Occupational stress and strain of female students: results of physiological, behavioral, and psychological monitoring

Decreased sympathetic cardiovascular influences and hormone-physiological changes in response to Covid-19-related adaptations under different learning environments

To examine the implications of the transition from face-to-face to online learning from a psychobiological perspective, this study investigated potential differences in physiological stress parameters of students engaged in online or face-to-face learning and determined whether these can be identified as possible mediators between learning experience and achievement emotions. In a randomized experimental field study, medical students (n = 82) attended either regular face-to-face classes of the microscopic anatomy course or the same practical course online using Zoom videoconferencing platform. The present study investigated Heart Rate Variability (HRV) and salivary cortisol concentration as stress correlates, within the contexts of online and face-to-face learning and compared these parameters with a control group that was measured at rest. Additionally, participants completed a standardized questionnaire about their experienced emotions in relation to task achievement and subjective stress levels. A significant reduction in HRV was found in face-to-face learning, suggesting stronger stress responses in the face-to-face learning environment (η²  = 0.421, P < 0.001). Furthermore, participants engaged in face-to-face learning showed significantly higher cortisol concentrations (η²  = 0.115, P = 0.032). Additionally, increased sympathetic activation correlated with the discrete positive emotion of enjoyment exclusively within the face-to-face condition (r = 0.365, P = 0.043). These results indicate that the transfer of a face-to-face practical course in microscopic anatomy to an online learning environment is associated with decreased sympathetic and enhanced vagal cardiovascular influences, together with lower cortisol concentrations in healthy medical students.

Evaluation of emotional excitation during standardized endotracheal intubation in simulated conditions

Objective

To assess how stressful conditions in endotracheal intubation could induct emotional excitation in a population of acute care physicians.

Materials and methods

Two situations were randomly tested: one in standard and easy intubation conditions the other under difficult conditions presumed to induce stress (monitoring alarms, manikin lying on the floor, difficult intubation). Emotional excitation was assessed using several physiological (cardiac patterns, electrodermal activity and eye-tracking) and psycho-cognitive patterns. Auto-evaluations of video recordings and mental workload were performed immediately after simulation.

Results

Significant physiological parameter modifications were observed under the stressful intubation conditions (SDNN 35 ± 15 vs. 42 ± 21; p = 0.035—AVNN 514 ± 94 vs. 548 ± 110; p < 0.0001). Emotional excitation was demonstrated to lead a higher mental workload (NASA-TLX = 39 ± 18 vs. 63 ± 15; p = 0.001), frustration and effort dimensions being its determinant components (p < 0.01). Video recording auto-evaluations depicted significant emotional excitation occurrence under the difficult conditions, with few differences according to the operator’s experience.

Conclusion

This study highlights the fact that a stress condition during ETI on a simulation model leads to an important emotional excitation as compared to the neutral condition.

Combining ecological momentary assessment with objective, ambulatory measures of behavior and physiology in substance-use research

Whereas substance-use researchers have long combined self-report with objective measures of behavior and physiology inside the laboratory, developments in mobile/wearable electronic technology are increasingly allowing for the collection of both subjective and objective information in participants' daily lives. For self-report, ecological momentary assessment (EMA), as implemented on contemporary smartphones or personal digital assistants, can provide researchers with near-real-time information on participants' behavior and mood in their natural environments. Data from portable/wearable electronic sensors measuring participants' internal and external environments can be combined with EMA (e.g., by timestamps recorded on questionnaires) to provide objective information useful in determining the momentary context of behavior and mood and/or validating participants' self-reports. Here, we review three objective ambulatory monitoring techniques that have been combined with EMA, with a focus on detecting drug use and/or measuring the behavioral or physiological correlates of mental events (i.e., emotions, cognitions): (1) collection and processing of biological samples in the field to measure drug use or participants' physiological activity (e.g., hypothalamic-pituitary-adrenal axis activity); (2) global positioning system (GPS) location information to link environmental characteristics (disorder/disadvantage, retail drug outlets) to drug use and affect; (3) ambulatory electronic physiological monitoring (e.g., electrocardiography) to detect drug use and mental events, as advances in machine learning algorithms make it possible to distinguish target changes from confounds (e.g., physical activity). Finally, we consider several other mobile/wearable technologies that hold promise to be combined with EMA, as well as potential challenges faced by researchers working with multiple mobile/wearable technologies simultaneously in the field.

Effects of elevation change on mental stress in high-voltage transmission tower construction workers

High-voltage transmission tower construction is a high-risk operation due to the construction site locations, extreme climatic factors, elevated working surfaces, and narrow working space. To comprehensively enhance our understanding of the psychophysiological phenomena of workers in extremely high tower constructions, we carried out a series of field experiments to test and compare three working surface heights in terms of frequency-domain heart rate variability (HRV) measurements. Twelve experienced male workers participated in this experiment. The dependent variables, namely, heart rate (HR), normalized low-frequency power (nLF), normalized high-frequency power (nHF), and LF-to-HF power ratio (LF/HF), were measured with the Polar RS800CX heart rate monitor. The experimental results indicated that the task workload was similar between working surface heights. Tower construction workers perceived an increased level of mental stress as working surface height increased.

Effort-reward imbalance, heart rate, and heart rate variability: the Cardiovascular Risk in Young Finns Study

BACKGROUND

Work stress indicated by effort-reward imbalance is hypothesized to cause autonomic arousal, which, if prolonged or frequent, could contribute to cardiovascular pathology. However, only limited empirical evidence on this mechanism is available.

PURPOSE

This study examined associations between effort-reward imbalance, heart rate (HR), and heart rate variability (HRV).

METHOD

The participants were 457 women and 406 men (mean age 32.3 years) derived from the population-based Young Finns Study. Effort-reward imbalance was defined as the ratio between effort and reward, higher efforts compared to rewards indicating greater imbalance.

RESULTS

In age-adjusted regression models, higher effort-reward imbalance was associated with lower HRV, and lower reward was associated with higher HR among women. These associations were not attenuated after additional adjustments for demographic characteristics and coronary risk factors. No significant associations of effort-reward imbalance or its components with HR and HRV were found in men.

CONCLUSION

Our finding of lower HRV and higher HR in young healthy women with high effort-reward imbalance and low rewards provides evidence of a potential mechanism that may link effort-reward imbalance to the development of coronary heart disease (CHD) in women.

Sleep latency testing as a time course measure of state arousal

The purpose of this study was to determine how long the effects of a brief period of physiological arousal persisted using repeated sleep latency testing and measurement of heart rate. Thirteen normal sleeping young adults spent two non-consecutive nights and the following days in the laboratory. On each day, subjects had five sleep latency measurements - at 09:00, 09:30, 10:00, 10:30, and 11:00 hours. The 09:00 test was a premanipulation baseline. Following this nap, subjects either walked for 5 min (on one day) or rested in bed for 10 min (on another day) prior to the 09:30 hours sleep latency test. Significant increases in sleep latency were found at 09:30, 10:00, and 11:00 hours following the single 5-min walk as compared with resting in bed (mean sleep latency after the walk was 11.7 min compared with 7.1 min for the resting condition). Heart rate was significantly higher throughout all of the postmanipulation naps following the walk. The elevated sleep latency is probably secondary to the changes in underlying physiological arousal as measured in this study by heart rate.

Exposure to violence and cardiovascular and neuroendocrine measures in adolescents

BACKGROUND

Exposure to violence has clear, detrimental psychological consequences, but the physiological effects are less well understood.

PURPOSE

This study examined the influence of exposure to violence on biological basal and reactivity measures in adolescents.

METHODS

There were 115 high school student participants. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), HR variability (HRV), and cortisol levels were recorded during baseline and a laboratory stressor. The Exposure to Violence interview was administered and assessed two dimensions: total observed violence and total personally experienced violence. These were then divided into component parts: lifetime frequency, proximity, and severity.

RESULTS

Greater total experienced violence was associated with increased basal SBP (r = .19, p < .05) and decreased acute stress reactivity in terms of SBP (beta = -.13, p = .05), HR (beta = -.21, p = .00), and HRV (beta = .13, p = .05). Lifetime frequency of experienced violence was associated with higher basal DBP (r = .33, p < .05), HR (r = .33, p < .05), and cortisol (r = .53, p < .00), and decreased SBP (beta = -.27, p < .05) and DBP (beta = -.31, p < .05) reactivity. Exposure to violence is associated with increased biological basal levels in adolescents, supporting allostatic-load research and decreased cardiovascular reactivity, supporting the inoculation effect.

CONCLUSIONS

The findings illustrate that being a victim of violence has more pervasive biological consequences than witnessing violence and that the accumulation of stressful experiences has the greatest effect on biological markers.

On the genesis of myocardial ischemia

About three quarters of myocardial ischemic events are triggered by the autonomic nervous system. The pathognomonic constellation is a combination of an almost complete withdrawal of tonic vagal activity with increased sympathetic activity. The reduction of tonic vagal activity, which is characteristic for ischemic heart disease, and the acute withdrawal of vagal drive preceding the onset of ischemia are not dependent on coronary artery disease. In this paper, the pathophysiological steps that lead from sympathetic-parasympathetic imbalance to myocardial ischemia shall be discussed. A considerable increase of aerobic glycolysis within the myocardium as a result of the autonomic imbalance is of special importance in this process.

The effect of mental stress on heart rate variability and blood pressure during computer work

The aim was to evaluate the cardiovascular and subjective stress response to a combined physical and mental workload, and the effect of rest. Twelve females who had no prior experience of laboratory experiments participated in the study. Computer-work-related mental stressors were either added to or removed from a standardized computer work session in the laboratory. Beat-to-beat blood pressure and electrocardiogram (ECG) were recorded continuously during the experiment. The participants reported subjective experiences of stress in six categories using an 11-point scale before and at the end of the work. Heart rate variability (HRV) variables were calculated from the ECG recordings, and a reduction in the high-frequency component of HRV and an increase in the low- to high-frequency ratio were observed in the stress situation compared to the control session. No changes were seen in the low-frequency component of HRV. The stressors induced an increase in blood pressure compared to baseline that persisted, and for the diastolic pressure it even increased in the subsequent control session. No differences were observed for subjective experience of stress with the exception of a time trend in the exhaustion scale, i.e. a progression in reported exhaustion with time. The results-and the dissociation between HRV and blood pressure variables-indicate that HRV is a more sensitive and selective measure of mental stress. It could be speculated that heart rate-derived variables reflect a central pathway in cardiovascular control mechanisms ("central command"), while the blood pressure response is more influenced by local conditions in the working muscles that partly mask the effect of changes in mental workloads. In the rest period after each work session, HRV and blood pressure variables were partly normalized as expected. However, an 8-min period of rest was insufficient to restore blood pressure to resting values.

The impact of music upon sleep tendency as measured by the multiple sleep latency test and maintenance of wakefulness test

Previous work has shown that background noise or music has a small positive impact on performance during sleep deprivation. The current study examined the effect of background music on the ability to fall asleep or remain awake. Twelve normal-sleeping young adults took multiple sleep latency tests (MSLT) and maintenance of wakefulness tests (MWT) after baseline sleep and one night of total sleep deprivation either with background music or under standard (quiet) conditions. It was hypothesized that the music would help maintain wakefulness both under baseline and sleep deprivation conditions. The results of the study showed that sleep latencies were increased in both MSLT and MWT when music was presented, but that this effect occurred primarily before subjects were sleep-deprived (a significant Music by Sleep Deprivation interaction). Sleep latencies were 15 and 11 min on the MSLT (33 and 26 min on the MWT) with Music as compared to Quiet after baseline sleep. Heart rate, used as a measure of physiological arousal, was significantly elevated in MWT and MSLT trials where music was presented. These data support previous work showing that level of arousal has an impact on measured sleep tendency which is independent of that of the sleep system. On a practical level, these data indicate that music may play a small beneficial role in helping to maintain arousal.

Level of arousal and the ability to maintain wakefulness

The ability to maintain wakefulness under baseline and sleep deprivation conditions was examined in a group of 14 normal young adults. Subjects participated in both standard and manipulation Maintenance of Wakefulness tests after being awake for 7, 19, and 31 h. In the manipulation Maintenance of Wakefulness tests, subjects performed varying degrees of physical activity at the onset of stage 1 to allow them to preserve wakefulness. As expected, ability to maintain wakefulness declined as time awake increased. With amount of time awake held constant, wakefulness was enhanced most after standing and doing knee bends, less after standing, less after sitting up, and least after subjects were spoken to. The improvement in alertness after doing knee bends as compared to being spoken to was of the same relative magnitude as the decrease in alertness after one night of total sleep deprivation. As expected, heart rate also increased consistently as activity increased. Each subject had a negative correlation between their EEG sleep latencies and their minimum r-r interval during the manipulation, i.e. the higher the heart rate, the longer the latency. These data were interpreted as a demonstration of the impact of discrete phasic arousal on the ability to maintain wakefulness.

Psychosocial factors and heart rate variability in healthy women

OBJECTIVE

This study was conducted to investigate associations between psychosocial risk factors, including social isolation, anger and depressive symptoms, and heart rate variability in healthy women.

METHODS

The study group consisted of 300 healthy women (median age 57.5 years) who were representative of women living in the greater Stockholm area. For the measurement of social isolation, a condensed version of the Interpersonal Support Evaluation List was used and household size assessed. Anger was measured by the anger scales previously used in the Framingham study and depressive symptoms by a questionnaire derived from Pearlin. Health behaviors were measured by means of standard questionnaires. From 24-hour ambulatory electrocardiographic monitoring, both time and frequency domain measures were obtained: SDNN index (mean of the SDs of all normal to normal intervals for all 5-minute segments of the entire recording), VLF power (very low frequency power), LF power (low frequency power), HF power (high frequency power), and the LF/HF ratio (low frequency by high frequency ratio) were computed.

RESULTS

Social isolation and inability to relieve anger by talking to others were associated with decreased heart rate variability. Depressive symptoms were related only to the LF/HF ratio. Adjusting for age, menopausal status, exercise and smoking habits, history of hypertension, and BMI did not substantially change the results.

CONCLUSIONS

These findings suggest heart rate variability to be a mediating mechanism that could explain at least part of the reported associations between social isolation, suppressed anger, and health outcomes.