQ) to survey a sample of 889 hospital staff at a tertiary hospital.

RESULTS

The findings revealed three distinct WR classes among hospital staff. Significant associations were found between work requirements and mental distress among medical staff in the low and moderate WR classes. Additionally, in these two classes, there were significant relationships in which rumination and WR classes had a chain-mediated nature about work requirements and mental distress. This suggests that future intervention studies should focus on these two classes and develop psychological health interventions for hospital staff according to different WR classes.

The protective role of cannabidiol in stress-induced liver injury: modulating oxidative stress and mitochondrial damage

Background

Stress-induced liver injury, resulting from acute or chronic stress, is associated with oxidative stress and inflammation. The endocannabinoid system, particularly cannabinoid receptor 2 (CB2R), plays a crucial role in liver damage. However, there are currently no clinical drugs targeting CB2R for liver diseases. Cannabidiol (CBD), a CB2R agonist, possesses anti-inflammatory and antioxidant properties. This study aims to investigate the pharmacological effects of CBD in a mouse model of stress-induced liver injury.

Methods

We employed a mouse model of stress-induced liver injury to evaluate the protective effects of CBD. Assessments included histopathological analysis, cytokine detection via ELISA, protein expression analysis using immunohistochemistry and Western blot, and gene transcription differential analysis. Transmission electron microscopy was utilized to observe mitochondrial morphology. Additionally, we examined the expression levels of CB2R, SLC7A11, α-SMA, and ACSL4 proteins to elucidate the mechanisms underlying CBD's effects.

Results

CBD exhibited significant protective effects against stress-induced liver injury in mice. Decreases in liver function indicators (including Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT)) and inflammatory cytokines (such as IL-1β and Tumor Necrosis Factor-alpha (TNF-α)) were observed. CBD enhanced CB2R expression and reduced α-SMA levels, mitigating liver fibrosis. It also decreased ACSL4 levels, increased SOD and GSH-Px activities, and upregulated SLC7A11 protein expression. Furthermore, CBD improved mitochondrial morphology, indicating a reduction in oxidative cell death.

Conclusion

CBD activates the CB2R/α-SMA pathway to modulate liver inflammation and fibrosis. Through the SLC7A11/ACSL4 signaling pathway, CBD alleviates oxidative stress in stress-induced liver injury, enhances mitochondrial morphology, and reduces liver damage. These findings provide a theoretical basis for the potential application of CBD in the prevention and treatment of stress-induced liver injury.

Life course exposure to work strain and cognitive disparities by race and ethnicity

There is a well-documented association between exposure to occupational strain and adverse older adult cognition. However, limited research examines differences in this association by race and ethnicity despite considerable disparities in older adult cognition and occupational segregation in the U.S. Using work history data from the U.S. Health and Retirement Study (HRS), we construct comprehensive measures of exposure to occupational strain over working ages and assess differential exposure to cumulative strain, and variation in the association between strain and cognition by race and ethnicity. We find that Black and Latino workers in the U.S. have more exposure to high strain jobs across working ages, and that this type of work history is associated with lower cognitive functioning at older ages. This analysis suggests that occupational segregation and unequal exposure to psychosocial work characteristics are critical social determinants of cognitive health disparities in older adulthood.

The impact of limited sucrose intake on perineuronal nets of parvalbumin interneurons in the basolateral amygdala: A potential role in stress resilience

Natural rewards like regular sucrose consumption can buffer physiological and behavioral stress responses, likely mediated, at least in part, by increased plasticity in parvalbumin-positive (PV+) interneurons in the basolateral amygdala (BLA). As PV+ interneuron plasticity is tightly regulated by specialized extracellular matrix structures called perineuronal nets (PNNs), this study investigated the impact of regular sucrose consumption vs. repetitive stress on the PNNs that surround PV+ interneurons in the BLA, as well as the number of glutamatergic (vGLUT1) and GABAergic (vGAT) appositions that PV+ cells receive. Male rats were given an established limited sucrose intake (LSI) feeding paradigm (vs. water-fed controls) and were co-exposed to a brief restraint stress (vs. no stress controls), daily for 14 days. Sucrose consumption increased the proportion of PV+ cells that were surrounded by PNNs, independent of stress exposure. PV+ cells with PNNs had more vGLUT1-positive and fewer vGAT-positive appositions compared to those lacking PNNs. Additionally, sucrose consumption increased the ratio of excitatory/inhibitory appositions onto PV+ cells, suggesting the possibility of elevated PV+ interneuron tone, leading to greater inhibition of the BLA's stress-excitatory output. These findings indicate that sucrose consumption influences PNN formation and structural plasticity on PV+ interneurons in the BLA, which has implications for understanding the neurological mechanisms underlying stress resilience by natural rewards.

Dual Psychosocial Screening of the Adolescent Patient by Implementing the Safe Environment for Every Kid Teen Questionnaire

OBJECTIVE

This study introduces the SEEK Teen Questionnaire, expanding the Safe Environment for Every Kid (SEEK) approach to include adolescent perspectives alongside caregiver responses for dual psychosocial screening. The objective of this study was to triangulate adolescent responses with those of their caregivers to demonstrate the benefits of dual psychosocial screening.

METHODS

The SEEK Teen Questionnaire was developed by integrating input from primary care and adolescent medicine professionals, national experts, and adolescent stakeholders. The resulting 32-item psychosocial screening tool was administered to adolescent patients aged 11-18 during well visits simultaneously with caregiver completion of the SEEK Parent Questionnaire from August to October, 2022 with interventions offered for identified problems. Responses were compared using McNemar's and Fisher's exact tests.

RESULTS

Four hundred and eighty caregivers and adolescents consented to the study. Participants were generally white (64%), non-Hispanic (81%), and privately insured (62%). Adolescents had a high completion rate (97%) with concordant responses among matched caregivers between 83% and 96%. Among discordant dyads, adolescents disclosed concerns for their caregivers more commonly than caregivers expressed for themselves: discipline (83% vs. 17%, P<0.001), food insecurity (71% vs. 29%, P=0.09), intimate partner violence (78% vs. 22%, P<0.018), stress (81% vs. 19%, P<0.001), depression (64% vs. 36%, P=0.12), and substance misuse (91% vs. 9%, P<0.001).

CONCLUSIONS

This study demonstrates adolescents' willingness to provide insights into their caregivers' well-being and their high awareness of stressors affecting them. Incorporating adolescent perspectives enhances the identification of issues that may otherwise go unnoticed, underscoring the importance of dual psychosocial screening during adolescence.

The Relationship Between Park Access and Quality and Various Health Metrics in a Metropolitan Area in South Carolina Using the CDC PLACES Dataset

OBJECTIVES

Limited access to high-quality green spaces could contribute to growing rates of chronic diseases and unhealthy behaviors. Public parks provide numerous benefits for population well-being. However, past research has shown mixed results regarding the association between proximal parks and residents' physical and mental health. This study examined the relationship between diverse elements of park access and quality and multiple health outcomes.

METHODS

Seventy-three unique parks within 70 census tracts in 4 cities in South Carolina were analyzed. Data about 7 aspects of park quality (transportation access, facility availability, facility quality, amenity availability, park aesthetics, park quality concerns, neighborhood quality concerns) were collected via on-site observations using the Community Park Audit Tool. Health data for each tract (obesity, no leisure time physical activity, high blood pressure, coronary heart disease, high cholesterol, diabetes, depression, poor mental health) were collected from the CDC PLACES dataset. Linear regression analyses examined the association between 10 park access and quality metrics and 8 health metrics, controlling for socio-demographic characteristics.

RESULTS

All associations were in the unexpected direction except 1 relationship involving mental health. Specifically, positive associations were found between the number of parks and obesity, the number of parks and no leisure time physical activity, transportation access and obesity, and transportation access and high blood pressure. As concerns about neighborhood quality increased, poor mental health status worsened.

CONCLUSIONS

This study provides valuable information for public health professionals and researchers. Further research is needed to expand on and elucidate these findings.

Post-pandemic depression, anxiety, and stress: A look at the mental health of medical and administrative staff

INTRODUCTION

Research has shown how mental health among hospital staff worldwide was affected during the COVID-19 pandemic. However, evidence of the physiological status of healthcare and administrative workers at the first level of medical care post-pandemic is scant. Therefore, it is necessary to identify mental health problems among hospital staff following the COVID-19 pandemic.

OBJECTIVE

To determine the prevalence of symptoms and severity of depression, anxiety, and stress among health personnel in the primary care post-pandemic of the Institute of Social Security and Services for State Workers in Puebla.

MATERIALS AND METHODS

A cross-sectional observational study was conducted on medical and administrative staff, comprising 190 participants who worked during the pandemic. A data collection instrument and the 21 item Depression, Anxiety, and Stress Scale were used to determine the prevalence of symptoms and severity of these three mental health issues.

RESULTS

The prevalence of symptoms of depression was 20.5 %, with a moderate predominant severity index (38.5 %), anxiety was 33.2 %, with an extremely severe predominant index (36.5 %), and stress was 30.0 %, with a moderate predominant severity index (36.8 %), respectively. The nursing subgroup, within the medical area staff, exhibited a prevalence of anxiety symptoms of 44.7 %, which was statistically significant (p = 0.008).

CONCLUSION

Despite the post-pandemic period during which this study was conducted, the nursing staff was the most affected group in terms of the prevalence of symptoms of anxiety and depression. Another relevant finding was that administrative workers showed an extremely severe intensity of symptoms of depression, anxiety, and stress.

Short- and long-term health effects of job insecurity. Fixed effects panel analysis of German data

OBJECTIVE

Previous research has linked job insecurity to health deterioration. The risk accumulation model suggests that health effects of job insecurity may persist even after job security is restored, yet long-term empirical analyses are scarce. Our study evaluates the long-term effects of accumulated exposures to affective job insecurity on mental and physical health among the working-age population in Germany.

METHOD

Using data from the German Socioeconomic Panel (12 624 individuals; 84 219 observations), we applied panel regression models with individual fixed effects to assess short- and long-term health changes associated with affective job insecurity. Job insecurity was measured by respondents' worries about job security. Mental and physical health was recorded with the SF-12 scale.

RESULTS

Job insecurity correlated with short-term worsening in mental and physical health. However, after job insecurity ceased, health recovery was incomplete resulting in a long-term health deterioration. The long-term effects were larger among respondents who accumulated more instances of job insecurity, and showed a similar pattern for mental and physical health. An additional analysis documented stronger health effects of job insecurity among lower educated persons.

CONCLUSION

Our study is one of the first to empirically demonstrate the negative long-term health effects of job insecurity. Our findings for a well-protected labor market like Germany's, suggest that the health risks associated with job insecurity may be substantial and potentially underestimated by studies that focus solely on short-term effects.

Neighborhood intergenerational mobility and population health inequality: Spatial dependency and heterogeneity

Health inequity represents a significant social injustice with major policy implications. This study examines the role of neighborhood intergenerational mobility (IM)-defined as the extent to which children within a specific neighborhood can achieve better socioeconomic outcomes than their parents-in shaping population health, addressing widening health inequalities. We propose that neighborhood IM is positively associated with population health, moderated by spatial dependency and heterogeneity. Analyzing over 69,000 census tracts in the contiguous United States using spatially-lagged X models, we find that neighborhood IM is positively associated with health status. The positive relationship weakens in neighborhoods surrounded by neighborhoods with higher levels of IM and strengthens in neighborhoods surrounded by neighborhoods with lower levels of IM. It also weakens in more advantaged environments-characterized by higher socioeconomic indicators, better built environment features, and more favorable natural environment conditions-and strengthens in less advantaged environments with poorer socioeconomic, built, and natural conditions. Our findings underscore the critical role of neighborhood context and heterogeneity in shaping the effects of social determinants on health, suggesting that policymakers should prioritize resources for disadvantaged neighborhoods with lower IM, particularly those surrounded by similarly low-IM areas, to mitigate health disparities more effectively. Our study provides new insights into the role of neighborhood IM in population health and demonstrates the value of geographic approaches for understanding and mitigating health disparities.

Climate change hopefulness, anxiety, and behavioral intentions among adolescents: randomized controlled trial of a brief "selfie" video intervention

AIM

We tested the utility of showing "selfie" videos to increase adolescents' climate change hope, agency, and behavioral intentions, and to decrease their climate anxiety.

METHODS

We conducted a randomized controlled trial among healthy volunteers, ages 14 to 18, enrolled through a crowdsourcing platform. We randomly assigned participants (N = 1039) to view one of three 110-s-long video interventions featuring the same adolescent protagonist: positive (depicting an action-oriented stance); negative (defeatist stance); and control (neutral stance and unrelated content). The primary outcome was climate change hope; secondary outcomes were climate change anxiety, behavioral intention scales, and 100-point sliders about hopefulness and agency.

RESULTS

Viewing positive "selfie" videos proved effective among adolescents in increasing hopefulness and a sense of agency regarding climate change (< 0.001), but not in decreasing climate anxiety or increasing intentions to engage in pro-environmental behaviors.

CONCLUSION

Brief video-based interventions featuring adolescent protagonists showed potential to increase hope and agency regarding climate change. While this single exposure did not directly affect anxiety levels or behavioral intentions, future research should examine whether repeated exposure and different "doses" of such interventions might influence these outcomes. The ubiquity and reach of social media hold promise to scale these inexpensive and specifically tailored interventions.

Dysmenorrhea and the clinical encounter: testing a conceptual model of physician-patient interactions among emerging adults

ABSTRACT

Dysmenorrhea affects as much as 85% of female youth in Canada and the United States and can negatively impact academic performance, overall health, and mental well-being. The physician-patient relationship can play an important role in supporting patients with pain conditions, such as dysmenorrhea. Through effective communication, trust, and validation, physician-patient interactions can empower pain patients, potentially improving pain outcomes. To date, no studies have quantitatively examined the impact of physician-patient interactions on youth's experiences of dysmenorrhea. Therefore, our aim was to explore the relationships among perceived physician communication, pain invalidation, trust in the physician, treatment adherence, menstrual sensitivity, and dysmenorrhea symptom severity among emerging adults (EA) and test a conceptual model of potential interactions using partial least squares structural equation modeling (PLS-SEM). The online survey was administered to Canadian and American EA aged 18 to 21 (Mage = 19.4, SD = 1.1) years with dysmenorrhea. Two models were tested using PLS-SEM: model A only included participants who had received a treatment plan from their physician (n = 279) and model B included the full data set (N = 362). In both models, the perception of more effective physician communication and reduced pain invalidation were related to lower dysmenorrhea symptom severity through menstrual sensitivity. In model A, better physician communication and lower pain invalidation were also associated with higher reported treatment adherence by trust in the physician; however, neither treatment adherence nor trust in the physician were associated with dysmenorrhea symptom severity. Future research should include additional elements within the clinical encounter and further refine the model.

Development of a psychological frailty index: results from the China health and retirement longitudinal study

Objective

Psychological frailty, an emerging concept, lacks a standardized definition, measuring instrument, and empirical evidence in Asian (especially Chinese) populations. An effective instrument to measure psychological frailty should be urgently developed. Therefore, this study aimed to develop and initially validate a Psychological Frailty Index (PFI) based on the China Health and Retirement Longitudinal Study (CHARLS). The study assessed the applicability of the PFI to adverse health outcomes as a secondary aim.

Results

Factor analysis of the 15-item PFI extracted four factors of psychological frailty (psychological distress, cognitive decline, physical vulnerability, and memory decline). The PFI demonstrated satisfactory internal consistency (Cronbach's alpha = 0.764) and criterion validity (rho = 0.806). Psychological frailty was significantly associated with lower life expectancy (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.71-2.29), higher outpatient treatments (1.25, 1.03-1.51), and increased hospitalization (1.45, 1.22-1.74).

Conclusion

The PFI could be a reliable instrument for identifying psychological frailty. The PFI is a novel tool that measures health indicators of older adults at risk of increased psychological vulnerability, but it requires further validation.

Economic inequality, intergenerational mobility, and life expectancy

This study explores the mediating role of intergenerational mobility (IM) in the relationship between economic inequality and population health in the United States, focusing on life expectancy. Using multilevel structural equation modeling across state and commuting zone (CZ) levels for both genders, we find that economic inequality indices, except for the top 1 percent's income share, adversely affect life expectancy through absolute and relative mobility. Specifically, economic inequality reduces life expectancy more significantly through absolute mobility, especially among males and lower-income groups, with nuanced impacts observed across different geographic levels. Relative mobility also plays a role, primarily affecting males in lower-income groups at the CZ level, showing disparities between genders and no effects on higher-income groups. Including certain covariates, particularly social capital and Black population share, renders previously statistically significant absolute mobility effects for females and relative mobility effects for males at the state level insignificant. The indirect effects of economic inequality on life expectancy through absolute mobility effects for males remain consistently significant across all covariate inclusions. Our study offers nuanced insights into how economic inequality affects life expectancy through IM, suggesting targeted interventions to mitigate disparities and improve public health.

Microglial type I interferon signaling mediates chronic stress-induced synapse loss and social behavior deficits

Inflammation and synapse loss have been associated with deficits in social behavior and are involved in pathophysiology of many neuropsychiatric disorders. Synapse loss, characterized by reduction in dendritic spines can significantly disrupt synaptic connectivity and neural circuitry underlying social behavior. Chronic stress is known to induce loss of spines and dendrites in the prefrontal cortex (PFC), a brain region implicated in social behavior. However, the underlying mechanisms are not well understood. In the present study, we investigated the role of type I Interferon (IFN-I) signaling in chronic unpredictable stress (CUS)-induced synapse loss and behavior deficits in mice. We found increased expression of type I IFN receptor (IFNAR) in microglia following CUS. Conditional knockout of microglial IFNAR in adult mice rescued CUS-induced social behavior deficits and synapse loss. Bulk RNA sequencing data show that microglial IFNAR deletion attenuated CUS-mediated changes in the expression of genes such as Keratin 20 (Krt20), Claudin-5 (Cldn5) and Nuclear Receptor Subfamily 4 Group A Member 1 (Nr4a1) in the PFC. Cldn5 and Nr4a1 are known for their roles in synaptic plasticity. Krt20 is an intermediate filament protein responsible for the structural integrity of epithelial cells. The reduction in Krt20 following CUS presents a novel insight into the potential contribution of cytokeratin in stress-induced alterations in neuroplasticity. Overall, these results suggest that microglial IFNAR plays a critical role in regulating synaptic plasticity and social behavior deficits associated with chronic stress conditions.

Behavioral Animal Models and Neural-Circuit Framework of Depressive Disorder

Depressive disorder is a chronic, recurring, and potentially life-endangering neuropsychiatric disease. According to a report by the World Health Organization, the global population suffering from depression is experiencing a significant annual increase. Despite its prevalence and considerable impact on people, little is known about its pathogenesis. One major reason is the scarcity of reliable animal models due to the absence of consensus on the pathology and etiology of depression. Furthermore, the neural circuit mechanism of depression induced by various factors is particularly complex. Considering the variability in depressive behavior patterns and neurobiological mechanisms among different animal models of depression, a comparison between the neural circuits of depression induced by various factors is essential for its treatment. In this review, we mainly summarize the most widely used behavioral animal models and neural circuits under different triggers of depression, aiming to provide a theoretical basis for depression prevention.

Knowledge of the Stress-Health Link as a Source of Resilience Among Mexicans in the Arizona Borderlands

Mexicans who migrate to the United States endure significant stressors related to the migration process and social and environmental conditions of life in the United States. Given that chronic stress exposure has been linked to the onset of health conditions, these ecological factors may expose them to increased risk for poor health. However, Mexicans have many positive health outcomes compared to those monitored nationally, making it crucial to understand possible sources of resilience in this population. Here, we investigate Mexicans' lay health knowledge in response to stress as a possible source of health-related resilience. Health knowledge is considered a central facet of practical and traditional knowledge as well as adaptive modes of intelligence and has a tangible impact on health. Using an ethnographically grounded community-based participatory research design informed by the theory of embodiment, our hybrid team of bilingual university and community-based researchers interviewed Mexican-origin residents (N = 30) living in rural southwestern Arizona about how they experienced and responded to stress and incorporated it into their etiological frameworks. Thematic analysis revealed that participants paid close attention to how stress presented itself in their bodies, which informed their understanding of its potentially harmful health impacts and motivated them to employ multiple stress reduction strategies. Our results highlight the breadth of Mexicans' lay health knowledge, thereby challenging dominant narratives about low rates of health literacy in this population. Findings can be harnessed to optimize potential health protective effects in home and community settings as well as to inform preventive and clinical interventions.

Impact of Stress and Anxiety on Cardiovascular Health in Pregnancy: A Scoping Review

Complex biological processes that enable optimal foetal growth throughout pregnancy are linked to notable haemodynamic and metabolic changes in the mother's body. An inability to adapt to these changes can affect cardiovascular health. During pregnancy, women may experience mood swings, anxiety, and emotional ambivalence. These symptoms can lead to stress and harm the mental well-being of expectant mothers. It is crucial to know the aspects that can influence the development of cardiovascular problems among pregnant women. Effective management requires identifying risk factors. Applying the PRISMA ScR guidelines, we conducted a scoping review to explore and summarise the evidence regarding the impact of stress and anxiety on cardiovascular health in pregnant women. The following enquiries were looked into as research topics: What effects do anxiety and stress have on a pregnant woman's cardiovascular health? How is it quantifiable? It is essential to comprehend the physiological changes that the body undergoes throughout pregnancy in order to inform and assist both patients and medical professionals. This makes it possible for them to identify any pathological disorders or risk factors that could worsen the health of expectant mothers. Psychological and cardiovascular risk factor screening, either before or during pregnancy, may be able to uncover circumstances that require specific medical and psychological therapies in order to lower maternal morbidity and death from cardiovascular disease. Our findings underscore the need for systematic psychological and cardiovascular screening during prenatal care to mitigate adverse outcomes and improve maternal-foetal health.

Relating Workaholism to Job Stress: Serial Mediating Role of Job Satisfaction and Psychological Capital of Nurses in Angola

Background/Objectives: Previous studies conducted in sub-Saharan African countries have concentrated on examining the challenges of nursing training and the organizational commitment of healthcare professionals, with little attention paid to exploring the mechanisms that contribute to reducing nurses' job stress. Consequently, the present study addresses a significant gap in the literature by offering an overview of the factors contributing to understanding job stress among nurses in Angola. This study aimed to analyze the direct and indirect relationship between workaholism and job stress with job satisfaction and psychological capital mediating this relationship. Methods: Using the quantitative methodology with a cross-sectional design, a questionnaire was administered to 340 nurses (172 men and 168 women). Results: The results confirmed that workaholism is positively related to job stress and that job satisfaction and psychological capital serially mediate the relationship between workaholism and job stress. Conclusions: These findings highlight the importance of fostering job satisfaction and psychological capital by establishing favorable work environments and promoting nurses' physical and emotional well-being. In addition, these results may encourage healthcare leaders to create well-designed break areas for nurses to take restorative breaks.

Predictors of Life Satisfaction in Native Hawaiian and Pacific Islander College Students

This study examines predictors of life satisfaction in Native Hawaiian and Pacific Islander (NH/PI) college students, who form an underrepresented group in well-being research. In a sample of 128 NH/PI students from a public university in Hawaii, self-report measures of life satisfaction, affect, stress, and mood were analyzed. The results indicate that positive affect and mood are significant positive predictors for life satisfaction, while negative affect predicts lower satisfaction. By contrast with other racial/ethnic groups, perceived stress did not significantly impact life satisfaction in NH/PI students. These findings suggest that emotional well-being is a key determinant for life satisfaction in NH/PI students, and stress is not. Culturally responsive interventions that focus on positive emotions and community support can enhance well-being and academic success in this population. This study contributes to the understanding of unique cultural influences on well-being in NH/PI students and provides implications for targeted interventions.

Improving brain health via the central executive network

Cognitive and physical stress have significant effects on brain health, particularly through their influence on the central executive network (CEN). The CEN, which includes regions such as the dorsolateral prefrontal cortex, anterior cingulate cortex and inferior parietal lobe, is central to managing the demands of cognitively challenging motor tasks. Acute stress can temporarily reduce connectivity within the CEN, leading to impaired cognitive function and emotional states. However a rebound in these states often follows, driven by motivational signals through the mesocortical and mesolimbic pathways, which help sustain inhibitory control and task execution. Chronic exposure to physical and cognitive challenges leads to long-term improvements in CEN functionality. These changes are supported by neurochemical, structural and systemic adaptations, including mechanisms of tissue crosstalk. Myokines, adipokines, anti-inflammatory cytokines and gut-derived metabolites contribute to a biochemical environment that enhances neuroplasticity, reduces neuroinflammation and supports neurotransmitters such as serotonin and dopamine. These processes strengthen CEN connectivity, improve self-regulation and enable individuals to adopt and sustain health-optimizing behaviours. Long-term physical activity not only enhances inhibitory control but also reduces the risk of age-related cognitive decline and neurodegenerative diseases. This review highlights the role of progressive physical stress through exercise as a practical approach to strengthening the CEN and promoting brain health, offering a strategy to improve cognitive resilience and emotional well-being across the lifespan.

The Mind Under Pressure: What Roles Does Education Play in the Relationship Between Chronic Stress and Cognitive Ability?

Chronic stress is an important predictor of mental and physical health, but little is known about its association with cognitive abilities and education during the lifespan. We hypothesized that chronic stress would be negatively correlated with cognitive abilities, particularly crystallized intelligence, and that this association would be stronger among individuals with lower educational attainment due to limited stress-coping resources. We used cross-sectional data from the German National Educational Panel Study (NEPS SC6), comprising 10,416 adults aged 29 to 71 years (50.80% female; 49.20% male). Fluid and crystallized intelligence were assessed with a reasoning test and a vocabulary test, respectively; chronic stress was assessed with a questionnaire on social stress and anxiety. The tests and the questionnaire were conceptualized for a heterogeneous and large-scale sample. Our results show small negative associations between chronic stress and both fluid and crystallized cognitive abilities, which persist after controlling for demographic variables. However, there were no significant differences between educational groups. Although the study does not address longitudinal patterns, it highlights the complex interaction between stress and cognition, and it underscores the need for further research to explore how educational resources may mitigate the impact of chronic stress on cognitive health.

The Impact of the Brain Wave Modulation Technique (BMW-T) on Heart Rate Variability: A Single Session for Short-Term Stress Reduction

Background: Recent advances in psychophysiology have underscored the importance of autonomic nervous system modulation in managing short-term stress. While several interventions have demonstrated efficacy in reducing short-term stress and anxiety symptoms, there remains a gap in understanding how different short-term techniques compare in terms of both psychological and physiological outcomes. This study investigated the effects of a single session of the Brain Wave Modulation Technique (BWM-T) compared with a psychoeducational session on short-term stress management. Methods: A total of 72 university students participated in this study (mean age = 27.5 years, 79% female). They were randomly assigned to either an experimental group (n = 36) receiving BWM-T or a control group (n = 36) receiving a standard psychoeducational short-term stress management session. Pre- and post-intervention measures included HRV parameters, perceived stress (using the Distress Thermometer, DT), and anxiety (using the STAI-Y State Anxiety Scale, S-ANX). Results: Both groups experienced significant reductions in perceived stress (DT: MD = 1.42, p < 0.001) and anxiety (S-ANX: MD = 6.93, p < 0.001). However, only the experimental group demonstrated physiological changes indicative of improved autonomic function: decreased low-frequency (LF) power (MD = -0.369, p < 0.05) and a lower LF/HF ratio (MD = -1.09, p < 0.05). These findings highlight the unique physiological benefits of BWM-T, beyond the general psychological improvements seen in both interventions. Conclusions: BWM-T appears to be a promising, effective short-term intervention for reducing short-term stress and enhancing autonomic regulation. Further studies are needed to evaluate its long-term effects and potential for broader implementation.

Comparative Effectiveness of In-Person and Virtual Picture-Naming Treatment for Poststroke Anomia

PURPOSE

In light of COVID-19, telepractice for speech therapy has been increasingly adopted. Telepractice promotes accessibility to therapy services for those in rural environments, lowers the frequency of missed appointments, and reduces the costs of rehabilitation. The efficacy of telepractice has been scarcely explored in the aphasia literature. Preliminary research has demonstrated comparable results of telepractice and in-person therapy for people with aphasia, but the current scope of research is insufficient to guide clinical practice. The present study examined whether the virtual administration of a picture-naming therapy paradigm was as effective as in-person administration.

METHOD

The treatment effects of two similar clinical trials, one completed in-person (n = 13) and one completed virtually (n = 13), are compared. Participants were adults with chronic (> 6 months) poststroke aphasia. Both clinical trials administered Cued Picture-Naming Therapy 4 days a week for 2 weeks (eight treatment sessions). Treatment outcomes were analyzed using Tau-U effect sizes and Mann-Whitney U tests.

RESULTS

Weighted Tau-U averages showed an advantage of telepractice over in-person treatment in the acquisition effects of trained words, with participants demonstrating a very large effect (0.84, p < .01) following telepractice and a large effect (0.75, p < .01) following in-person treatment. Both telepractice and in-person rehabilitation demonstrated significant treatment effects and were not significantly different from each other per Mann-Whitney U independent-samples t tests.

CONCLUSIONS

The present study demonstrated that telepractice of a picture-naming paradigm is as effective as in-person treatment administration. This justifies the use of telepractice to overcome accessibility and cost barriers to speech therapy administration and justifies taking patient preference into account. Future research should explore the efficacy of telepractice for treatments that promote greater generalizability to functional communication.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27641031.

Exploring infodemiology: unraveling the intricate relationships among stress, headaches, migraines, and suicide through Google Trends analysis

Introduction

Google Trends has emerged as a vital resource for understanding public information-seeking behavior. This study investigates the interconnected search trends of stress, headaches, migraines, and suicide, highlighting their relevance to public health and mental well-being. By employing infodemiology, the study explores temporal and geographical patterns in search behavior and examines the impact of global events like the COVID-19 pandemic.

Methods

Data mining was conducted using Google Trends for the search terms "stress," "headache," "migraine," and "suicide." Relative Search Volume (RSV) data from October 2013 to October 2023 was collected and adjusted for time and location. Statistical analyses, including Pearson correlation tests, linear regression, and seasonal Mann-Kendall tests, were applied to identify correlations, trends, and seasonal variations. Geographical differences were also analyzed to understand regional disparities.

Results

Significant correlations were observed among the search terms, with "migraine" and "suicide" showing the strongest association. Seasonal variations revealed a peak in search volumes during winter months. Geographical analysis highlighted consistently high RSV in the Philippines for all terms. During the COVID-19 pandemic, searches for stress, headaches, and migraines showed notable increases, reflecting heightened public interest in mental health-related topics during this period.

Discussion

The study underscores the interconnected nature of stress, headaches, migraines, and suicide in public search behavior. Seasonal patterns and regional variations emphasize the need for targeted interventions. The observed surge in search volume during the COVID-19 pandemic highlights the profound impact of global crises on mental health and the importance of timely public health responses.

Conclusion

Google Trends provides valuable insights into the public's interest in health-related topics, demonstrating the intricate relationship between stress, headaches, migraines, and suicide. The findings highlight the need for increased mental health awareness and interventions, particularly during times of heightened stress. Further research is essential to develop strategies that mitigate the impact of these stressors on public health.

Personality traits, mindfulness, and perceived stress in Chinese adults: a sequential explanatory mixed-methods approach

Background

This study explores how personality traits and mindfulness facets interact to influence perceived stress, focusing on a Chinese adult sample. It aims to address gaps in understanding the combined effects of dispositional and mindfulness factors on stress.

Methods

A sequential explanatory mixed-methods design was employed. In the quantitative phase, 637 Chinese adults completed surveys measuring personality traits, mindfulness (attention, acceptance), and perceived stress. Hierarchical multiple regression, moderation, and mediation analyses were conducted. In the qualitative phase, semi-structured interviews with selected participants provided deeper insights into the quantitative findings.

Results

Neuroticism (β = 0.29, p < 0.001) and conscientiousness (β = 0.15, p < 0.01) were positively associated with perceived stress, while mindfulness-acceptance (β = -0.25, p < 0.001) was a significant negative predictor. Neuroticism and mindfulness-acceptance uniquely explained 8 and 6% of the variance in stress, respectively. Mindfulness-attention moderated the relationship between agreeableness and stress, amplifying agreeableness' stress-buffering effect in individuals with low mindfulness-attention. Mediation analysis revealed mindfulness-acceptance partially mediated the agreeableness-stress link. Qualitative interviews underscored the role of personality and mindfulness in shaping stress responses and coping mechanisms.

Conclusion

The findings highlight mindfulness-acceptance as a critical factor in reducing stress, particularly in individuals with agreeable personalities. These results support the development of mindfulness-based interventions targeting acceptance to enhance stress resilience across diverse personality profiles.

Mental Health and Well-Being in the Modern Era: A Comprehensive Review of Challenges and Interventions

A critical global concern in the modern era is mental health and well-being, where rapid socioeconomic change, technological advancements, and lifestyle shifts have significantly impacted individuals' psychological health. Primary stressors today include urbanization, digital dependency, social isolation, and economic pressures, alongside the escalating prevalence of mental health disorders such as depression, anxiety, and burnout. The COVID-19 pandemic has further exacerbated global mental health crises, increasing the vulnerability of populations during times of uncertainty and instability. This paper critically examines emerging connections between mental health and lifestyle factors such as sleep, diet, and exercise. Interventions are discussed from a multidimensional perspective, encompassing pharmacological treatments, psychotherapy, digital mental health tools, and community-based programs. Special attention is given to the rise of telemedicine and mobile mental health apps, offering innovative solutions to bridge gaps in mental healthcare accessibility. Furthermore, the review underscores the importance of preventive approaches, promoting mental health literacy, reducing stigma, and fostering resilience through mindfulness, cognitive behavioral techniques, and social support systems.

Comparison of stress related physiological parameters with biological parameters of saliva among college students - An observational study

Background

Stress can also be defined as a physical, mental, or emotional response to events that causes bodily or mental tension. Starting with a lack of concentration, it creates a lot of inconveniences and problems with a snowball effect. Saliva, a prime component of the oral cavity, plays an important role in oral health. Under any stressful situation, this unstimulated salivary flow rate decreases, leading to an increase in salivary acidity, which in turn leads to a reduction in the salivary pH, leading to a lot of other complications.

Aim and Objectives

This study was conducted to understand the difference in the levels of salivary pH and the sleep pattern of dental students during their exams. The objective is to prove that there is a marked decrease in the salivary pH and a reduction in the number of hours of sleep when the students are subjected to a stressor.

Settings and Design

180 male and female college-going students were selected for a cross-sectional questionnaire study based on a random sampling method.

Materials and Methods

A questionnaire was circulated among the subjects as Google forms, and their responses were retrieved in excel sheets. Unstimulated salivary sample were collected in a sterile manner, and pH was estimated using a pH meter. An understanding of the sleep pattern was gained using a questionnaire.

Statistical Analysis Used

This study is a descriptive analysis of varied information on stress and salivary parameters. The responses recorded were made into graphical representation; the pH analysis and flow rate were estimated, and it showed variations in subjects during the examination.

Results and Conclusion

This study is the first-of-its-kind in comparing parameters of saliva, sleep quality and quantity in association with stress. We concluded that psychological variables-anxiety and stress-have a significant effect on reducing salivary flow rate which ultimately leads to a reduction in salivary pH.

The effects of stress on surgical performance: a systematic review

INTRODUCTION

Acute stress, the psychological response to short-term challenging stimuli, is frequently encountered in the high-pressure environment of the operating theatre. Surgeon stress is associated with deterioration in surgical performance, surgical team working and compromised patient safety. Given these concerns, the aim of this review was to understand the impact of acute stress on surgical performance in technical and non-technical domains as well as patient outcomes.

METHODS

A systematic review was conducted following PRISMA guidelines. Electronic databases were searched for studies examining acute stress in medical professionals during real or simulated surgical procedures that reported performance outcomes in technical and non-technical skills. Risk of bias assessment was conducted using appropriate tools for each study design.

RESULTS

Out of 1445 identified studies, 19 met the inclusion criteria. In simulated environments, acute stress consistently led to impairment in both technical and non-technical skills during surgical procedures. Technical skill deterioration included higher procedural error rates, longer task completion times and diminished instrument handling. Non-technical skills, such as teamwork and communication, also were impaired under stress conditions. Real-world studies echoed these findings, demonstrating acute stress resulting in higher error rates and impaired non-technical skills. No studies identified surgeon stress as having a causal relationship with patient outcomes.

CONCLUSION

Acute stress significantly impacts both technical and non-technical skills during surgical procedures, impairing performance in simulated and real-world surgical environments. Despite the growing understanding of the detrimental effects of stress, gaps remain in comprehensively assessing its impact on patient outcomes. Further research is warranted to develop reliable stress measurement methods applicable in surgical settings and explore effective stress management strategies.

Noise and mental health: evidence, mechanisms, and consequences

The recognition of noise exposure as a prominent environmental determinant of public health has grown substantially. While recent years have yielded a wealth of evidence linking environmental noise exposure primarily to cardiovascular ailments, our understanding of the detrimental effects of noise on the brain and mental health outcomes remains limited. Despite being a nascent research area, an increasing body of compelling research and conclusive findings confirms that exposure to noise, particularly from sources such as traffic, can potentially impact the central nervous system. These harms of noise increase the susceptibility to mental health conditions such as depression, anxiety, suicide, and behavioral problems in children and adolescents. From a mechanistic perspective, several investigations propose direct adverse phenotypic changes in brain tissue by noise (e.g. neuroinflammation, cerebral oxidative stress), in addition to feedback signaling by remote organ damage, dysregulated immune cells, and impaired circadian rhythms, which may collectively contribute to noise-dependent impairment of mental health. This concise review linking noise exposure to mental health outcomes seeks to fill research gaps by assessing current findings from studies involving both humans and animals.

Enhancing Psychophysiological Well-Being Through Nature-Based Soundscapes: An Examination of Heart Rate Variability in a Cross-Over Study

Stress and psychological disorders are substantial public health concerns, necessitating innovative therapeutic strategies. This study investigated the psychophysiological benefits of nature-based soundscapes, drawing on the biophilia hypothesis. Using a randomized, acute cross-over design, 53 healthy participants experienced either a nature-based or a reference soundscape for 10 min, with a 2-min washout period. The nature-based soundscape integrated nature sounds with elements of music to create an immersive nature experience. A calm coffee shop soundscape without discernible speech was selected as a reference to represent a typical urban relaxation environment. Heart rate variability (HRV) was the primary outcome, with exploratory outcomes including heart and respiratory rates, and questionnaires assessing affective well-being, creativity, and belonging. Results showed that the nature-based soundscape significantly improved HRV and reduced heart and respiratory rates, indicating enhanced parasympathetic activity. Participants reported lower feelings of anxiety and depression and increased feelings of comfort, enthusiasm, creativity, and belonging. This study highlights the multifaceted benefits of nature-based soundscapes, suggesting they could serve as easily accessible therapeutic options for promoting immediate recovery and reducing daily stress in healthy individuals.

Hatha yoga reduces momentary stress but does not impact diurnal profiles of salivary cortisol and alpha-amylase: A randomized controlled trial

Does the practice of yoga impact stress? Various studies have suggested that yoga may reduce both self-reported stress and stress biomarkers, but the evidence for such claims remains inconclusive, especially for yoga styles with a focus on physical postures. In a randomized controlled trial with 98 participants, we therefore examined whether an eight-week Hatha yoga intervention (60 min, 3×/week or more) led to reduced levels of diurnal salivary cortisol (sCort), salivary alpha-amylase (sAA), and subjective momentary stress as compared to a waitlist control group. To ensure the concomitant assessment of self-report and biological measures in an ecologically valid setting, and to capture the diurnal profile of cortisol and alpha-amylase, we employed an ecological momentary assessment approach. Five times per day, participants reported their momentary stress levels on a visual analogue scale and collected saliva samples for the assessment of salivary biomarkers. The intervention led to a significant reduction of subjective momentary stress but there was no change in diurnal sCort or sAA levels. There are several potential explanations for these findings: The intervention may have helped participants to cope better with stress while leaving diurnal levels of stress biomarkers unaffected, or the change may at least not have been reflected in sCort and sAA. Alternatively, there may have been a self-report bias, insofar as a favorable disposition towards yoga may have led participants to report reductions in stress in order to indicate positive effects of the intervention. Our findings contribute to a better understanding of the effects of distinct yoga interventions, demonstrating their potential to serve as low-risk stress relief tools.

Targeted delivery of a selenium-sulfa compound via cationic starch microparticles: Modulation of oxidative stress and pain pathways in fibromyalgia-like symptoms in mice

Cationic starch microparticles (CStMPs) loaded with 4-amino-3 -(phenylselenyl)benzenesulfonamide (4-APSB) were prepared and investigated in a model of fibromyalgia (FM) induced by intermittent cold stress (ICS) in male and female Swiss mice. The CStMPs/4-APSB were characterized by Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), energy-dispersive X-ray (EDX) spectroscopy, zeta potential, and particle size measurements, providing information about their chemical composition, surface charge, morphology/microstructure, and size (1.50 ± 0.5 μm). Following ICS exposure, the animals were treated with free 4-APSB (1 mg/kg), CStMPs/4-APSB (containing 0.13 mg of 4-APSB per mg of microparticles), or CStMPs, from days 5 to 10. The results revealed the successful incorporation of 4-APBS in the CStMPs. Free 4-APSB and CStMPs/4-APSB reversed nociceptive- and depressive-related behaviors in male and female mice exposed to ICS, attenuating the hallmark symptoms of FM. Those treatments (free 4-APSB and CStMPs/4-APSB) normalized the monoamine oxidase (MAO)-A activity in the cerebral cortex and the oxidative damage, providing the correct functioning of the enzyme Ca2+ -ATPase in the cerebral cortex and hippocampus of mice exposed to ICS. The CStMPs/4-APSB modulated the oxidative stress markers, specifically in the spinal cord of mice - an anatomical region intricately linked to pain pathways.

Association of stressful life events with subjective age and the mediating role of depression: A cross-sectional study of older adults in China

OBJECTIVE

While previous studies have examined the relationship between stressful life events (SLEs) and subjective age (SA), the results were inconclusive and the mechanisms linking the association were unclear. This study investigated whether the experience of SLEs was associated with an older SA and the potential mediating role of depression linking this association in a cross-sectional study of older adults in China.

METHODS

Data were drawn from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 7643 participants aged 60 and older. The association between SLEs and SA was examined using multivariate linear regression, and the mediation effect of depression was evaluated.

RESULTS

Experiencing SLEs over the past year was associated with a 0.018 increase in proportional felt age (95 % CI: 0.012, 0.024) and a 0.011 increase in proportional look age (95 % CI: 0.005, 0.016), respectively. Depression appeared to be a significant mediator, accounting for 22.2 % and 27.3 % of the association of SLEs with proportional felt age and proportional look age, respectively.

CONCLUSION

Findings revealed that having SLEs was associated with an older SA, partially through the pathway of depression. More attention and appropriate intervention should be given to the older adults incurring SLEs to prevent the adverse effect of older SA.