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Lange M, Löwe A, Stassen G, Schaller A. Health literacy, health status and health behaviors of German students- study protocol for the "Healthy Habits" cohort study. BMC Public Health 2021; 21:1523. [PMID: 34362337 PMCID: PMC8344330 DOI: 10.1186/s12889-021-11542-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The emerging adulthood is traditionally viewed as a time of optimal health, but also as a critical life span, characterized by changing life circumstances and the establishment of an individual lifestyle. Especially university life seems to hold several challenges impeding the manifestation of a health supporting manner, as many students tend to show a poorer health behavior and a higher amount of health-related problems than comparable age groups. This, along with a steady growth of the higher education sector, brings increased attention to the university setting in the context of prevention. To date, there are few empirical longitudinal and coherent cross-sectional data on the status of students' health literacy, health status, and health behaviors, and on the impact of the study format on students' health. The aim of this prospective cohort study is to reduce this research gap. METHODS Starting during winter semester 2020/21, the prospective cohort study collects data on health literacy, health status and health behavior on a semester-by-semester basis. All enrolled students of the IST University of Applied Sciences, regardless of study format and discipline, can participate in the study at the beginning of their first semester. The data are collected digitally via a specifically programmed app. A total of 103 items assess the subjectively perceived health status, life and study satisfaction, sleep quality, perceived stress, physical activity, diet, smoking, alcohol consumption, drug addiction and health literacy. Statistical analysis uses (1) multivariate methods to look at changes within the three health dimensions over time and (2) the association between the three health dimensions using multiple regression methods and correlations. DISCUSSION This cohort study collects comprehensive health data from students on the course of study. It is assumed that gathered data will provide information on how the state of health develops over the study period. Also, different degrees of correlations of health behavior and health literacy will reveal different impacts on the state of students' health. Furthermore, this study will contribute to empirically justified development of target group-specific interventions. TRIAL REGISTRATION German Clinical Trials Register: DRKS00023397 (registered on October 26, 2020).
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Affiliation(s)
- Martin Lange
- Department of Fitness and Health, IST University of Applied Sciences, Erkrather Straße 220 a-c, 40233, Düsseldorf, Germany.
| | - Alexandra Löwe
- Department of Fitness and Health, IST University of Applied Sciences, Erkrather Straße 220 a-c, 40233, Düsseldorf, Germany
| | - Gerrit Stassen
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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202
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Nixon P, Boß L, Heber E, Ebert DD, Lehr D. A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention. BMC Public Health 2021; 21:1511. [PMID: 34353294 PMCID: PMC8339390 DOI: 10.1186/s12889-021-11504-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/16/2021] [Indexed: 02/08/2023] Open
Abstract
Background Web-based stress management interventions (SMI) fit increasingly digital lifestyles, reduce barriers of uptake and are easily scalable. SMIs might lower levels of stress in employees and thereby contribute to the prevention of depressive symptomatology. Different guidance formats can impact the efficacy of SMIs, with higher intensity assumed to result in larger effects. However, head-to-head comparisons of guidance formats are rare. This is the first trial to examine the impact of adherence-focused guidance compared to self-help on the efficacy of an occupational SMI compared to a wait list control condition. Additionally, it will be investigated if the SMI enfolds its impact on preventing depressive symptomatology by different pathways through reducing health impairing and increasing promoting factors. Methods A three-armed randomised controlled trial (RCT) on an occupational SMI was conducted. 404 employees with elevated levels of perceived stress (PSS-10 ≥ 22) were randomly assigned to: adherence-focused guidance (AFG), self-help (SH) or a wait list control group (WLC). The primary outcome was perceived stress (PSS-10). Secondary outcomes included health- and work-related measures. A parallel mediation analysis with stress and resilience as mediators for the effect on depression (CES-D) was carried out. Data collection took place at baseline (T1), after 7 weeks (T2) and 6 months (T3). Results The SMI was effective for all groups on the primary and secondary outcomes. For stress, analyses of covariance (ANCOVA) revealed significant group effects at T2 (F2,400 = 36.08, P < .001) and T3 (F2,400 = 37.04, P < .001) with large effect sizes for AFG (T2: d = 0.83; T3: d = 0.85) and SH (T2: d = 0.88; T3: d = 0.91) compared to WLC. No significant group differences were found for the efficacy between AFG and SH on the outcomes. Adherence in terms of completed modules was significantly higher for AFG compared to SH. The SMI’s impact on depression was mediated by perceived stress: a1b1 = − 0.77, 95% CI [− 1.26, − 0.34] and resilience: a2b2 = − 0.62, 95% CI [− 1.05, − 0.26]. Conclusions The SMI was effective for reducing stress and improving other health- and work-related outcomes, irrespective of the guidance format. Results did not demonstrate superiority of adherence-focused guidance for the efficacy but for adherence in terms of completed modules. Among other reasons, better communication strategies about offered guidance and awareness-raising measures are discussed. Results from mediation analysis suggest that preventive SMIs should be designed to reach two goals: reducing the risk factor of stress and simultaneously increasing health promoting factors such as resilience. Trial registration German Clinical Trial Registration (DRKS) DRKS00005687, 6/6/2014.
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Affiliation(s)
- Patricia Nixon
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany
| | - Elena Heber
- Department for Sport & Health Sciences, Technical University of Munich, Psychology & Digital Mental Health Care, Munich, Germany
| | | | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University of Lueneburg, Lueneburg, Germany.
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203
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Vincent A, Beck K, Becker C, Zumbrunn S, Ramin-Wright M, Urben T, Quinto A, Schaefert R, Meinlschmidt G, Gaab J, Reinhardt T, Bassetti S, Schuetz P, Hunziker S. Psychological burden in patients with COVID-19 and their relatives 90 days after hospitalization: A prospective observational cohort study. J Psychosom Res 2021; 147:110526. [PMID: 34051515 PMCID: PMC8132501 DOI: 10.1016/j.jpsychores.2021.110526] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 01/28/2023]
Abstract
OBJECTIVE COVID-19 causes psychological distress for patients and their relatives at short term. However, little research addressed the longer-term psychological outcomes in this population. Therefore, we aimed to prospectively assess clinically relevant psychological distress in hospitalized patients with COVID-19 and their relatives 90 days after hospital discharge. METHODS This exploratory, prospective, observational cohort study included consecutive adult patients hospitalized in two Swiss tertiary-care hospitals between March and June 2020 for confirmed COVID-19 and their relatives. The primary outcome was psychological distress defined as clinically relevant symptoms of anxiety and/or depression measured with the Hospital Anxiety and Depression Scale (HADS) 90 days after discharge. RESULTS Clinically relevant psychological distress 90 days after hospital discharge was present in 23/108 patients (21.3%) and 22/120 relatives (18.3%). For patients, risk and protective factors associated with clinically relevant psychological distress included sociodemographic, illness-related, psychosocial, and hospital-related factors. A model including these factors showed good discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.84. For relatives, relevant risk factors were illness-related, psychosocial, and hospital-related factors. Resilience was negatively associated with anxiety and depression in both patients and relatives and regarding PTSD in relatives only. CONCLUSION COVID-19 is linked to clinically relevant psychological distress in a subgroup of patients and their relatives 90 days after hospitalization. If confirmed in an independent and larger patient cohort, knowledge about these potential risk and protective factors might help to develop preventive strategies.
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Affiliation(s)
- Alessia Vincent
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland,Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Katharina Beck
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Christoph Becker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland,Emergency Department, University Hospital Basel, Basel, Switzerland
| | - Samuel Zumbrunn
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Maja Ramin-Wright
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Tabita Urben
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Adrian Quinto
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Rainer Schaefert
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland,Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland,Medical Faculty of the University of Basel, Basel, Switzerland
| | - Gunther Meinlschmidt
- Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland,Medical Faculty of the University of Basel, Basel, Switzerland,Division of Clinical Psychology and Cognitive Behavioural Therapy, International Psychoanalytic University, Berlin, Germany,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Jens Gaab
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Switzerland
| | - Thomas Reinhardt
- Human Resources & Leadership Development, University Hospital Basel, Basel, Switzerland
| | - Stefano Bassetti
- Medical Faculty of the University of Basel, Basel, Switzerland,Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Philipp Schuetz
- Medical Faculty of the University of Basel, Basel, Switzerland,Department of Internal Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Sabina Hunziker
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Department for Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland; Medical Faculty of the University of Basel, Basel, Switzerland.
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204
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Wissmath B, Mast FW, Kraus F, Weibel D. Understanding the psychological impact of the COVID-19 pandemic and containment measures: An empirical model of stress. PLoS One 2021; 16:e0254883. [PMID: 34324498 PMCID: PMC8320973 DOI: 10.1371/journal.pone.0254883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/06/2021] [Indexed: 11/19/2022] Open
Abstract
Epidemics such as COVID-19 and corresponding containment measures are assumed to cause psychological stress. In a survey during the lockdown in Switzerland (n = 1565), we found substantially increased levels of stress in the population. In particular, individuals who did not agree with the containment measures, as well as those who saw nothing positive in the crisis, experienced high levels of stress. In contrast, individuals who are part of a risk group or who are working in healthcare or in essential shops experienced similar stress levels as the general public. The psychological mechanisms that determine stress, caused by the COVID-19 pandemic and containment measures, are not yet clear. Thus, we conducted a path analysis to gain a deeper understanding of the psychological mechanisms that lead to stress. Experiencing fear of the disease is a key driver for being worried. Our model further shows that worries about the individual, social, and economic consequences of the crisis, strongly boost stress. The infection rate in the canton (i.e., state) of residence also contributes to stress. Positive thinking and perceived social, organizational, and governmental support mitigate worries and stress. Our findings indicate that containment measures increase worries and stress, especially for those who feel that these measures either are not sufficient or go too far. Thus, highlighting positive aspects of the crisis and convincing people of the effectiveness and necessity of mitigation measures can, not only promote compliance, but also reduce stress. Our model suggests that people who feel protected by the authorities have fewer worries, which can, in turn, limit the negative impact of the crisis on mental health.
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Affiliation(s)
- Bartholomäus Wissmath
- Institute of Psychology, University of Bern, Bern, Switzerland
- w hoch 2 GmbH, Bern, Switzerland
- Swiss Distance Learning University, Brig, Switzerland
| | - Fred W. Mast
- Institute of Psychology, University of Bern, Bern, Switzerland
- Swiss Distance Learning University, Brig, Switzerland
| | - Fabian Kraus
- Institute of Psychology, University of Bern, Bern, Switzerland
- w hoch 2 GmbH, Bern, Switzerland
| | - David Weibel
- Institute of Psychology, University of Bern, Bern, Switzerland
- w hoch 2 GmbH, Bern, Switzerland
- Swiss Distance Learning University, Brig, Switzerland
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205
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Wepf H, Joseph S, Leu A. Pathways to Mental Well-Being in Young Carers: The Role of Benefit Finding, Coping, Helplessness, and Caring Tasks. J Youth Adolesc 2021; 50:1911-1924. [PMID: 34282492 PMCID: PMC8352805 DOI: 10.1007/s10964-021-01478-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/03/2021] [Indexed: 11/26/2022]
Abstract
Although prior research has shown that young carers may perceive benefits from their challenging situation, it is unclear how and when benefit finding leads to better mental health. This study examines pathways through which benefit finding may influence mental well-being. Self-reported data were obtained from 601 adolescents aged 15–21 (Mage = 17.87, 71.9% female) who provided care for a close person with physical or mental health problems. Benefit finding was associated with better mental well-being directly as well as indirectly via better coping and lower helplessness. These findings were similar across young carers with different caring task profiles, except for a few differences regarding social/emotional and instrumental care. The study suggests that benefit finding could promote coping skills and mental well-being in adolescent young carers with implications for the design of future research on interventions with young carers.
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Affiliation(s)
- Hannah Wepf
- Department of Psychology, University of Zurich, Zurich, Switzerland.
- Careum School of Health, Kalaidos University of Applied Sciences, Zurich, Switzerland.
| | - Stephen Joseph
- School of Education, University of Nottingham, Nottingham, UK
| | - Agnes Leu
- Careum School of Health, Kalaidos University of Applied Sciences, Zurich, Switzerland
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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206
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Huang C, Xie J, Owusua T, Chen Z, Wang J, Qin C, He Q. Is psychological flexibility a mediator between perceived stress and general anxiety or depression among suspected patients of the 2019 coronavirus disease (COVID-19)? PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 183:111132. [PMID: 34305218 PMCID: PMC8279940 DOI: 10.1016/j.paid.2021.111132] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/06/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022]
Abstract
This study is aimed to investigate the status of general anxiety and depression among suspected patients of COVID-19 and explore whether psychological flexibility can serve as a mediator between perceived stress and general anxiety or depression. Total of 180 participants completed the online questionnaire which comprised demographic information, the Perceived Stress Scale (PSS), the 7-item Generalized Anxiety Disorder scale (GAD-7), the 9-item Patients Health Questionnaire (PHQ-9), the Acceptance and Action Questionnaire-II (AAQ-II) and the Cognitive Fusion Questionnaire (CFQ). Statistical methods including correlation analysis, multiple linear regression analysis and structural equation model were used in this study. The scores of 23.9% (43/180) and 34.4% (62/180) of participants were higher than the cut points of GAD-7 and PHQ-9 respectively. Psychological flexibility was significantly correlated with perceived stress, general anxiety and depression. Multiple regression analyses showed the possible mediation effect of psychological flexibility between perceived stress and general anxiety or depression. The structural equation model confirmed that psychological flexibility partially mediated between perceived stress and general anxiety or depression. Our findings suggested the potential benefit of Acceptance and Commitment Therapy (ACT) as a psychological support approach in suspected patients of COVID-19 because ACT targets psychological flexibility.
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Affiliation(s)
- Chi Huang
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha 410013, China
| | - Jiaying Xie
- XiangYa School of Nursing, Central South University, Changsha 410013, China
| | - Theresah Owusua
- XiangYa School of Nursing, Central South University, Changsha 410013, China
| | - Zhiheng Chen
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha 410013, China
| | - Jiangang Wang
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha 410013, China
| | - Chunxiang Qin
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha 410013, China
| | - Qingnan He
- Department of Health Management, The Third XiangYa Hospital, Central South University, Changsha 410013, China
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207
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Voltmer E, Köslich-Strumann S, Walther A, Kasem M, Obst K, Kötter T. The impact of the COVID-19 pandemic on stress, mental health and coping behavior in German University students - a longitudinal study before and after the onset of the pandemic. BMC Public Health 2021; 21:1385. [PMID: 34256717 PMCID: PMC8275908 DOI: 10.1186/s12889-021-11295-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 06/09/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to massive restrictions in public and private lives, including a shut-down of face-to-face teaching at universities in Germany. We aimed to examine the impact of these changes on perceived stress, mental health and (study-)related health behavior of students in a longitudinal study. METHODS For two timepoints - the year before the COVID-19 pandemic (2019, n = 1377) and the year during the COVID-19 pandemic (2020, n = 1867) - we surveyed students of all faculties at one German university for perceptions and preventive behavior regarding the COVID-19 pandemic using standard instruments for stress, anxiety, depression, and behavior and experience patterns. RESULTS About 90% of students (n = 1633) in 2020 did not have a known contact infected with SARS-CoV-2, while 180 (9.8%) did have one. Only 10 respondents (0.5%) reported an infection with SARS-CoV-2. Wearing masks and washing hands more often were practiced by ≥80% of students. Taking more care about cleanliness (51.8%) and using disinfectants (39.2%) were practiced much less. A higher percentage of female compared with male students and medical/health science students compared with science, technology, engineering, and mathematics students engaged more frequently in specific or nonspecific preventive measures. More than three quarters (77.1%) of all students rated their general health as (very) good. There were no significant differences in general health, stress, and depression between 2019 and 2020 in the students who responded at both timepoints. The distribution of behavior and experience patterns for this group showed a slight but significant difference from 2019 to 2020, namely decreasing proportions of students with a healthy pattern and a risk pattern for overexertion. Students with different behavior and experience patterns showed marked differences in perceptions and reaction to the COVID-19 pandemic as well as psychosocial stress and symptoms, with higher scores for mental health symptoms and lower scores in preventive behavior regarding risk patterns. CONCLUSION Despite massive alterations to students' lives in 2020, there were only moderate consequences for mental health compared with 2019 in the total student group of this German university. However, identifying students at risk would offer opportunities to foster mental health in relevant subgroups.
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Affiliation(s)
- Edgar Voltmer
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Susen Köslich-Strumann
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Anna Walther
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Mahmoud Kasem
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Katrin Obst
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Thomas Kötter
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, 23562, Lübeck, Germany
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208
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Levkovich I, Shinan-Altman S. Impact of the COVID-19 pandemic on stress and emotional reactions in Israel: a mixed-methods study. Int Health 2021; 13:358-366. [PMID: 33049782 PMCID: PMC7665529 DOI: 10.1093/inthealth/ihaa081] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/08/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a profound impact worldwide. This study sought to assess the pandemic's psychological impact on the Israeli public. METHODS Using mixed methods we assessed Israeli adults during the COVID-19 outbreak. In the quantitative study, participants (N=1407) completed an online battery of measures assessing psychological variables and perceived threat related to COVID-19. Statistical analyses included tests for between-group differences and Pearson correlations. The qualitative study entailed in-depth, semistructured interviews conducted by telephone (N=38). RESULTS The quantitative findings indicate that about 48% of the public had negative emotional reactions and 20% perceived they were liable to contract the virus. Moreover, a positive correlation was found between these feelings and the degree of perceived threat. Three major themes emerged from the qualitative study: 1) a sense of shock and chaos; 2) gradual adjustment to the new reality; and 3) fears and concerns for self and family members. The study's results revealed the following sources of participants' emotional responses and sense of threat: health concerns regarding themselves and their loved ones; employment concerns; problems with children and spouses caused by being together at home; and difficulties entailed in working at home. CONCLUSIONS The study reveals many of the psychological variables and perceived threats related to COVID-19 in Israel. While social distancing may make people feel safer, it can also increase their feelings of isolation, stress and frustration and cause difficulties in many life situations. The findings point to the necessity of addressing the public's perceived susceptibility and emotional reactions about COVID-19.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon 36006, Israel
| | - Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work Bar Ilan University, Max and Anna Web st., Ramat Gan 5290002, Israel
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209
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Giessing L, Kannen J, Strahler J, Frenkel MO. Direct and Stress-Buffering Effects of COVID-19-Related Changes in Exercise Activity on the Well-Being of German Sport Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7117. [PMID: 34281054 PMCID: PMC8297212 DOI: 10.3390/ijerph18137117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/31/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022]
Abstract
Maintaining or initiating exercise activity in the COVID-19 pandemic may act as a buffer against the observed stress-related deterioration in well-being, with emotion regulation (ER) discussed as a possible moderator. Therefore, the present study investigated the interaction between stress, exercise activity (EA), and ER on mood. In an online survey, 366 German sports science students (56% women, Mage = 23.04, SD = 2.87) reported their stress levels (general and COVID-19-specific), mood (energy, valence, calmness), EA before and during the pandemic, and use of ER strategies in spring 2020. Pandemic-related change in EA was calculated as residual change. Due to gender differences in mental health and EA, the main and interaction effects were tested in twelve hierarchical regression analyses, separately for men and women. Overall, EA significantly decreased during the pandemic and was positively associated with energy in both men and women. ER was positively associated with women's energy, but negatively with all three mood dimensions in men. Only one three-way interaction appeared significant: in the case of high stress, low levels of EA and high use of ER were associated with the greatest deteriorations in energy in men. Our findings suggest that EA may buffer deteriorations in energy in men with high stress and difficulties in ER.
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Affiliation(s)
- Laura Giessing
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
| | - Julia Kannen
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
| | - Jana Strahler
- Faculty of Psychology and Sport Science, Justus-Liebig University Gießen, 35394 Gießen, Germany;
| | - Marie Ottilie Frenkel
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
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210
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Karing C. Prevalence and predictors of anxiety, depression and stress among university students during the period of the first lockdown in Germany. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 5:100174. [PMID: 34642682 PMCID: PMC8497174 DOI: 10.1016/j.jadr.2021.100174] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbates the risk for mental health issues of university students. The aims of the study were to investigate the prevalence of anxiety, depression and stress among university students during the period of the first lockdown in Germany, and the associations of possible risk and protective factors with all three outcome variables. METHODS A total of 2.548 university students were included in the study. The study took place during the period of the first lockdown in Germany. Multiple hierarchical regression analyses were conducted to explore the role of demographic variables, personality traits, psychological capital variables, mindfulness, COVID-19 related variables, and coping strategies on anxiety, depression and stress. RESULTS Results showed on average mild depressive and anxiety symptoms, and moderate perceived stress among the students. Alarmingly, 35.9% of the students showed a moderate-to-severe level of depression, 27.7% reported moderate to severe symptoms of anxiety, and 25.1% perceived high stress. Mindfulness and optimism were the most relevant protective factors against depression, anxiety and stress, whereas COVID-related stressors (e.g., worries about study and financial problems, being stressed by the Corona-pandemic and media reporting, quarantine experience) as well as personal characteristics (e.g., neuroticism, older age, being female) were risk factors for increasing mental health issues and/ or stress. CONCLUSION The pandemic has negatively affected the mental health of students. The results emphasize the importance of both professional help for students with mental health problems and effective prevention programs on university campuses that promote coping skills, and mental health during the current pandemic.
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Affiliation(s)
- Constance Karing
- Friedrich-Schiller-Universität Jena, Friedrich-Schiller-Universitat Jena, Jena, Germany
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211
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Hödl M, Bauer S, Eglseer D, Fangmeyer M, Flatscher-Thöni M, Kellerer J, Kreyer C, Müller G, Pallauf M, Rohringer M, Toromanova A, Schoberer D. [Make nursing practice visible through nursing science in times of COVID-19]. Wien Med Wochenschr 2021; 171:340-347. [PMID: 34196875 PMCID: PMC8246423 DOI: 10.1007/s10354-021-00858-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
Die Pflegepraxis steht durch die COVID-19-Pandemie vor enormen Herausforderungen. Dennoch war die Pflegewissenschaft als Sprachrohr für die Praxis im öffentlichen Diskurs rund um die COVID-19-Pandemie kaum aktiv vertreten. Dementsprechend stellt sich die Frage, welche Projekte mit Fokus auf Pflege und COVID-19 an österreichischen Hochschulen durchgeführt wurden. Insgesamt wurden 6 Projekte mittels Schneeballverfahren identifiziert. Eine Studie zeigte, dass eine erhöhte Tragedauer von Masken mit einem erhöhten Stresslevel der Pflegepersonen zusammenhängt. Ein weiteres Studienergebnis zeigte, dass 50 % der Laien, Masken fehlerhaft benutzten. Individuelle Erfahrungen, getroffene Maßnahmen und Lösungsansätze aus der Sicht der Pflegepersonen hinsichtlich ethischer Herausforderungen in Pflegeheimen wurden in einem weiteren Projekt erhoben. Durch diese und andere Projekte ergreift die Pflegewissenschaft mit ihren Erkenntnissen als Sprachrohr für Pflegekräfte die Initiative und bringt sich in den COVID-19-Diskurs ein. Die Erkenntnisse aus den Projekten können zukünftig als Basis für politische Entscheidungen genutzt werden.
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Affiliation(s)
- Manuela Hödl
- Institut für Pflegewissenschaft, Medizinische Universität Graz, Universitätsplatz 4, 8010, Graz, Österreich.
| | - Silvia Bauer
- Institut für Pflegewissenschaft, Medizinische Universität Graz, Universitätsplatz 4, 8010, Graz, Österreich
| | - Doris Eglseer
- Institut für Pflegewissenschaft, Medizinische Universität Graz, Universitätsplatz 4, 8010, Graz, Österreich
| | - Martin Fangmeyer
- Department für Evidenzbasierte Medizin und Evaluation, Zentrum Cochrane Österreich, Donau-Universität Krems, Krems, Österreich
| | - Magdalena Flatscher-Thöni
- Institut für Public Health, Medical Decision Making und HTA, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Jan Kellerer
- Institut für Pflegewissenschaft, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Christiane Kreyer
- Institut für Pflegewissenschaft, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Gerhard Müller
- Institut für Pflegewissenschaft, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Martin Pallauf
- Institut für Pflegewissenschaft, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Matthias Rohringer
- Institut für Pflegewissenschaft, UMIT - Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik, Hall in Tirol, Österreich
| | - Ana Toromanova
- Department für Evidenzbasierte Medizin und Evaluation, Zentrum Cochrane Österreich, Donau-Universität Krems, Krems, Österreich
| | - Daniela Schoberer
- Institut für Pflegewissenschaft, Medizinische Universität Graz, Universitätsplatz 4, 8010, Graz, Österreich
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Hoedl M, Eglseer D, Bauer S. Associations between personal protective equipment and nursing staff stress during the COVID-19 pandemic. J Nurs Manag 2021; 29:2374-2382. [PMID: 34174009 PMCID: PMC8420325 DOI: 10.1111/jonm.13400] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 06/08/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022]
Abstract
Aim This study gives insights into the association between the use of personal protective equipment (PPE), wearing time of masks and stress among frontline nursing staff during the COVID‐19 pandemic. Background PPE can have physical consequences like headache and pain, which could result in increased nurse stress levels. Methods A total of 2600 nurses participated in this online survey. The questionnaire is based on literature and includes the perceived level of stress scale. Results We found no significant association between the use of PPE and stress. Nurses who wore masks for more than 8 h had significant higher stress levels than those who used the masks for a shorter period. Conclusions The duration of wearing masks is associated with nurse's stress level. Our findings can help nurses to argue a higher frequency of breaks and a maximum duration of mask usage in their organisations. Implications for Nursing Management We recommend that nursing managers implement practical strategies such as a mask break task force. This task force could promote awareness for mask breaks and recommend and allocate rooms or locations such as balconies for mask breaks.
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Affiliation(s)
- Manuela Hoedl
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Doris Eglseer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Silvia Bauer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
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213
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Andhavarapu M, Orwa J, Temmerman M, Musana JW. Maternal Sociodemographic Factors and Antenatal Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136812. [PMID: 34201920 PMCID: PMC8297233 DOI: 10.3390/ijerph18136812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 11/24/2022]
Abstract
Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We conducted a secondary analysis of data from 150 pregnant women attending antenatal care services at a rural referral hospital in Kenya. The participants completed a sociodemographic and clinical questionnaire, the Cohen’s Perceived Stress Scale (PSS) and gave a hair sample for cortisol and cortisone analysis. The association between selected sociodemographic predictors (age, parity, marital status, maternal education, household income, polygyny, and intimate partner violence) and outcomes (hair cortisol, hair cortisone, and PSS score) was examined using univariate, bivariate and multivariate models. We found a negative association between PSS scores and household income (β = −2.40, p = 0.016, 95% CI = −4.36, −0.45). There was a positive association of the ratio of hair cortisone to cortisol with Adolescent age group (β = 0.64, p = 0.031, 95% CI = 0.06, 1.22), and a negative association with Cohabitation (β = −1.21, p = 0.009, 95% CI = −2.11, −0.31). We conclude that household income influenced psychological stress in pregnancy. Adolescence and cohabitation may have an influence on biological stress, but the nature of this effect is unclear.
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Affiliation(s)
- Maheshwari Andhavarapu
- Department of Obstetrics & Gynaecology, The Aga Khan University, Nairobi 00100, Kenya; (M.T.); (J.W.M.)
- Correspondence: ; Tel.: +254-720-885527
| | - James Orwa
- Department of Population Health, The Aga Khan University, Nairobi 00100, Kenya;
| | - Marleen Temmerman
- Department of Obstetrics & Gynaecology, The Aga Khan University, Nairobi 00100, Kenya; (M.T.); (J.W.M.)
| | - Joseph Wangira Musana
- Department of Obstetrics & Gynaecology, The Aga Khan University, Nairobi 00100, Kenya; (M.T.); (J.W.M.)
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Schmidt K, Kleine-Borgmann J, Holle-Lee D, Gaul C, Bingel U. Impact of a 12-week open-label placebo treatment on headache days in episodic and chronic migraine: a study protocol for a parallel-group, multicentre, randomised controlled trial. BMJ Open 2021; 11:e045969. [PMID: 34162645 PMCID: PMC8230930 DOI: 10.1136/bmjopen-2020-045969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Migraine is the most common neurological disorder and one of the major causes of years lived with disability. Its treatment (especially of chronic forms) is often challenging and accompanied with adverse effects. Although new therapeutic approaches have recently emerged (eg, calcitonin gene-related peptide antibodies), these are linked to strict prescribing guidelines and therefore limited to only a minority of patients. Recently, randomised controlled trials have demonstrated that open-label placebo treatments can lead to significant and clinically relevant improvements of chronic pain conditions. METHODS AND ANALYSIS This multicentre, randomised controlled clinical trial following a parallel group between-subject design aims to systematically investigate the impact of a 12-week open-label placebo treatment on moderate to severe headache days (primary outcome) in patients with episodic and chronic migraine in addition to treatment as usual. Secondary outcomes comprise the number of migraine days, pain intensity, intake of acute medication, quality of life, disability, global impression of change, tolerability and a responder rate. To systematically address potential predictors of placebo responses in patients with migraine, this study assesses potential psychometric predictors, salivary cortisol and alpha-amylase awakening responses, catechol-o-methyltransferase Val158Met polymorphisms, as well as functional and structural brain connectivity (ie, resting state functional MRI, diffusion tensor imaging). The data analysis will be performed on basis of the general linear model considering repeated measures (mixed model). ETHICS AND DISSEMINATION This protocol and all corresponding documents were approved with regard to their content and compliance with ethical regulations by the Ethics Committee of the Medical Faculty of the University Duisburg-Essen, Germany and the Ethics Committee of the Landesärztekammer Hessen. The results from this study will be actively disseminated through manuscript publications and conference presentations. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00021259).
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Affiliation(s)
- Katharina Schmidt
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Julian Kleine-Borgmann
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Dagny Holle-Lee
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
| | - Charly Gaul
- Migraine and Headache Clinic Koenigstein, Königstein im Taunus, Germany
| | - Ulrike Bingel
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Medicine Essen, Essen, Germany
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Lipert A, Kozłowski R, Timler D, Marczak M, Musiał K, Rasmus P, Kamecka K, Jegier A. Physical Activity as a Predictor of the Level of Stress and Quality of Sleep during COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115811. [PMID: 34071446 PMCID: PMC8198542 DOI: 10.3390/ijerph18115811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023]
Abstract
Background: The coronavirus pandemic and the government restrictions significantly disturbed the daily functioning of people, thereby influencing healthy behaviors, such as physical activity—the core indicator of well-being. This study evaluates the associations between physical activity (PA), the level of stress and quality of sleep during the COVID-19 pandemic lockdown. Methods: An online survey was distributed during the governmental lockdown in April 2020 and included measures for assessing physical activity, stress and sleep. The surveyed participants included all adults aged 18 years and over. The final data were collected from the 1959 respondents using: International Physical Activity Questionnaire-Short Form (IPAQ-SF), Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Findings: Almost half of the respondents indicated a low level of PA, performing only 60 min of PA daily. Most of the participants reported a moderate or high level of stress (57% and 29%, respectively) and 64% of them reported poor quality of sleep. People with low levels of stress performed on average 85.1 min/day of walking (WPA), 40.9 min/day of moderate PA (MPA) or 52.6 min/day of vigorous PA (VPA). People with good quality of sleep performed 82.9 min/day of WPA, 43.6 min/day MPA and 40.5 min/day VPA. Interpretation: The results from the study indicate that the volume of daily PA may be a predictor of the level of stress and sleep quality in adults during the COVID-19 pandemic lockdown. To retain a low level of stress and good quality of sleep, a lifestyle that allows to achieve a moderate level of physical activity should be maintained. The optimal daily dose of PA is at least 70 min per day, involving different intensities.
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Affiliation(s)
- Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
- Correspondence:
| | - Remigiusz Kozłowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland;
| | - Dariusz Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (K.K.)
| | - Kamila Musiał
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
| | - Paweł Rasmus
- Department of Medical Psychology, Medical University of Lodz, 90-131 Lodz, Poland;
| | - Karolina Kamecka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (K.K.)
| | - Anna Jegier
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland; (K.M.); (A.J.)
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Apolinário-Hagen J, Harrer M, Dederichs M, Fritsche L, Wopperer J, Wals F, Loerbroks A, Lehr D, Salewski C, Angerer P, Ebert DD. Exploring the influence of testimonial source on attitudes towards e-mental health interventions among university students: Four-group randomized controlled trial. PLoS One 2021; 16:e0252012. [PMID: 34038455 PMCID: PMC8153476 DOI: 10.1371/journal.pone.0252012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 05/09/2021] [Indexed: 11/18/2022] Open
Abstract
Electronic mental health services (eMHSs) offer additional options for the dissemination of psychological interventions for university students. Still, many university students are reluctant to use eMHSs. Narrative messages may help increase the awareness and acceptance of quality-approved programs. However, little is known about the usefulness of narrative messages to improve attitudes towards eMHSs. In this experiment, we thus aimed to explore in how far different ways of targeting information to students affect their attitudes towards eMHSs for stress prevention and therapy, and to identify potential determinants of attitude change. N = 451 students (Mean = 32.6 years, SD = 10.2, 75% female, 7% with eMHS experience) were randomly assigned to one of four study arms involving information designed to induce different levels of perceived similarity. While the active control condition only received general information (arm 1, “information only”, n = 116), the other experimental arms were additionally exposed to testimonials on specific eMHSs either addressing an unspecified audience (arm 2, n = 112), employees (arm 3, n = 115) or working university students (arm 4, n = 108). Two-way ANOVA revealed no impact of information on the alteration of attitudes towards eMHSs for stress coping (d = 0.20). Only a small effect of target-group specific testimonials on attitudes towards online therapies was identified at post-intervention (d = 0.29). Regression analyses demonstrated significant influences of source credibility and perceived similarity on attitudes for preventative eMHSs (ps<0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicated no meaningful impact of information on attitudes and limited evidence for benefits of tailored narrative messages. Since attitudes were already positive at baseline, further research with a representative student sample mimicking real-world decision scenarios is needed to gain an in-depth understanding of acceptance-facilitating message features that may contribute to promote the adoption of evidence-based eMHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Melina Dederichs
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Jeannette Wopperer
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Frank Wals
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Adrian Loerbroks
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - Christel Salewski
- Faculty of Psychology, Department of Health Psychology, University of Hagen, Hagen, Germany
| | - Peter Angerer
- Faculty of Medicine, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Daniel Ebert
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Süss H, Willi J, Grub J, Ehlert U. Estradiol and progesterone as resilience markers? - Findings from the Swiss Perimenopause Study. Psychoneuroendocrinology 2021; 127:105177. [PMID: 33676150 DOI: 10.1016/j.psyneuen.2021.105177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/12/2021] [Accepted: 02/24/2021] [Indexed: 12/13/2022]
Abstract
While resilience seems to be associated with a variety of biological markers, studies assessing such correlates in women during the perimenopause are lacking. The perimenopause constitutes a phase of major biopsychosocial changes, during which the sex hormones estradiol (E2) and progesterone (P4) eventually decrease significantly. The aim of this study was to examine the extent to which the declining levels of E2 and P4 serve as resilience markers in perimenopausal women. In 129 healthy perimenopausal women aged 40-56 years, saliva samples were collected on every fourth day over a period of four weeks in order to investigate E2 and P4 levels. All participants completed psychosocial questionnaires including variables related to resilience, well-being, and mental health. Perimenopausal status was determined using the Stages of Reproductive Aging Workshop (STRAW) criteria. The results indicate that P4 is linked to psychosocial resilience. More precisely, women with higher P4 levels seem to be more resilient than women with lower P4 levels, irrespective of the perimenopausal status. No such relation was found for E2 levels. Further analyses revealed that women with higher P4 levels experience significantly higher life satisfaction, lower perceived stress, and lower depressive symptoms than women with lower P4 levels. Accordingly, P4 can be considered as a biological marker of resilience in perimenopause.
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Affiliation(s)
- Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Parent C, Pokhvisneva I, de Mendonça Filho EJ, O'Donnell KJ, Meaney MJ, Kee MZL, Thng G, Wing H, Adler NE, Keeton V, Pantell MS, Hessler D, Gottlieb LM, Silveira PP. Salivary cytokine cluster moderates the association between caregivers perceived stress and emotional functioning in youth. Brain Behav Immun 2021; 94:125-137. [PMID: 33662503 DOI: 10.1016/j.bbi.2021.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/14/2021] [Accepted: 02/24/2021] [Indexed: 10/22/2022] Open
Abstract
Some individuals exposed to early life stress show evidence of enhanced systemic inflammation and are at greater risk for psychopathology. In the current study, caregivers and their offspring (0-17 years) were recruited at a pediatric clinic visit at the University of California, San Francisco (UCSF). Mothers and seven-year-old children from the Growing Up inSingaporeTowards healthy Outcomes (GUSTO) prospective birth cohort were used as a replication cohort. Caregivers perceived stress was measured to determine potential intergenerational effects on the children's functioning and inflammation levels. Children's emotional functioning in the UCSF cohort was evaluated using the Pediatric Quality of Life (PedsQL) inventory. Child emotional and behavioral functioning was measured using the Child Behavior Checklist (CBCL) in GUSTO. Saliva was collected from the children and salivary levels of IL-6, IL-1β, IL-8 and TNF-α were measured using an electrochemiluminescent cytokine multiplex panel. Child IL-6, IL-1β, IL-8 cytokine levels were clustered into low, average, and high cytokine cluster groups using hierarchical cluster analysis. We did not find that salivary cytokine clusters were significantly associated with children's emotional or behavioral function. However, cytokine clusters did significantly moderate the association between increased caregiver perceived stress and reduced child emotional functioning (UCSF cohort) and increased Attention-Deficit-Hyperactivity (ADH) problems (GUSTO cohort, uncorrected Cohen's F2 = 0.02). Using a cytokine clustering technique may be useful in identifying those children exposed to increased caregiver perceived stress that are at risk of emotional and attention deficit hyperactivity problems.
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Affiliation(s)
- Carine Parent
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada
| | | | - Kieran J O'Donnell
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; CIFAR, Toronto, ON, Canada; Yale Child Study Center & Department of Obstetrics Gynecology & Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Michael J Meaney
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Republic of Singapore; CIFAR, Toronto, ON, Canada
| | - Michelle Z L Kee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Republic of Singapore
| | - Gladi Thng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Republic of Singapore
| | - Holly Wing
- University of California, San Francisco, Center for Health and Community, San Francisco, CA, United States
| | - Nancy E Adler
- University of California, San Francisco, Department of Psychiatry and Pediatrics, San Francisco, CA, United States
| | - Victoria Keeton
- University of California, San Francisco, Family Health Care Nursing, School of Nursing, San Francisco, CA, United States
| | - Matthew S Pantell
- University of California, San Francisco, Department of Pediatrics, School of Medicine, San Francisco, CA, United States
| | - Danielle Hessler
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, United States
| | - Laura M Gottlieb
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, United States
| | - Patricia P Silveira
- Douglas Mental Health University Institute, Douglas Research Center, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.
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Pieh C, Budimir S, Delgadillo J, Barkham M, Fontaine JRJ, Probst T. Mental Health During COVID-19 Lockdown in the United Kingdom. Psychosom Med 2021; 83:328-337. [PMID: 33009276 DOI: 10.1097/psy.0000000000000871] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The coronavirus disease (COVID-19) pandemic and related lockdown measures have raised important questions about the impact on mental health. This study evaluated several mental health and well-being indicators in a large sample from the United Kingdom (UK) during the COVID-19 lockdown where the death rate is currently among the highest in Europe. METHODS A cross-sectional online survey with a study sample that mirrors general population norms according to sex, age, education, and region was launched 4 weeks after lockdown measures were implemented in the UK. Measures included mental health-related quality of life (World Health Organization Quality-of-Life Brief Version psychological domain), well-being (World Health Organization Well-Being Index), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), perceived stress (Perceived Stress Scale-10), and insomnia (Insomnia Severity Index). Analyses of variances, Bonferroni-corrected post hoc tests, and t tests were applied to examine mental health indicators across different sociodemographic groups (age, sex, employment, income, physical activity, relationship status). RESULTS The sample comprised n = 1006 respondents (54% women) from all regions of the UK. Approximately 52% of respondents screened positive for a common mental disorder, and 28% screened positive for clinical insomnia. Mean scores and standard deviations were as follows: Patient Health Questionnaire-9, mean = 9.0 ± 7.7; Generalized Anxiety Disorder-7, mean = 8.0 ± 6.5; Insomnia Severity Index, mean = 10.4 ± 7.0; Perceived Stress Scale-10, mean = 17.7 ± 7.9; World Health Organization Quality-of-Life Brief Version, mean = 58.6 ± 21.4; and World Health Organization Well-Being Index score, mean = 13.0 ± 6.0. Statistical analyses consistently indicated more severe mental health problems in adults younger than 35 years, women, people with no work, and people with low income (all p values < .05). Mental health indices also varied across UK regions. CONCLUSIONS The prevalence of depressive, anxiety, and insomnia symptoms is significantly higher in the UK relative to prepandemic epidemiological data. Further studies are needed to clarify the causes for these high rates of mental health symptoms.
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Affiliation(s)
- Christoph Pieh
- From the Department for Psychotherapy and Biopsychosocial Health (Pieh, Budimir, Probst), Danube University Krems, Krems an der Donau, Austria; Clinical Psychology Unit, Department of Psychology (Delgadillo, Barkham), University of Sheffield, Sheffield, United Kingdom; and Department of Work, Organization and Society (Budimir, Fontaine), Ghent University, Ghent, Belgium
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Klein E, Zenger M, Tibubos A, Ernst M, Reiner I, Schmalbach B, Brähler E, Beutel M. Loneliness and its relation to mental health in the general population: Validation and norm values of a brief measure. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100120] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Effects of glucose intake on stress reactivity in young, healthy men. Psychoneuroendocrinology 2021; 126:105062. [PMID: 33524887 DOI: 10.1016/j.psyneuen.2020.105062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 11/23/2022]
Abstract
The psychobiological stress response has a broad impact on energy metabolism, while the availability of energy may, in turn, affect the stress response. Specifically, a reduced cortisol response has been found after 8-11 hours of fasting, while glucose intake has led to an increase in cortisol reactivity. We compared the effects of standardized glucose or artificial sweetener drinks, as well as water, ingested prior to a physical (cold pressor test, CPT) or a psychosocial stressor (Trier Social Stress Test, TSST) after four hours of fasting. Healthy male subjects (N = 151) were randomized to one of six groups (either glucose, sweetener or water group and stress induction with the CPT or TSST). Thirty minutes after ingestion, participants were exposed to the stressor. Repeated measures of the subjective stress response, salivary cortisol and alpha amylase as well as continuous heart rate recordings were taken to capture the psychobiological stress response. Capillary blood glucose levels were measured four times. We found significant psychobiological stress responses for all variables and both stressors, but significantly stronger responses for the TSST. Moreover, we found a significant but small effect for a slightly stronger cortisol response to stress after glucose ingestion, which is presumably driven by a more pronounced effect in the TSST compared to the CPT condition. Responder rates did not differ for the three conditions in either the TSST or in the CPT. Our results demonstrate that even after a short fasting timeframe of four hours, higher glucose availability results in slightly higher cortisol stress responses in men.
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Male depression risk, psychological distress, and psychotherapy uptake: Validation of the German version of the male depression risk scale. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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223
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Bablok I, Binder H, Stelzer D, Kaier K, Graf E, Wangler J, Jansky M, Löhr M, Schulz M, Kockläuner M, Geschke K, Wuttke-Linnemann A, Fellgiebel A, Farin E. Primary dementia care based on the individual needs of the patient: study protocol of the cluster randomized controlled trial, DemStepCare. BMC Geriatr 2021; 21:222. [PMID: 33794789 PMCID: PMC8012747 DOI: 10.1186/s12877-021-02114-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 11/27/2022] Open
Abstract
Background Most people with dementia (PwD) are cared for at home, with general practitioners (GPs) playing a key part in the treatment. However, primary dementia care suffers from a number of shortcomings: Often, diagnoses are made too late and therapies by GPs do not follow the guidelines. In cases of acute crises, PwD are too often admitted to hospital with adverse effects on the further course of the disease. The aim of this study is to implement and evaluate a new GP-based, complex dementia care model, DemStepCare. DemStepCare aims to ensure demand-oriented, stepped care for PwD and their caregivers. Methods/design In a cluster randomized controlled trial, the care of PwD receiving a complex intervention, where the GP is supported by a multi-professional team, is compared to (slightly expanded) usual care. GPs are clustered by GP practice, with 120 GP practices participating in total. GP practices are randomized to an intervention or a control group. 800 PwD are to be included per group. Recruitment takes place in Rhineland-Palatinate, Germany. In addition, a second control group with at least 800 PwD will be formed using aggregated routine data from German health insurance companies. The intervention comprises the training of GPs, case management including repeated risk assessment of the patients’ care situation, the demand-oriented service of an outpatient clinic, an electronic case record, external medication analyses and a link to regional support services. The primary aims of the intervention are to positively influence the quality of life for PwD, to reduce the caregivers’ burden, and to reduce the days spent in hospital. Secondary endpoints address medication adequacy and GPs’ attitudes and sensitivity towards dementia, among others. Discussion The GP-based dementia care model DemStepCare is intended to combine a number of promising interventions to provide a complex, stepped intervention that follows the individual needs of PwD and their caregivers. Its effectiveness and feasibility will be assessed in a formative and a summative evaluation. Trial registration German Register of Clinical Trials (Deutsches Register Klinischer Studien, DRKS), DRKS00023560. Registered 13 November 2020 - Retrospectively registered. HTML&TRIAL_ID=DRKS00023560.
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Affiliation(s)
- Isabella Bablok
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Dominikus Stelzer
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Erika Graf
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Julian Wangler
- Center for General and Geriatric Medicine, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - Michael Jansky
- Center for General and Geriatric Medicine, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - Michael Löhr
- Landschaftsverband Westfalen-Lippe, Hospital Gütersloh, Gütersloh, Germany.,Diakonie University of Applied Sciences, Bielefeld, Germany
| | - Michael Schulz
- Landschaftsverband Westfalen-Lippe, Hospital Gütersloh, Gütersloh, Germany.,Diakonie University of Applied Sciences, Bielefeld, Germany
| | - Marie Kockläuner
- Department of Pharmacy, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany
| | - Katharina Geschke
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.,Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Alexandra Wuttke-Linnemann
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.,Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Andreas Fellgiebel
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University, Mainz, Germany.,Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Erik Farin
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Frisone F, Sicari F, Settineri S, Merlo EM. Clinical Psychological Assessment of Stress: A Narrative Review of the Last 5 Years. CLINICAL NEUROPSYCHIATRY 2021; 18:91-100. [PMID: 34909024 PMCID: PMC8629067 DOI: 10.36131/cnfioritieditore20210203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Work-related stress typically occurs due to particularly challenging dynamics, risks and pressure. Prolonged exposure to stress may cause serious consequences on psychophysical well-being. The current study was conducted to reexamine the clinical instruments useful for evaluating the risk factors and to examine two closely linked dimensions, which may constitute protective factors such as coping strategies and satisfaction. METHOD Through a narrative review of the scientific literature of the last 5 years, carried out through the PubMed, Web of Science and Scopus databases, the most relevant clinical instruments used in the evaluation of stress, job satisfaction and coping strategies were examined. RESULTS Based on the considered inclusion criteria, 142 articles were selected, and 10 of the most used psycho-diagnostic instruments were identified for the evaluation of the three dimensions. The selected assessment instruments were deeply discussed in order to highlight strengths and limitations. CONCLUSIONS A variety of studies used a range of psycho-diagnostic tools in order to measure stress, coping strategies and job satisfaction. However, their integration is necessary to guarantee a complete evaluation protocol.
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Affiliation(s)
- Fabio Frisone
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Italy,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Italy
| | - Federica Sicari
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Italy
| | - Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Emanuele Maria Merlo
- CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Italy,Department of Adult and Childhood Human Pathology “Gaetano Barresi”, University of Messina, Italy,Corresponding author Emanuele Maria Merlo E-mail:
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225
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Preuss H, Capito K, van Eickels RL, Zemp M, Kolar DR. Cognitive reappraisal and self-compassion as emotion regulation strategies for parents during COVID-19: An online randomized controlled trial. Internet Interv 2021; 24:100388. [PMID: 33912402 PMCID: PMC8063732 DOI: 10.1016/j.invent.2021.100388] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Parenting during pandemic restrictions places extreme demands on everyday family life, leading to increased stress levels for parents and distressed parent-child interactions. This RCT aimed to investigate whether cognitive reappraisal and self-compassion are helpful emotion regulation (ER) strategies to reduce individual and parental stress during the COVID-19 pandemic. METHOD An online intervention for parents was developed focusing on the application of ER strategies to pandemic requirements of families. A sample of 265 parents were randomly assigned to either cognitive reappraisal (CR; n = 88), self-compassion (SC; n = 90) or wait-list control (WLC; n = 87) group. Interventions included two video sessions (day 1 and day 3) and three email reminders to transfer the application of ER strategies to daily family life (days 2, 4, 5). Parents' perceived individual stress and parental stress were assessed at baseline (T0), at T1 prior to the booster session on day 3, and at T2 (7 days after baseline). RESULTS Significant decreases from T0 to T2 emerged for both primary stress outcomes in both intervention groups. Individual stress significantly decreased in CR compared to WLC at T2, but not compared to SC. No time × group interactions for parental stress were found. However, mediation analyses suggested that parental stress was indirectly decreased via reductions in individual stress for CR compared to WLC at both time points. CONCLUSIONS COVID-19 will not be the last pandemic to affect family life. Cognitive reappraisal as a brief online intervention can ease acute stress and strengthen the mental health of parents in acute crises.
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Affiliation(s)
- Hanna Preuss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Klara Capito
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Rahel Lea van Eickels
- Department of Clinical and Health Psychology, University of Vienna, Renngasse 6-8, 1010 Vienna, Austria
| | - Martina Zemp
- Department of Clinical and Health Psychology, University of Vienna, Renngasse 6-8, 1010 Vienna, Austria
| | - David Raphael Kolar
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336 Munich, Germany
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226
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Dale R, Budimir S, Probst T, Stippl P, Pieh C. Mental Health during the COVID-19 Lockdown over the Christmas Period in Austria and the Effects of Sociodemographic and Lifestyle Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3679. [PMID: 33916019 PMCID: PMC8036255 DOI: 10.3390/ijerph18073679] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/23/2022]
Abstract
Since the beginning of the COVID-19 pandemic a decline in mental health has been reported. This online study investigated mental health and well-being in Austria during a strict lockdown. In total, N = 1505 participants were recruited between 23 December 2020 and 4 January 2021 and levels of depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), well-being (WHO-5), quality of life (WHO-QOL) and stress (PSS-10) were measured. 26% scored above the cut-off for moderate depressive symptoms (PHQ-9 ≥ 10; ♀ = 32%; ♂ = 21%), 23% above the cut-off for moderate anxiety (GAF-7 ≥ 10; ♀ = 29%; ♂ = 17%) and 18% above the cut-off for moderate insomnia (ISI ≥ 15; ♀ = 21%; ♂ = 16%). Mean-scores for quality of life (psychological WHO-QOL) were 68.89, for well-being (WHO-5) 14.34, and for stress (PSS-10) 16.42. The youngest age group (18-24) was most burdened and showed significantly more mental health symptoms compared with the oldest age group (65+) in depressive symptoms (50% vs. 12%), anxiety symptoms (35% vs. 10%), and insomnia (25% vs. 11%, all p-values < 0.05). Mental health decreased compared to both the first lockdown earlier in 2020 and pre-pandemic data. Further analyses indicate these findings were especially apparent for the under 24-year-olds, women, single/separated people, low incomes and those who do not partake in any physical activity (all p-values < 0.05). We highlight the need for ongoing mental health support, particularly to the most burdened groups.
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Affiliation(s)
- Rachel Dale
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (S.B.); (T.P.)
| | - Sanja Budimir
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (S.B.); (T.P.)
- Department of Work, Organization and Society, Ghent University, Sint-Pietersnieuwstraat, 9000 Ghent, Belgium
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (S.B.); (T.P.)
| | - Peter Stippl
- Austrian Federal Association for Psychotherapy (ÖBVP), 1030 Vienna, Austria;
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (R.D.); (S.B.); (T.P.)
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Costa C, Briguglio G, Mondello S, Teodoro M, Pollicino M, Canalella A, Verduci F, Italia S, Fenga C. Perceived Stress in a Gender Perspective: A Survey in a Population of Unemployed Subjects of Southern Italy. Front Public Health 2021; 9:640454. [PMID: 33869130 PMCID: PMC8046934 DOI: 10.3389/fpubh.2021.640454] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022] Open
Abstract
Stressful life events, are differently handled by women and men. This study evaluates gender differences in perceived stress and health status among a sample of subjects going through a transition period from unemployment to work. This cross-sectional study enrolled 395 participants, 245 men (62%) and 150 (38%) women, between 19 and 67 years, that were going to be hired for a 6-month contract. Before being employed, all participants underwent a mandatory protocol consisting in a general medical check. Stress assessment was performed by using the Perceived Stress Scale (PSS). Most of the participants (68%) showed normal to low perceived stress level. But dividing the sample by gender, out of the remaining 32% with medium to high stress level, 11% male subjects and 22.7% females reported high perceived stress values. We found mean PSS values that are overlapping with those in the general population of developed countries. This study does not suggest an association between perceived stress and health or social parameters. However, our results highlight that the female gender is associated with higher stress level, pointing out the relevance of specific and designed interventions in the context of health promotion programs, especially in order to mitigate stress in more susceptible subjects.
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Affiliation(s)
- Chiara Costa
- Clinical and Experimental Medicine Department, University of Messina, Messina, Italy
| | - Giusi Briguglio
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Michele Teodoro
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Manuela Pollicino
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Canalella
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Francesca Verduci
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Sebastiano Italia
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Concettina Fenga
- Occupational Medicine Section, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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228
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The Arabic Version of the Cohen Perceived Stress Scale: Factorial Validity and Measurement Invariance. Brain Sci 2021; 11:brainsci11040419. [PMID: 33810322 PMCID: PMC8066085 DOI: 10.3390/brainsci11040419] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 01/17/2023] Open
Abstract
University students experience high levels of stress due to university transition, academic commitments, and financial matters. Higher stress perceptions along with limited coping resources endanger mental health for a considerable number of students and may ruin their performance. The current study evaluated the psychometric properties of the Cohen Perceived Stress Scale (10 items), PSS-10, in a sample of 379 female Emeriti students. Exploratory factor analysis resulted in two factors with eigenvalues of 3.88 and 1.19, which explained 60.6% of the variance. Confirmatory factor analysis revealed good model fits of two correlated factors (Comparative Fit Index (CFI) = 0.962, Tucker–Lewis Index (TLI) = 0.950, standardized root-mean-square residual (SRMR) = 0.0479, and root mean-square error of approximation (RMSEA) = 0.067). Internal consistency of the PSS-10 and its positive and negative subscales was acceptable (coefficient α = 0.67, 0.79, and 0.86, respectively). Multigroup analysis revealed that the PSS-10 holds invariance across different groups of age, marital status, and financial status (average monthly expenditure). Convergent and concurrent validity tests signify the importance of considering scores of subscales of the PSS-10 along with its total score.
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Lampe LC, Müller-Hilke B. Mindfulness-based intervention helps preclinical medical students to contain stress, maintain mindfulness and improve academic success. BMC MEDICAL EDUCATION 2021; 21:145. [PMID: 33663478 PMCID: PMC7934360 DOI: 10.1186/s12909-021-02578-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/22/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Stress among students is on the rise during early medical school and has been implicated in poor academic performance. Several methods are being discussed to efficiently reduce stress, among them mindfulness-based interventions. We therefore set out to assess how stress, mindfulness, and academic performance are connected and if an intervention on mindfulness based stress reduction could alleviate stress among medical students and improve their academic achievements. METHODS A non-randomized controlled trial including 143 medical students in their preclinical years was performed in 2019. The students completed two surveys - one in the first, the other in the third term - recording perceived stress and mindfulness via validated scales (PSS-10 and MAAS). In between both, 41 students participated in a voluntary mindfulness-based intervention including six two-hours courses. 86 students served as controls. Scholarly success was assessed via the scores achieved in six exams written during the observation period. RESULTS Stress was inversely related with mindfulness and with the results of the most challenging exam. The intervention on mindfulness based stress reduction helped to contain stress and maintain mindfulness during the observation period and this effect lasted for at least six months beyond completion of the intervention. In contrast, beneficial effects on scholarly success were transient and only detectable at completion of the intervention. CONCLUSION Our observation of short- and intermediate term effects resulting from six individual interventions on mindfulness based stress reduction is encouraging and calls for alternative strategies to induce long-lasting impacts.
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Affiliation(s)
- Luisa Charlotte Lampe
- Core Facility for Cell Sorting & Cell Analysis, Laboratory for Clinical Immunology, University Medical Center Rostock, Rostock, Germany
| | - Brigitte Müller-Hilke
- Core Facility for Cell Sorting & Cell Analysis, Laboratory for Clinical Immunology, University Medical Center Rostock, Rostock, Germany.
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Javelle F, Laborde S, Hosang TJ, Metcalfe AJ, Zimmer P. The Importance of Nature Exposure and Physical Activity for Psychological Health and Stress Perception: Evidence From the First Lockdown Period During the Coronavirus Pandemic 2020 in France and Germany. Front Psychol 2021; 12:623946. [PMID: 33746842 PMCID: PMC7969516 DOI: 10.3389/fpsyg.2021.623946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/01/2021] [Indexed: 12/14/2022] Open
Abstract
Objective: This cross-sectional questionnaire-based study aims to compare physical activity and nature exposure levels between people living in France and Germany during the lockdown. Furthermore, the secondary aim is to observe the relationship between perceived stress, psychological health, physical activity, and nature exposure in Germany and France during the coronavirus disease 2019 (COVID-19)-related lockdown of April/May 2020. Methods: The study includes 419 participants who have completed the Perceived Stress Scale 10, the World Health Organization Quality of Life-BREF, the Godin-Shephard Leisure-Time Physical Activity Questionnaire, the modified Nature Exposure Scale, and complementary questions related to the lockdown period from April 19 to May 11, 2020. Multiple regression models were constructed to evaluate the relationship of nature exposure and physical exercise with overall stress perception and psychological health in France and Germany when considering a broad range of covariates. Results: Exposure to nature during the lockdown (ηp 2 = 0.034, p < 0.001), amount of physical activity ηp 2 = 0.014, p < 0.001), and psychological health (ηp 2 = 0.041, p < 0.001) were greater in German compared with French participants. Godin Index and Nature Exposure Scale total score were both inversely correlated to stress perception and positively correlated to psychological health. The stress and psychological health regression models explained 10% of the results' variance. Physical activity (Godin Index) was a significant for both models. Nature Exposure Scale total score was a significant predictor only for psychological health. When including all significant covariates, the regression models explained 30.7% for the perceived stress and 42.1% for the psychological health total overall variance. Conclusion: Physical activity and nature exposure are significant predictors of psychological health. Even though both variables are associated with stress perception, only physical activity is a significant predictor of stress perception. Our results suggest that physical activity and nature exposure were key factors to go through the lockdown period in France and Germany.
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Affiliation(s)
- Florian Javelle
- Clinical Exercise-Neuroimmunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Thomas Jean Hosang
- Experimental Psychology Unit, Faculty of Humanities and Social Sciences, Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Alan James Metcalfe
- Clinical Exercise-Neuroimmunology Group, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University, Cologne, Germany
| | - Philipp Zimmer
- Department for Performance and Health (Sports Medicine), Institute for Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
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Humer E, Pieh C, Probst T, Kisler IM, Schimböck W, Schadenhofer P. Telephone Emergency Service 142 (TelefonSeelsorge) during the COVID-19 Pandemic: Cross-Sectional Survey among Counselors in Austria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2228. [PMID: 33668235 PMCID: PMC7967694 DOI: 10.3390/ijerph18052228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 11/16/2022]
Abstract
Telephone emergency services play an important role in providing low-threshold, anonymous crisis intervention free of cost. The current study aims to examine the mental well-being and perceived stress level of counselors as well as the main topics of helpline callers during the COVID-19 pandemic in Austria. In the current study, 374 counselors were recruited within the Austrian nationwide organization TelefonSeelsorge during the second wave of COVID-19 infection in Austria. The mental well-being (WHO-5) and perceived stress-level (PSS-10) were assessed and counselors were asked about the frequency of different topics thematized by callers and changes compared to pre-pandemic times. Compared to a reference group of the Austrian general population, counselors experienced less stress (13.22 vs. 16.42) and higher mental well-being (66.26 vs. 57.36; p < 0.001). The most frequent topics during the second wave of the COVID-19 pandemic in Austria were loneliness and mental health. More calls were registered in 2020 compared to 2019 and especially the topics loneliness, mental health, professional activities and relationships were reported to be thematized more often during the COVID-19 pandemic compared to the time before (p < 0.001). The results contribute to an understanding of the impact of the COVID-19 pandemic on telephone crisis intervention.
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Affiliation(s)
- Elke Humer
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
| | - Christoph Pieh
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria; (C.P.); (T.P.)
| | - Ida-Maria Kisler
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (I.-M.K.); (W.S.); (P.S.)
| | - Wolfgang Schimböck
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (I.-M.K.); (W.S.); (P.S.)
| | - Petra Schadenhofer
- ABILE-Viktor Frankl Education Austria, 3390 Melk, Austria; (I.-M.K.); (W.S.); (P.S.)
- Telephone Emergency Service—Lower Austria (TelefonSeelsorge NÖ), Diocese St. Pölten, 3100 St. Pölten, Austria
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Rothe J, Buse J, Uhlmann A, Bluschke A, Roessner V. Changes in emotions and worries during the Covid-19 pandemic: an online-survey with children and adults with and without mental health conditions. Child Adolesc Psychiatry Ment Health 2021; 15:11. [PMID: 33612122 PMCID: PMC7897360 DOI: 10.1186/s13034-021-00363-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The novel coronavirus disease (Covid-19) has spread quickly worldwide with dramatic consequences on our daily lives. Adverse psychosocial consequences of Covid-19 might be particularly severe for children and adolescents, parents of young children and people with mental health conditions (mhc), who are more prone to the experience of psychosocial stress and who are more dependent on the access to professional psychosocial support. The present survey therefore aimed to explore perceived stress and the emotional responses of children and adolescents as well as adults with and without mhc during the social restrictions due to the Covid-19 pandemic. METHODS The survey gathered information about 284 children and adolescent (parent-on-child-reports) and 456 adults (including 284 parents, self-reports). The participants were allocated to four groups: children and adolescents with mhc, children and adolescent without mhc, adults with mhc and adults without mhc. The survey included general questions about socio-demographic characteristics and mental health status, the CoRonavIruSHealth Impact Survey and the Perceived Stress Scale (only data on adults). Wilcoxon signed-rank tests were used for comparing the emotional responses during the Covid-19 pandemic with emotions before the Covid-19 pandemic. Independent sample t-test were used to compare the level of perceived stress between the adult groups, linear regression analyses were conducted to examine which variables predicted perceived stress during the Covid-19 restrictions. RESULTS An increase to the worse during the Covid-19 restrictions was observed for most emotions and worries in all four groups (children and adolescents with mhc, children and adolescents without mhc, adults with mhc, adults without mhc). Contrary to our expectations, a greater number of emotions worsened significantly for children and adolescents as well as adults without mhc as compared to those with mhc. We found higher perceived stress in parents as compared to adults without children in the same household and in adults with mhc as compared to those without mhc. DISCUSSION Covid-19-related social restrictions and potential health risks seem to affect emotions and perceived stress in children, adolescents and adults. Especially, Covid-19 seems to be have worsened the mental well-being of children and adolescent and their families, who were mentally healthy before the Covid-19 pandemic.
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Affiliation(s)
- Josefine Rothe
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Judith Buse
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Anne Uhlmann
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Annet Bluschke
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
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233
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Hormonal and Subjectively Perceived Stress of the Emergency Physicians of the Airborne Rescue Service. J Clin Psychol Med Settings 2021; 28:771-780. [PMID: 33594632 PMCID: PMC8590658 DOI: 10.1007/s10880-021-09767-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 11/22/2022]
Abstract
Due to their work activities, emergency physicians are regularly exposed to exceptional mental and physical situations. In order to prevent stress-related illnesses, the triggers of hormonal and subjectively perceived stress must be understood better. On a sample of emergency physicians from two air rescue services (N = 80), the cortisol awakening response (CAR) was determined on flight rescue days, clinic days, and days off. Pearson correlations showed significant connections between the CAR on flight rescue days and individual scales of the Trier Inventory for Chronic Stress (TICS) and the Perceived Stress Scale (PSS). The results indicate that a lower subjective stress level is associated with higher levels of hormonal stress. Stepwise regression analyses showed a significant influence of the number of professional years, subjectively perceived stress, pressure to succeed, and social isolation. The results suggest that the hormonal stress burden of emergency physicians is in a complex relationship with perceived strain.
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234
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Jarczok MN, Buckley T, Guendel HO, Boeckelmann I, Mauss D, Thayer JF, Balint EM. 24 h-Heart Rate Variability as a Communication Tool for a Personalized Psychosomatic Consultation in Occupational Health. Front Neurosci 2021; 15:600865. [PMID: 33642974 PMCID: PMC7905098 DOI: 10.3389/fnins.2021.600865] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/06/2021] [Indexed: 11/23/2022] Open
Abstract
New tools for non-specific primary prevention strategies covering somatic and mental health in occupational medicine are urgently needed. Heart rate variability (HRV) reflects the capacity of the body to adapt to environmental challenges and of the mind to regulate emotions. Hence, a 24 h-measurement of HRV offers a unique possibility to quantify the interaction between situation-specific emotional regulation within a specific psychosocial environment and physiological state, thereby increasing self-perception and inducing motivation to change behavior. The focus of the present study represents such a 24 h-measurement of HRV and its presentation as a comprehensive graph including protocol situations of the client. A special training program for occupational health physicians and questionnaires for clients were developed and administered. The article reports the first data of the study “healthy leadership and work – body signals for managers and employees”, an investigator-initiated, interventional, single-arm, open (non-blinded), multicenter, national trial with 168 participants. They reported a significantly improved perception of their bodily needs after the consultation (from Median = 7, interquartile range 5–8 to Median = 8, interquartile range 7–9; scale range from 1 to 10; p < 0.001, Wilcoxon rank test; effect size 0.49). The 16 occupational health physicians stated that the measurement of HRV was very well suited to enter into dialog with the managers and was feasible to show interactions between situations, thoughts, feelings, and bodily reactions. Taken together, we show that a 24 h-HRV-measurement can be a feasible and effective approach for holistic, psychosomatic primary prevention in occupational medicine. We discuss possible mechanisms for improving the individual health via the consultation, containing mindset and improved ANS activity.
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Affiliation(s)
- Marc N Jarczok
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Thomas Buckley
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Harald O Guendel
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.,Leadership Personal Center Ulm (LPCU), University of Ulm, Ulm, Germany
| | - Irina Boeckelmann
- Occupational Medicine, Faculty of Medicine, Otto-von-Guericke University, Magdeburg, Germany
| | - Daniel Mauss
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Julian F Thayer
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, United States
| | - Elisabeth M Balint
- Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.,Leadership Personal Center Ulm (LPCU), University of Ulm, Ulm, Germany
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235
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Amanvermez Y, Karyotaki E, Cuijpers P, Salemink E, Spinhoven P, Struijs S, de Wit LM. Feasibility and acceptability of a guided internet-based stress management intervention for university students with high levels of stress: Protocol for an open trial. Internet Interv 2021; 24:100369. [PMID: 33614413 PMCID: PMC7878182 DOI: 10.1016/j.invent.2021.100369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 10/27/2022] Open
Abstract
UNLABELLED More than half of university students have high levels of stress. Stress management programs can help students improve coping skills and prevent psychological distress. However, studies have generally targeted all university students regardless of whether they experience high levels of stress or not, and thus more studies are needed to examine the feasibility and acceptability of e-health interventions for students with elevated stress. The present open trial aims to examine the feasibility and acceptability of a guided internet-based stress management program for university students with high levels of stress. In this study, participants are recruited via e-mail, newsletters, and flyers from four universities in the Netherlands to participate in a guided internet-based stress management program. Guidance is delivered by e-coaches who provide weekly asynchronous text-based motivational feedback after each module is completed. Primary outcomes are satisfaction with the intervention, assessed by the Client Satisfaction Scale (CSQ-8), and usability, assessed by the System Usability Scale (SUS-10). Secondary outcomes are perceived stress, quality of life, and depression, assessed by the Perceived Stress Scale (PSS-10), the EuroQol- 5 Dimension- 5 Level Scale (EQ- 5D- 5L), and the Patient Health Questionnaire (PHQ-9) respectively. Adherence rates to the program are assessed by examining the number of completed modules, time spent on the platform, and completed exercises. The Caring Universities Project was funded in (September 2019). In June 2020, the project was officially announced to the students and recruitment began immediately. As of October 2020, recruitment continues. The expected date of the publication of the results is in 2021. It is expected that the results of the proposed study will be informative for designing and implementing e-health interventions in higher education. Moreover, it is assumed that the findings will contribute to the growing literature on internet interventions by yielding preliminary evidence related to the feasibility and acceptability of an online stress management program. TRIAL REGISTRATION Netherlands Trial Register NL8686; https://www.trialregister.nl/trial/8686.
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Affiliation(s)
- Yagmur Amanvermez
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands,Corresponding author at: Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands.
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Elske Salemink
- Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Leiden University, Leiden, the Netherlands,Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Sascha Struijs
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands,Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Leonore M. de Wit
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
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Lautenbach F, Leisterer S, Walter N, Kronenberg L, Manges T, Leis O, Pelikan V, Gebhardt S, Elbe AM. Amateur and Recreational Athletes' Motivation to Exercise, Stress, and Coping During the Corona Crisis. Front Psychol 2021; 11:611658. [PMID: 33584445 PMCID: PMC7873522 DOI: 10.3389/fpsyg.2020.611658] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/23/2020] [Indexed: 12/21/2022] Open
Abstract
The COVID-19 pandemic has negatively impacted mobility worldwide. As a corollary, the health of top- and lower-level athletes alike is profoundly reliant on movement and exercise. Thus, the aim of this study is to understand impacts of the COVID-19 pandemic lockdown on athletes' motivation to exercise and train. In detail, we aim to better understand who (i.e., demographic, sport-specific, and psychological state and trait variables) reported a change in motivation to train due to the lockdown, why they reported lower motivation (i.e., open-ended questions on problems), what they did to help themselves, what support they received from others, and what they are looking forward to after the lockdown (i.e., open questions). Questionnaire data and answers to these open-ended questions were assessed via an online questionnaire, completed by 95 amateur and recreational athletes during the first COVID-19 lockdown in Germany (April to mid-May 2020). Results show that greater numbers of female athletes are less motivated to train in comparison to male athletes (p = 0.029). No differences in motivation were found regarding type of sport (individual vs. team sport) and number of competitions during the year. Also, more motivated to train amateur and recreational athletes showed lower athletic identity than athletes who reported no change in motivation to exercise during the lockdown (p = 0.03). Additionally, differences in state emotional, perceived stress, and personality variables (i.e., orientation to happiness, volition) were found between athletes who stated that they were less motivated to train compared to athletes who reported no changes in motivation. In particular, closure of sports facilities and social distancing measures were perceived to be highly problematic. Even though athletes received emotional support, organized themselves via routines and schedules, and trained using online tools, they predominately stated that they wished that their coaches would have supported them more. Understanding the impacts of a pandemic-related lockdown on athletes' motivation, athletes' coping strategies, and their desired support will help better support them in future crises.
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237
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“What Can I Be When I Grow Up?”—The Influence of Own and Others’ Career Expectations on Adolescents’ Perception of Stress in Their Career Orientation Phase. SUSTAINABILITY 2021. [DOI: 10.3390/su13020912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The future that adolescents are growing up to live and work in becomes increasingly complex and vague, making job choice a moving target. Thus, adolescents develop and are confronted with a number of different options for what job they wish to take up and have to balance their own and their social environment’s job aspirations for them. Prior research has suggested including more dynamic approaches to understanding career choice and counseling. In this research, we therefore draw on the possible selves approach and aim at understanding how far imbalance between adolescents’ own and their social environments’ expectations for their vocational future will cause stress. In an online mixed-methods study, 163 adolescent participants, aged 14–22, reported their own and their parents’, teachers’, and friends’ emotions, future orientation, and perceived stress regarding the career choice. Results showed a variety of expectations for future careers held by participants and their social environment, as well as emotions regarding these expectations. Positive deactivating emotions (satisfaction and relief) negatively predicted adolescents’ stress and strain and the older and closer to final job choice participants were, the more they reported stress and strain. These findings suggest including adolescents’ social environment in the career choice process.
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238
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Wunsch K, Fiedler J, Bachert P, Woll A. The Tridirectional Relationship among Physical Activity, Stress, and Academic Performance in University Students: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E739. [PMID: 33467118 PMCID: PMC7830011 DOI: 10.3390/ijerph18020739] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 01/09/2023]
Abstract
Higher education students often suffer from physiological and psychological health problems caused by stress, which may negatively impact their academic performance (AP). Physical activity (PA) can be a promising strategy to buffer these stress-induced complaints. Therefore, the aim of this investigation was to summarize evidence for the tridimensional construct of PA, stress, and AP, as well as to quantify the relationships among these variables. Five databases (PubMed, Scopus, SMEI, ERIC, and Web of Science) were systematically searched in November 2019 for publications that examined PA, stress, and AP of university students, without any restrictions regarding the publication period. The systematic review includes four original research studies with a moderate-to-high risk of bias. Results of included studies were narratively summarized and quantified in a meta-analysis using random effect models. Whereas study results point to a positive relation between PA and AP, relationships between PA and stress seem to be negative, while the relation between stress and AP is undecided. The meta-analysis found no significant associations and considerable heterogeneity of the results. Findings indicate a research gap concerning the connection of PA, stress, and AP in university students. Future studies should use validated measuring tools and consider the timepoint of data collection in order to extract truly stressful periods.
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239
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Pannicke B, Kaiser T, Reichenberger J, Blechert J. Networks of stress, affect and eating behaviour: anticipated stress coping predicts goal-congruent eating in young adults. Int J Behav Nutr Phys Act 2021; 18:9. [PMID: 33422046 PMCID: PMC7796605 DOI: 10.1186/s12966-020-01066-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Many people aim to eat healthily. Yet, affluent food environments encourage consumption of energy dense and nutrient-poor foods, making it difficult to accomplish individual goals such as maintaining a healthy diet and weight. Moreover, goal-congruent eating might be influenced by affects, stress and intense food cravings and might also impinge on these in turn. Directionality and interrelations of these variables are currently unclear, which impedes targeted intervention. Psychological network models offer an exploratory approach that might be helpful to identify unique associations between numerous variables as well as their directionality when based on longitudinal time-series data. METHODS Across 14 days, 84 diet-interested participants (age range: 18-38 years, 85.7% female, mostly recruited via universities) reported their momentary states as well as retrospective eating episodes four times a day. We used multilevel vector autoregressive network models based on ecological momentary assessment data of momentary affects, perceived stress and stress coping, hunger, food craving as well as goal-congruent eating behaviour. RESULTS Neither of the momentary measures of stress (experience of stress or stress coping), momentary affects or craving uniquely predicted goal-congruent eating. Yet, temporal effects indicated that higher anticipated stress coping predicted subsequent goal-congruent eating. Thus, the more confident participants were in their coping with upcoming challenges, the more they ate in line with their goals. CONCLUSION Most eating behaviour interventions focus on hunger and craving alongside negative and positive affect, thereby overlooking additional important variables like stress coping. Furthermore, self-regulation of eating behaviours seems to be represented by how much someone perceives a particular eating episode as matching their individual eating goal. To conclude, stress coping might be a potential novel intervention target for eating related Just-In-Time Adaptive Interventions in the context of intensive longitudinal assessment.
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Affiliation(s)
- Björn Pannicke
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria.
| | - Tim Kaiser
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
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240
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Süss H, Willi J, Grub J, Ehlert U. Psychosocial factors promoting resilience during the menopausal transition. Arch Womens Ment Health 2021; 24:231-241. [PMID: 32719937 PMCID: PMC7979610 DOI: 10.1007/s00737-020-01055-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/16/2020] [Indexed: 01/23/2023]
Abstract
Despite significant biological, psychological, and social challenges in the perimenopause, most women report an overall positive well-being and appear to be resilient to potentially negative effects of this life phase. The objective of this study was to detect psychosocial variables which contribute to resilience in a sample of perimenopausal women. A total of 135 healthy perimenopausal women aged 40-56 years completed a battery of validated psychosocial questionnaires including variables related to resilience, well-being, and mental health. First, using exploratory factor analysis, we examined which of the assessed variables related to resilience can be assigned to a common factor. Second, linear regression analyses were performed to investigate whether a common resilience factor predicts well-being and mental health in the examined sample of women. Optimism (LOT-R-O), emotional stability (BFI-K-N), emotion regulation (ERQ), self-compassion (SCS-D), and self-esteem (RSES) in perimenopausal women can be allocated to a single resilience-associated factor. Regression analyses revealed that this factor is related to higher life satisfaction (SWLS; β = .39, p < .001, adj. R2 = .20), lower perceived stress (PSS-10; β = - .55, p < .001, adj. R2 = .30), lower psychological distress (BSI-18; β = - .49, p < .001, adj. R2 = .22), better general psychological health (GHQ-12; β = - .49, p < .001, adj. R2 = .22), milder menopausal complaints (MRS II; β = - .41, p < .001, adj. R2 = .18), and lower depressive symptoms (ADS-L; β = - .32, p < .001, adj. R2 = .26). The α levels were adjusted for multiple testing. Our findings confirm that several psychosocial variables (optimism, emotional stability, emotion regulation, self-compassion, and self-esteem) can be allocated to one common resilience-associated factor. This resilience factor is strongly related to women's well-being as well as mental health in perimenopause.
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Affiliation(s)
- Hannah Süss
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jasmine Willi
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Jessica Grub
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050 Zurich, Switzerland ,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, 8050, Zurich, Switzerland. .,URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
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Mücke M, Ludyga S, Brand S, Colledge F, Pühse U, Gerber M. Associations Between Cardiorespiratory Fitness and Endocrine, Autonomous and Psychological Stress Reactivity in Male Adolescents. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract. High stress burden during adolescence can have severe long-term health consequences. While some studies reported that adults with higher fitness levels show lower stress reactivity, research on adolescents is scarce. Accordingly, the aim of the present study was to investigate the association between cardiorespiratory fitness and physiological and psychological stress reactivity in male adolescents. Forty-three healthy, male adolescents aged 16–20 years underwent the Physical Working Capacity 170 bicycle ergometer test to determine cardiorespiratory fitness. The Trier Social Stress Test (TSST) was used to trigger a stress reaction, which was measured physiologically with changes in salivary cortisol and alpha-amylase concentrations, and psychologically using self-rated changes in state-anxiety. Under consideration of potential confounders, hierarchical regression analyses were calculated for each outcome. For cortisol and psychological stress reactivity, fitness did not significantly explain variance. However, 28% of variance in alpha-amylase reactivity were explained by fitness and sleep complaints [adjusted R2 = .28, F(2, 36) = 8.36, p = .001], with 16% of variance explained by fitness alone (β = −.41, p = .006). Accordingly, higher fitness was associated with lower stress reactivity of the autonomous nervous system in male adolescents. The promotion of cardiorespiratory fitness may therefore be considered an important factor in preventing negative health consequences of stress in this age group.
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Affiliation(s)
- Manuel Mücke
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
- Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, University of Basel, Switzerland
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences (KUMS), Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Iran
- School of Medicine, Tehran University of Medical Sciences, Iran
| | - Flora Colledge
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Switzerland
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Al-Adawi S, Al Shamli S, Al Omrani S, Al-Mahrouqi T, Chan M, Al Salmi O, Al-Saadoon M, Ganesh A. Perceived stress and its correlates among medical trainees in Oman: A single-institution study. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_37_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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243
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Adamson MM, Phillips A, Seenivasan S, Martinez J, Grewal H, Kang X, Coetzee J, Luttenbacher I, Jester A, Harris OA, Spiegel D. International Prevalence and Correlates of Psychological Stress during the Global COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9248. [PMID: 33321950 PMCID: PMC7763004 DOI: 10.3390/ijerph17249248] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/02/2020] [Accepted: 12/04/2020] [Indexed: 12/19/2022]
Abstract
This study reports perceived stress and associated sociodemographic factors from an international sample of adults, during the COVID-19 pandemic. The Perceived Stress Scale (PSS-10) along with socio-demographic questions were conducted between 8 April 2020 and 11 May 2020. The survey was translated from English into five languages. Recruitment was conducted worldwide using social media. A total of 1685 survey responses were collected across 57 countries with eleven countries (≥30 responses/country) included in the sub-analyses. Overall, the mean PSS-10 score was 19.08 (SD = 7.17), reflecting moderate stress compared to previously reported norms. Female gender was associated with a higher PSS score (3.03, p < 0.05) as well as four-year degree holders (3.29, p < 0.05), while adults over 75 years (-7.46, p < 0.05) had lower PSS scores. Personal care composite score (including hours of sleep, exercise, and meditation) was associated with lower PSS scores (-0.39, p < 0.01). Increases in personal care and changes in work expectations were associated with lower PSS scores (-1.30 (p < 0.05) and -0.38 (p < 0.01), respectively). Lower total PSS scores were reported in Germany (-4.82, p < 0.01) compared to the global response sample mean. This information, collected during the initial period of global mitigation orders, provides insight into potential mental health risks and protective factors during crises.
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Affiliation(s)
- Maheen M. Adamson
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Angela Phillips
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Srija Seenivasan
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Julian Martinez
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Harlene Grewal
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - Xiaojian Kang
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
| | - John Coetzee
- Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA; (A.P.); (S.S.); (J.M.); (H.G.); (X.K.); (J.C.)
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - Ines Luttenbacher
- Department of Psychology, University of Amsterdam, 1001 NH Amsterdam, The Netherlands;
| | - Ashley Jester
- Science and Engineering Libraries, Stanford Libraries, Stanford University, Stanford, CA 94305, USA;
| | - Odette A. Harris
- Department of Neurosurgery, Stanford School of Medicine, Stanford, CA 94305, USA;
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA 94305, USA;
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Herrmann-Lingen C, Albus C, de Zwaan M, Geiser F, Heinemann K, Hellmich M, Michal M, Sadlonova M, Tostmann R, Wachter R, Herbeck Belnap B. Efficacy of team-based collaborative care for distressed patients in secondary prevention of chronic coronary heart disease (TEACH): study protocol of a multicenter randomized controlled trial. BMC Cardiovasc Disord 2020; 20:520. [PMID: 33302871 PMCID: PMC7731481 DOI: 10.1186/s12872-020-01810-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is the leading cause of death and years of life lost worldwide. While effective treatments are available for both acute and chronic disease stages there are unmet needs for effective interventions to support patients in health behaviors required for secondary prevention. Psychosocial distress is a common comorbidity in patients with CHD and associated with substantially reduced health-related quality of life (HRQoL), poor health behavior, and low treatment adherence. METHODS In a confirmatory, randomized, controlled, two-arm parallel group, multicenter behavioral intervention trial we will randomize 440 distressed CHD patients with at least one insufficiently controlled cardiac risk factor to either their physicians' usual care (UC) or UC plus 12-months of blended collaborative care (TeamCare = TC). Trained nurse care managers (NCM) will proactively support patients to identify individual sources of distress and risk behaviors, establish a stepwise treatment plan to improve self-help and healthy behavior, and actively monitor adherence and progress. Additional e-health resources are available to patients and their families. Intervention fidelity is ensured by a treatment manual, an electronic patient registry, and a specialist team regularly supervising NCM via videoconferences and recommending protocol and guideline-compliant treatment adjustments as indicated. Recommendations will be shared with patients and their physicians who remain in charge of patients' care. Since HRQoL is a recommended outcome by both, several guidelines and patient preference we chose a ≥ 50% improvement over baseline on the HeartQoL questionnaire at 12 months as primary outcome. Our primary hypothesis is that significantly more patients receiving TC will meet the primary outcome criterion compared to the UC group. Secondary hypotheses will evaluate improvements in risk factors, psychosocial variables, health care utilization, and durability of intervention effects over 18-30 months of follow-up. DISCUSSION TEACH is the first study of a blended collaborative care intervention simultaneously addressing distress and medical CHD risk factors conducted in cardiac patients in a European health care setting. If proven effective, its results can improve long-term chronic care of this vulnerable patient group and may be adapted for patients with other chronic conditions. TRIAL REGISTRATION German Clinical Trials Register, DRKS00020824, registered on 4 June, 2020; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020824.
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Affiliation(s)
- Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Von-Siebold-Str. 5, 37075, Göttingen, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn Medical Center, Bonn, Germany
| | - Katrin Heinemann
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Monika Sadlonova
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- Department of Thoracic and Cardiovascular Surgery, University of Göttingen Medical Center, Göttingen, Germany
| | - Ralf Tostmann
- Clinical Trials Unit, University of Göttingen Medical Center, Göttingen, Germany
| | - Rolf Wachter
- Clinic and Policlinic for Cardiology, University Hospital of Leipzig, Leipzig, Germany
| | - Birgit Herbeck Belnap
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Von-Siebold-Str. 5, 37075, Göttingen, Germany
- Center for Behavioral Health, Media, and Technology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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245
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Giessing L, Oudejans RRD, Hutter V, Plessner H, Strahler J, Frenkel MO. Acute and Chronic Stress in Daily Police Service: A Three-Week N-of-1 Study. Psychoneuroendocrinology 2020; 122:104865. [PMID: 32961407 DOI: 10.1016/j.psyneuen.2020.104865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 01/14/2023]
Abstract
On duty, police officers are exposed to a variety of acute, threatening stress situations and organizational demands. In line with the allostatic load model, the resulting acute and chronic stress might have tremendous consequences for police officers' work performance and psychological and physical health. To date, limited research has been conducted into the underlying biological, dynamic mechanisms of stress in police service. Therefore, this ecological momentary assessment study examined the associations of stress, mood and biological stress markers of a 28-year-old male police officer in a N-of-1 study over three weeks (90 data points). Four times a day (directly after waking up, 30 minutes later, 6 hours later, before going to bed), he answered questions about the perceived stress and mood using a smartphone application. With each data entry, he collected saliva samples for the later assessment of salivary cortisol (sCort) and alpha-amylase (sAA). In addition, data was collected after six police incidents during duty. sCort and sAA were not related to perceived stress in daily life and did not increase in police incidents. Regarding mood measures, deterioration of calmness, but not valence and energy was associated with perceived stress. The results suggest continued police service to constitute a major chronic stressor resulting in an inability to mount a proper response to further acute stress. As an indicator of allostatic load, psychological and biological hyporesponsivity in moments of stress may have negative consequences for police officers' health and behavior in critical situations that require optimal performance. Prospectively, this research design may also become relevant when evaluating the efficacy of individualized stress management interventions in police training.
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Affiliation(s)
- Laura Giessing
- Institute for Sport and Sport Sciences, Heidelberg University, Germany.
| | - Raôul R D Oudejans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Institute for Brain and Behaviour Amsterdam, the Netherlands; Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, the Netherlands
| | - Vana Hutter
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Institute for Brain and Behaviour Amsterdam, the Netherlands
| | - Henning Plessner
- Institute for Sport and Sport Sciences, Heidelberg University, Germany
| | - Jana Strahler
- Faculty of Psychology and Sport Science, Justus-Liebig University, Gießen, Germany
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246
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Gavurova B, Ivankova V, Rigelsky M. Relationships between Perceived Stress, Depression and Alcohol Use Disorders in University Students during the COVID-19 Pandemic: A Socio-Economic Dimension. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8853. [PMID: 33260778 PMCID: PMC7730954 DOI: 10.3390/ijerph17238853] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/17/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022]
Abstract
The objective of the study was to examine the effects of perceived stress on depression and subsequently to examine the effects of depression on alcohol use disorders. The data were obtained by an electronic questionnaire survey during the coronavirus disease 2019 (COVID-19) pandemic (n = 1523 Slovak university students). Descriptive, regression, and correlation analysis were used in the analytical processing, while the analyses included students' scores in three diagnostic tools (Perceived Stress Scale (PSS), Patient Health Questionnaire for depression (PHQ 9), and Alcohol Use Disorders Identification Test (AUDIT)), as well as gender and income characteristics. The PSS identified an increased level of perceived stress in female students, while in contrast, the AUDIT showed an increased level of alcohol use disorders in male students. Differences in mental and behavioural disorders between the gender and income categories were significant in most of the analysed cases. In terms of gender-income characteristics, it was possible to confirm a significant positive effect of the PSS score on the PHQ 9 score, as well as a significant positive effect of the PHQ 9 score on the AUDIT score. As a result, efforts to reduce stress will be reflected in a reduction of depressive disorders as well as a reduction of excessive alcohol consumption among students.
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Affiliation(s)
- Beata Gavurova
- Center for Applied Economic Research, Faculty of Management and Economics, Tomas Bata University in Zlin, 5139, 760 00 Zlin, Czech Republic
| | - Viera Ivankova
- Faculty of Management, University of Presov in Presov, 16, 080 01 Presov, Slovakia; (V.I.); (M.R.)
| | - Martin Rigelsky
- Faculty of Management, University of Presov in Presov, 16, 080 01 Presov, Slovakia; (V.I.); (M.R.)
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247
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Mücke M, Ludyga S, Colledge F, Pühse U, Gerber M. The Influence of an Acute Exercise Bout on Adolescents' Stress Reactivity, Interference Control, and Brain Oxygenation Under Stress. Front Psychol 2020; 11:581965. [PMID: 33244305 PMCID: PMC7683805 DOI: 10.3389/fpsyg.2020.581965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/19/2020] [Indexed: 12/03/2022] Open
Abstract
Background High psychosocial stress can impair executive function in adolescents, whereas acute exercise has been reported to benefit this cognitive domain. The aim of this study was to investigate whether an acute bout of aerobic exercise improves the inhibitory aspect of executive function and the associated dorsolateral prefrontal cortex (DLPFC) oxygenation when under stress. Methods Sixty male high school students aged 16–20 years performed a Stroop task (baseline condition) and were randomly assigned to an exercise group (30 min on ergometer at 70% of maximum heart rate) and a control group (30 min of reading). Subsequently, all participants underwent a modified Trier Social Stress Test, which included a Stroop task under enhanced stress. The Stroop tasks in both conditions were combined with functional near-infrared spectroscopy to record changes in DLPFC oxygenation in response to the tasks. Stress reactivity was measured with saliva samples (cortisol, alpha-amylase), heart rate monitoring, and anxiety scores. Results All stress parameters indicated increases in response to the stressor (p < 0.001), with higher alpha-amylase [t(58) = −3.45, p = 0.001, d = 1.93] and anxiety [t(58) = −2.04, p = 0.046, d = 0.53] reactions in the control compared to the exercise group. Controlling for these two parameters, repeated measures analyses of covariance targeting changes in Stroop interference scores showed no main effect of stress [F(1,58) = 3.80, p = 0.056, ηp2 = 0.063] and no stress × group interaction [F(1,58) = 0.43, p = 0.517, ηp2 = 0.008]. Similarly, there was no main effect of stress [F(1,58) = 2.38, p = 0.128, ηp2 = 0.040] and no stress × group interaction [F(1,58) = 2.80, p = 0.100, ηp2 = 0.047] for DLPFC oxygenation. Conclusion Our study confirms potentially health-enhancing effects of acute exercise on some of the physiological and psychological stress reactivity indicators. However, our data do not support the notion of an effect on interference control and DLPFC activation under stress.
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Affiliation(s)
- Manuel Mücke
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Sebastian Ludyga
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Flora Colledge
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland
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248
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The Dark Side of Healthy Eating: Links between Orthorexic Eating and Mental Health. Nutrients 2020; 12:nu12123662. [PMID: 33260760 PMCID: PMC7761061 DOI: 10.3390/nu12123662] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Orthorexia nervosa (OrNe) describes a behavior where eating overly healthy develops into an obsession leading to significant impairment and stress. Initial studies support a bi-dimensional structure of orthorexic eating with one dimension healthy orthorexia (HeOr, interest in healthy eating), which can be distinguished from the dimension OrNe. The present study pursued the goals to examine the negative consequences of OrNe on mental health, whether HeOr buffers these effects, and the role of gender. Data from two cross-sectional online surveys were combined (study 1 n = 385, 310 women; study 2 n = 398, 265 women; mean age: 28.9 ± 12.0 year) both generating data on psychological wellbeing, life satisfaction, stress, anxiety, and depressive symptoms in relation to OrNe and HeOr (Teruel Orthorexia Scale). By means of correlation and moderation analyses, OrNe was shown to be associated with poorer mental health, especially in the female sample. In terms of HeOr, clear gender differences appeared. There were no meaningful correlations in women. In men, however, HeOr correlated with better mental health. Further, the link between OrNe and poorer mental health was mitigated when there were high HeOr levels. Present findings support the hypotheses that OrNe is associated with pathological consequences and that HeOr may act as a buffer for these consequences. Gender differences in the clinical manifestation of orthorexic eating confirm previous knowledge and have important implications for targeted prevention and treatment strategies.
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249
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Pan Y, Meister R, Löwe B, Kaptchuk TJ, Buhling KJ, Nestoriuc Y. Open-label placebos for menopausal hot flushes: a randomized controlled trial. Sci Rep 2020; 10:20090. [PMID: 33208855 PMCID: PMC7674475 DOI: 10.1038/s41598-020-77255-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
This study investigated the efficacy of an open-label placebo (OLP) treatment for menopausal hot flushes. Women with at least five moderate or severe hot flushes per day were allocated to receive four weeks of OLP for twice a day or no-treatment. Intention-to-treat analyses included n = 100 women. In comparison to no-treatment, OLP reduced the log-transformed hot flush composite score (frequency × intensity) (mean difference in change: − 0.32, 95% CI [− 0.43; − 0.21], p < 0.001, Cohen’s d = 0.86), hot flush frequency (− 1.12 [− 1.81; − 0.43], p = 0.02, Cohen’s d = 0.51), and improved overall menopause-related quality of life (− 2.53 [− 4.17; − 0.89], p = 0.02, Cohen’s d = 0.49). Twelve (24%) (vs. three [6%]) patients had 50% lesser hot flushes. Problem rating of hot flushes and subdomains of quality of life did not improve. After four weeks, the OLP group was further divided via randomization to continue or discontinue the treatment. Benefits were maintained at week 8 (log-transformed score: − 0.04 [− 0.06; 0.14], p = 0.45). There was no difference between taking placebos for 8 or 4 weeks (log-transformed score: 0.04 [− 0.17; 0.25], p = 0.73). Results indicate that open-label placebos may be an effective, safe alternative for menopausal hot flushes.
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Affiliation(s)
- Yiqi Pan
- Department of Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, Hamburg, Germany. .,Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | - Ramona Meister
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ted J Kaptchuk
- Program in Placebo Studies and the Therapeutic Encounter (PiPS), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | - Kai J Buhling
- Department of Gynecological Endocrinology, Clinic of Gynecology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Clinical Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, Hamburg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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250
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Tan SL, Jetzke M, Vergeld V, Müller C. Independent and Combined Associations of Physical Activity, Sedentary Time, and Activity Intensities With Perceived Stress Among University Students: Internet-Based Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e20119. [PMID: 33174855 PMCID: PMC7688394 DOI: 10.2196/20119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/06/2020] [Accepted: 10/24/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Mental health is an emerging topic on university campuses, with students reporting higher levels of psychological distress than the general population of the same age. Increasing physical activity and reducing sedentary time have been proved promising measures to promote mental health in the general population. However, to derive and implement effective measures to promote mental health among university students, further exploration of the associations between physical activity, sedentary time, and perceived stress in this specific setting is needed. OBJECTIVE This study aims to identify associations between physical activity, sedentary time, and perceived stress after controlling for sociodemographic and behavioral variables among university students in Germany. We hypothesize that perceived stress is inversely related to physical activity and positively associated with sedentary time. Furthermore, we hypothesize that combined associations of concurrently high physical activity and low sedentary time on perceived stress are stronger compared with either alone and that the association between physical activity and perceived stress depends on activity intensity. METHODS We conducted cross-sectional analyses from a large-scale internet-based student health survey (n=4189; response rate=10.0%). Physical activity, sedentary time, and engaging in moderate and vigorous activity intensities were assessed using the International Physical Activity Questionnaire Short Form with categorization into low, intermediate, and high levels. We measured perceived stress using the 10-item Perceived Stress Scale (range 0-40). RESULTS The results indicate that higher physical activity and lower sedentary time are associated with reduced levels of perceived stress. Following adjustment for gender, BMI, income, fruit and vegetable intake, alcohol consumption, and sleep quality, perceived stress scores were lower for students reporting high physical activity levels and low sedentary time compared with the least active and highly sedentary students (Perceived Stress Scale -2.2, 95% CI -2.9 to -1.5, P<.001 for physical activity and -1.1, CI 95% -1.7 to -0.5, P<.001 for sedentary time). Combined associations with perceived stress revealed that students concurrently reporting high total physical activity and low sedentary time reported the lowest perceived stress scores of all possible combinations following adjustment for confounders (Perceived Stress Scale -3.5, CI 95% -4.6 to -2.5, P<.001 compared with students reporting low physical activity levels and concurrently high sedentary time). Associations between vigorous physical activities and perceived stress were not stronger compared with moderate activity intensities. CONCLUSIONS Self-reported physical activity and low sedentary time are favorably associated with perceived stress, while the intensity of physical activities seems to be of minor importance. These results help to effectively implement health-promoting measures on campus among university students through increasing physical activity and reducing sedentary time.
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Affiliation(s)
- Shu Ling Tan
- Department for Social Sciences of Sport, Institute for Sport and Exercise Science, University of Münster, Münster, Germany
| | - Malte Jetzke
- Department for Social Sciences of Sport, Institute for Sport and Exercise Science, University of Münster, Münster, Germany
| | - Vera Vergeld
- Department of Sport and Exercise Psychology, Institute for Sport and Exercise Science, University of Münster, Münster, Germany
| | - Carsten Müller
- University Sports, University of Münster, Münster, Germany
- Department of Physical Therapy, European University of Applied Sciences, Cologne (Köln), Germany
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