Effort-reward imbalance for learning is associated with fatigue in school children

The effect of students' effort-reward imbalance on learning engagement: the mediating role of learned helplessness and the moderating role of social support

Introduction

To explore the predictive effect of effort-reward imbalance on students' learning engagement and to elucidate the underlying mechanism, 796 students were selected for a survey.

Methods

The participants were required to complete four scales: the Effort-reward Imbalance Scale, the Learning Engagement Scale, the Learned Helplessness Questionnaire, and the Perceived Social Support Scale.

Results

(1) Students' effort-reward imbalance significantly and negatively predicts their learning engagement; (2) Learned helplessness serves as a mediator in the relationship between students' effort-reward imbalance and learning engagement; (3) Social support plays a moderating role in the association between effort-reward imbalance and learned helplessness. High levels of social support can buffer the impact of an effort-reward imbalance on learned helplessness, and the protective effect of social support is more obvious when the effort-reward imbalance is low.

Discussion

The present study revealed how an effort-reward imbalance affects learning engagement among students through the dimensions of learned helplessness and perceived social support. The constructed model not only further clarifies the mechanism underlying the relationship between effort-reward imbalance and learning engagement but also holds significant implications for guiding students' education.

The association between academic pressure and adolescent mental health problems: A systematic review

BACKGROUND

Academic pressure is a potential contributor to adolescent mental health problems, but international evidence on this association has never been synthesised.

METHODS

We conducted the first systematic review of the association between academic pressure and adolescent depression, anxiety, self-harm, suicidality, suicide attempts and suicide. We searched MEDLINE, PsycINFO, ERIC and Web of Science (core collection) up to November 24, 2022, for studies of school-going children or adolescents, which measured academic pressure or timing within the school year as the exposure and depression, anxiety, self-harm, or suicidal ideation, attempts or suicide as outcomes. Risk of bias was assessed using the Mixed Methods Appraisal Tool. We used narrative synthesis to summarise the evidence. The review was prospectively registered with PROSPERO (CRD42021232702).

RESULTS

We included 52 studies. Most studies assessed mixed anxiety and depressive symptoms (n = 20) or depressive symptoms (n = 19). Forty-eight studies found evidence of a positive association between academic pressure or timing within the school year and at least one mental health outcome.

LIMITATIONS

Most studies were cross-sectional (n = 39), adjusted for a narrow range of confounders or had other limitations which limited the strength of causal inferences.

CONCLUSIONS

We found evidence that academic pressure is a potential candidate for public health interventions which could prevent adolescent mental health problems. Large population-based cohort studies are needed to investigate whether academic pressure is a causal risk factor that should be targeted in school- and policy-based interventions.

FUNDING

UCL Health of the Public; Wellcome Institutional Strategic Support Fund.

The Relationship between Effort-Reward Imbalance for Learning and Academic Burnout in Junior High School: A Moderated Mediation Model

Although effort-reward imbalance has been proven to affect academic burnout, how effort-reward imbalance affects academic burnout remains unclear. This study, from the perspective of learning satisfaction and resilience, investigates how effort-reward imbalance affects academic burnout and reveals the influence of effort-reward imbalance on academic burnout. A sample of 755 junior high school students was assessed using the Revised Effort-Reward Imbalance for Learning Scale, Revised Learning Satisfaction Scale, Academic Burnout Scale, and Resilience Scale. Junior high school students' effort-reward imbalance rates for learning, learning satisfaction, and academic burnout were all significantly correlated with each other; learning satisfaction mediated the relationship between them. Learning satisfaction mediated the relationship between junior high school students' effort-reward imbalance rate for learning and academic burnout, and resilience negatively moderated the path from junior high school students' effort-reward imbalance rate from learning to learning satisfaction. The results suggest that improving students' resilience can effectively decrease the negative effects of effort-reward imbalance.

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

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

Listening-Related Fatigue in Children With Hearing Loss: Perspectives of Children, Parents, and School Professionals

PURPOSE

Children with hearing loss (CHL) are considered at risk for listening-related fatigue and its negative consequences. We collected data via focus groups and interviews from three stakeholder groups-CHL, their parents, and teachers/school professionals-in order to define the construct of listening-related fatigue from the perspective of CHL and key stakeholders. This is an important first step in our long-term goal to construct and validate a measure (i.e., scale) of listening-related fatigue for the pediatric population, with a focus on CHL. This article provides an overview of the data gathering process, analysis of qualitative reports, and the development of a theoretical framework for understanding the experience of listening-related fatigue in CHL.

METHOD

We conducted focus groups and interviews in school-age children exhibiting bilateral, moderate-to-profound hearing loss (n = 43), their parents (n = 17), and school professionals who work with CHL (n = 28). The discussions were audio-recorded, transcribed, and coded using a hierarchical coding system. Qualitative analysis was conducted using an iterative inductive-deductive approach.

RESULTS

We identified primary themes from the focus group/interview discussions to develop a theoretical framework of listening-related fatigue in CHL. The framework demonstrates the complex interaction among situational determinants that impact fatigue, symptoms or manifestations of fatigue, and the utilization of, and barriers to, coping strategies to reduce listening-related fatigue.

CONCLUSIONS

Participant discussion suggests that listening-related fatigue is a significant problem for many, but not all, CHL. Qualitative data obtained from these stakeholder groups help define the construct and provide a framework for better understanding listening-related fatigue in children.

Language Tasks and the Network Control Role of the Left Inferior Frontal Gyrus

Recent work has combined cognitive neuroscience and control theory to make predictions about cognitive control functions. Here, we test a link between whole-brain theories of semantics and the role of the left inferior frontal gyrus (LIFG) in controlled language performance using network control theory (NCT), a branch of systems engineering. Specifically, we examined whether two properties of node controllability, boundary and modal controllability, were linked to semantic selection and retrieval on sentence completion and verb generation tasks. We tested whether the controllability of the left IFG moderated language selection and retrieval costs and the effects of continuous θ burst stimulation (cTBS), an inhibitory form of transcranial magnetic stimulation (TMS) on behavior in 41 human subjects (25 active, 16 sham). We predicted that boundary controllability, a measure of the theoretical ability of a node to integrate and segregate brain networks, would be linked to word selection in the contextually-rich sentence completion task. In contrast, we expected that modal controllability, a measure of the theoretical ability of a node to drive the brain into specifically hard-to-reach states, would be linked to retrieval on the low-context verb generation task. Boundary controllability was linked to selection and to the ability of TMS to reduce response latencies on the sentence completion task. In contrast, modal controllability was not linked to performance on the tasks or TMS effects. Overall, our results suggest a link between the network integrating role of the LIFG and selection and the overall semantic demands of sentence completion.

The effect of flaxseed on physical and mental fatigue in children and adolescents with overweight/obesity: a randomised controlled trial

Anti-inflammatory agents such as long-chain n-3 fatty acids have been recognised to improve disease-related fatigue. We hypothesised that α-linolenic acid may also benefit in reduction of fatigue in low-grade inflammation such as overweight/obesity. Seventy-two healthy children and adolescents with BMI > 25 kg/m2 were randomised to flaxseed (n 38) and puffed wheat (n 34) groups. Participants consumed isoenergetic amounts of either 20 g/d flaxseed or 25 g/d puffed wheat for 4 weeks. Fatigue, mood feelings (depression, anxiety and stress), appetite, energy intake, weight, height and waist circumference were measured. Analysis was performed based on per-protocol and intention-to-treat (ITT) approaches. Consumption of flaxseed decreased mental fatigue and caused a significant between-group difference (P < 0·001). Although no significant change in physical and total score of fatigue was observed in either group, a significant between-group difference occurred due to a more remarkable change in these parameters in the flaxseed group. General fatigue, motivation, activity and mood feelings did not change significantly between groups. Flaxseed showed less benefit than puffed wheat on anthropometric measures as it caused a smaller increase in height (0·53 (sd 0·89) v. 1·09 (sd 0·87) cm, P = 0·03) and reduction in BMI (-0·25 (sd 0·63) v. -0·67 (sd 0·56) kg/m2, P = 0·01) than puffed wheat. Appetite and waist circumference decreased in both groups, but no significant difference was observed between groups. In ITT analysis, only alteration in mental fatigue was significant. In conclusion, consumption of flaxseed may improve mental fatigue in children with overweight/obesity. However, because of smaller increase in height, it is better to hinder administration of flaxseed during periods of growth.

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

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

Sleep quality and sex modify the relationships between trait energy and fatigue on state energy and fatigue

The objective of this study was to identify the associations between trait energy and fatigue with state energy fatigue, as well as exploring if these relationships interacted with sex and/or sleep quality. The study population included a convenience sample of adults and college students (n ranges from 687 to 694). Key measures were state and trait mental and physical energy and fatigue scales, PSQI (a measure of sleep quality), and sex. Multiple regression models included age, polyphenol consumption, POMS scores, physical activity, mental load, and caffeine consumption as covariates. Analyses yielded a strong (r = .65) positive association between each trait and state variable. Overall, several statistically significant interactions were identified. First, the relationship between state and trait physical fatigue was particularly strong for women with high trait scores. There were also interactions with sleep quality. In the case of physical fatigue, poor sleep quality magnified the association between physical fatigue trait and state among those with low trait physical fatigue, while sleep quality did not make a difference for those with high trait physical fatigue. Conversely, in the case of physical energy and mental fatigue, good sleep quality was associated with both higher “highs” and lower “lows” of their respective traits; both interactions were present only among males. Our analyses suggest that sleep quality and sex could influence the effects of trait physical and mental energy and fatigue on state. Findings were more complex than initially assumed, suggesting that the interrelationship between trait and state may be modified by how males and females react and adapt to their trait.

Psychometric Properties of the Effort-Reward Imbalance Questionnaire for Teachers (Teacher ERIQ)

The effort-reward imbalance (ERI) model is a theoretical model of a psychosocial work environment with adverse effects on health and well-being that focuses on a mismatch between high efforts spent and low rewards received at work. This study aimed to develop and psychometrically test an effort-reward imbalance questionnaire for teachers (Teacher ERIQ) based on the ERI model. The structure validity, reliability, and criterion validity of the new questionnaire’s scores were evaluated in a sample of 475 Chinese teachers. The results of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) showed that a structure of four factors of effort (workload, emotional demands, student-related issues, and social responsibility) and two factors of reward (emotional reward and material reward) in accordance with the ERI model had significant factor loadings and acceptable model fit. The Cronbach’s Alpha coefficients of all dimensions’ scores showed that the questionnaire scores had good reliability. Criterion validity was indicated by significant correlation coefficients of scores of most dimensions along with teachers’ self-reported job burnout and non-reciprocal social relations, as well as the ANOVA results showing that the differences of the scores of the two criterion scales in different ERI ratio levels were significant. The results also showed that teacher’s ERI level varied with demographic variables such as age, gender and school type. The Teacher ERIQ is a valid and reliable new measurement for assessing teachers’ psychosocial work characteristics. It can be an important tool to provide new explanations of stress-related health risks among teachers and to guide the development of preventive measurements.

Balancing Effort and Rewards at University: Implications for Physical Health, Mental Health, and Academic Outcomes

BACKGROUND

The effort-reward imbalance model suggests that, when the efforts required within the workplace are disproportionately large in comparison to the rewards resulting from those efforts, there is an increased risk of stress-related health issues. The model posits that higher levels of "overcommitment," in addition to a high effort-reward imbalance ratio, magnifies this risk of ill-health. While work has been conducted to assess the validity of this model within the school setting, research in the higher education sector is limited.

OBJECTIVES

This study explored the validity of the effort-reward imbalance model for explaining burnout, poor health, and academic productivity among university students.

DESIGN AND METHODS

This study utilized a cross-sectional survey of Australian university students (n = 395) from a range of universities.

RESULTS

An imbalance of effort and reward was associated with poorer physical health, increased burnout, and reduced productivity. Effort-reward imbalance mediated a relationship between overcommitment and burnout; those high in overcommitment were more likely to experience an imbalance of effort and reward at university.

CONCLUSION

The relationships between effort-reward imbalance, health, burnout, and academic productivity support the generalizability of this model to the university setting. In addition, the personal characteristic of overcommitment also appears to have an important relationship with burnout.

Acute Exercise Effects among Young Adults with Analogue Generalized Anxiety Disorder

Recent findings support positive effects of acute aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with subclinical, or analogue, generalized anxiety disorder (GAD). However, exercise effects among young adult men with analogue GAD are unstudied.

PURPOSE

This study replicated initial findings of positive effects of acute vigorous-intensity aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with analogue GAD, examined responses among young adult men with analogue GAD, and explored sex-related differences and moderation by physical activity level, trait anxiety, depression, and poor sleep status.

METHODS

Thirty-five young adults (21.4 ± 2.3 yr; 19 males; 16 females) with Penn State Worry Questionnaire scores ≥45 (60 ± 8) completed two counterbalanced 30-min conditions: treadmill running at ~71.2% ± 0.04% HR reserve and seated quiet rest. Outcomes included worry, worry engagement, absence of worry, state anxiety, and feelings of energy and fatigue.

RESULTS

No outcome or moderator differed at baseline between sexes. Exercise significantly improved state anxiety (P < 0.04; d = 0.27) and feelings of energy (P < 0.001; d = 1.09). Small nonsignificant improvements were found for worry (d = 0.22), worry engagement (d = 0.18), and feelings of fatigue (d = 0.21). The magnitude of improvements in worry, worry engagement, absence of worry, and feelings of energy were stronger among females. Significant large, potentially clinically meaningful increases in feelings of energy were found among women (d = 1.35) and men (d = 0.92). A nonsignificant, but potentially clinically meaningful, moderate reduction in worry (d = 0.53) was found among women. High-trait anxiety and poor sleep quality were supported as moderators.

CONCLUSIONS

Findings replicated positive effects of acute aerobic exercise among young adult women with analogue GAD, and extended to support for positive effects among young adult men with analogue GAD.

A Pilot Exploratory Proteomics Investigation of Mental Fatigue and Mental Energy

Fatigue is a common and poorly understood problem that impacts approximately 45% of the United States (US) population. Fatigue has also been associated with fatigue-related driving accidents, school absences, decline in school performance and negative health outcomes. Fatigue has been linked to many diseases and is consistently underreported in medical care. Despite these high financial and societal costs, fatigue is a poorly understood problem and there is no consensus on how to measure fatigue. Proteomics is one of the most unbiased approach to measure differences in the protein levels from various biological fluids in two conditions, i.e. before and after mental exercise, aka fatigue. There are, however, challenges associated with such analyses: proteomics experiments are usually expensive and time consuming and also require a large number of participants. Here, we performed a proteomics experiment of three (pre- and post-fatigue) samples and also three matched controls (pre- and post-non-fatigue). We found no particular protein that has significant changes in fatigue sample upon treatment. We did note a potential association between changes in mental energy and Annexin A1. However, the study has value simply because it is an extra study in the field of fatigue, but also allows other to correlate our results with their results.

Sleep quality moderates the association between physical activity frequency and feelings of energy and fatigue in adolescents

Physical activity (PA) can improve sleep quality, low energy, and fatigue. Though poor sleep quality may induce feelings of low energy and fatigue, the potential moderating effect of sleep quality on associations between PA and feelings of energy and fatigue among adolescents is unknown. Thus, this study examined the moderating effect of sleep quality on associations between PA frequency and feelings of energy and fatigue among adolescents in Ireland. Adolescents (N = 481; 281 males, 200 females) aged 15.1 ± 1.7 years self-reported PA frequency, feelings of energy and fatigue, and sleep quality (September to December 2015). Two-way ANCOVAs examined variation in feelings of energy and fatigue according to the interaction of PA and sleep quality. Standardized mean difference (d) quantified the magnitude of differences. Poor sleepers with low PA reported greater feelings of fatigue compared to normal sleepers with low PA (d = 1.02; 95% CI 0.60, 1.44), and poor sleepers with moderate PA reported greater feelings of fatigue compared to normal sleepers with moderate PA (d = 0.50; 0.17, 0.82). Poor sleepers with low PA reported greater feelings of fatigue compared to both poor sleepers with moderate PA (d = 0.44; 0.05, 0.83) and poor sleepers with high PA (d = 0.87; 0.46, 1.28). Poor sleepers with moderate PA reported greater feelings of fatigue compared to poor sleepers with high PA (d = 0.52; 0.14, 0.91). Poor sleep did not moderate the association between PA and feelings of energy. Sleep quality moderates the association between PA frequency and feelings of fatigue. Fatigue symptoms improve as PA frequency increases among adolescents with poor sleep quality.

Examining longitudinal relationship among effort reward imbalance, coping strategies and academic burnout in Korean middle school students

The present study examined the longitudinal relationship between effort-reward imbalance as a stressor and academic burnout as a strain. The study also examined the moderation effect of coping strategies, a problem-focused coping and an emotion-focused coping, in the relationship between effort-reward imbalance as a stressor and middle school students’ academic burnout as a strain using multi-group latent growth modeling (LGM) analysis. The results indicated a significant relationship between the initial status of effort-reward imbalance and the initial status of academic burnout. The results also indicated a significant relationship between the change rate of effort-reward imbalance and that of academic burnout. In addition, problem-focused coping strategies had a moderation effect on the relationship between effort-reward imbalance and academic burnout longitudinally. However, the emotion-focused coping strategy did not have a moderation effect. The authors discuss specific findings and practical implications for teachers and school psychologists.

Student ERI: Psychometric properties of a new brief measure of effort-reward imbalance among university students

BACKGROUND

Psychosocial stress among university students, particularly medical students, is considered a widely prevalent problem. There is a need for valid measurement of an adverse psychosocial stress environment in university settings. The aim of this study was to examine the psychometric properties of a newly developed short student version of the effort-reward imbalance (ERI) questionnaire in a sample of medical students.

METHODS

A cross-sectional survey with a self-administrated questionnaire containing three scales was conducted among 406 medical students. Item-total correlations and Cronbach's alpha were calculated to assess the internal consistency of the scales. Confirmatory factor analysis was applied to test factorial validity of the questionnaire structure.

RESULTS

The student version of the ERI questionnaire provides acceptable psychometric properties. The Cronbach's alpha coefficients for effort, reward, and over-commitment were 0.67, 0.65, and 0.79, respectively. Confirmatory factor analysis displayed a satisfactory fit of the data structure with the theoretical concept (GFI>0.94).

CONCLUSIONS

This student version of the ERI questionnaire provides a psychometrically tested tool for studies focussing on psychosocial environment in university settings. Further applications of this approach in other student groups are needed, in addition to prospective studies assessing associations with health outcomes.

Low putamen activity associated with poor reward sensitivity in childhood chronic fatigue syndrome

Motivational signals influence a wide variety of cognitive processes and components of behavioral performance. Cognitive dysfunction in patients with childhood chronic fatigue syndrome (CCFS) may be closely associated with a low motivation to learn induced by impaired neural reward processing. However, the extent to which reward processing is impaired in CCFS patients is unclear. The aim of the present functional magnetic resonance imaging (fMRI) study was to determine whether brain activity in regions related to reward sensitivity is impaired in CCFS patients. fMRI data were collected from 13 CCFS patients (mean age, 13.6 ± 1.0 years) and 13 healthy children and adolescents (HCA) (mean age, 13.7 ± 1.3 years) performing a monetary reward task. Neural activity in high- and low-monetary-reward conditions was compared between CCFS and HCA groups. Severity of fatigue and the reward obtained from learning in daily life were evaluated by questionnaires. Activity of the putamen was lower in the CCFS group than in the HCA group in the low-reward condition, but not in the high-reward condition. Activity of the putamen in the low-reward condition in CCFS patients was negatively and positively correlated with severity of fatigue and the reward from learning in daily life, respectively. We previously revealed that motivation to learn was correlated with striatal activity, particularly the neural activity in the putamen. This suggests that in CCFS patients low putamen activity, associated with altered dopaminergic function, decreases reward sensitivity and lowers motivation to learn.

Effects of a selective educational system on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan

OBJECTIVE

The aim of the study reported here was to clarify the effects of academic pressure on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan.

METHODS

This cross-sectional study enrolled 757 senior high school adolescents who were classified into four groups: Grade 1 (n=261), Grade 2 (n=228), Grade 3T (n=199; Grade 3 students who had another college entrance test to take), and Grade 3S (n=69; Grade 3 students who had succeeded in their college application). Fatigue, sleep quality, daytime sleepiness, and depression were assessed using the Chinese version of the Multidimensional Fatigue Symptom Inventory - Short Form, Pittsburgh Sleep Quality Index-Taiwan Form, the Chinese version of the Epworth Sleepiness Scale, and the Chinese version of the Beck Depression Inventory(®)-II (BDI-II), respectively.

RESULTS

Physical, emotional, and mental fatigue scores were all higher in higher-grade groups. The Grade 3T (test) students had the worst fatigue severity, and the Grade 3S (success) students had the least fatigue severity. More than half of the students (60.9%) went to bed after 12 am, and they had on average 6.0 hours of sleep per night. More than 30% of the students in Grade 2 (37.3%) and Grades 3T/S (30.2%/30.4%) possibly had daily sleepiness problems. The students in Grade 3T had the worst BDI-II score (13.27±9.24), and the Grade 3S students had a much lower BDI-II score (7.91±6.13).

CONCLUSION

Relatively high proportions of fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents were found in our study. The severities of fatigue, sleep problems, and depression were significantly diminished in the group under less academic stress (Grade 3S). Our findings may increase the understanding of the mental health of senior high school students under academic pressure in Taiwan. Further large sample size and population-based study should be done for better understanding about this topic.

Effort-reward imbalance in the school setting: associations with somatic pain and self-rated health

AIMS

According to the workplace theory of effort-reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort-reward imbalance model to the school setting. It aims to analyse the associations that effort-reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents.

METHODS

Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14-16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort-reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted.

RESULTS

The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort-reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health.

CONCLUSIONS

Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students.

Osmotic release oral system-methylphenidate improves neural activity during low reward processing in children and adolescents with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is neurobehavioral disorder characterized by inattention, hyperactivity/impulsivity and impaired reward system function, such as delay aversion and low reward sensitivity. The pharmacological treatment for ADHD includes methylphenidate (MPH), or osmotic release oral system-MPH (OROS-MPH), which increases extrasynaptic dopamine and noradrenaline levels by blocking their reuptake. Although previous functional magnetic resonance imaging (fMRI) studies revealed that acute treatment with MPH alters activation of the nucleus accumbens during delay aversion in children and adolescents with ADHD, the effects a relatively long period of OROS-MPH treatment on delay aversion as well as reward sensitivity remain unclear. Thus, we evaluated brain activation with fMRI during a reward sensitivity paradigm that consists of high monetary reward and low monetary reward conditions before and after a 3-month treatment with OROS-MPH in 17 children and adolescents with ADHD (mean age, 13.3 ± 2.2) and 17 age- and sex-matched healthy controls (mean age, 13.0 ± 1.9). We found that before treatment there was decreased activation of the nucleus accumbens and thalamus in patients with ADHD during only the low monetary reward condition, which was improved to same level as those of the healthy controls after the treatment. The observed change in brain activity was associated with improved ADHD symptom scores, which were derived from Japanese versions of the ADHD rating scale-IV. These results suggest that treatment with OROS-MPH for a relatively long period is effective in controlling reward sensitivity in children and adolescents with ADHD.

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Attention deficit/hyperactivity disorder (ADHD) has low reward sensitivity.

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Activity in thalamus and nucleus accumbens was decreased in low monetary reward.

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Osmotic release oral system-methylphenidate (OROS-MPH) is a medication for ADHD.

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Brain activity and ADHD symptoms were improved by 3-month treatment with OROS-MPH.

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OROS-MPH treatment for long periods may change brain activity of pediatric ADHD.

Relationship between cognitive functions and prevalence of fatigue in elementary and junior high school students

BACKGROUND

Fatigue is a common complaint among elementary and junior high school students, and is related to poor academic performance. Since grade-dependent development of cognitive functions also influences academic performance, we attempted to determine whether cognitive functions were associated with the prevalence of fatigue.

METHODS

Participants were 148 elementary school students from 4th- to 6th-grades and 152 junior high school students from 7th- to 9th-grades. Participants completed a questionnaire about fatigue (Japanese version of the Chalder Fatigue Scale) and paper-and-pencil and computerized cognitive tests which could evaluate the abilities of motor processing, immediate, delayed and working memory, selective, divided and alternative attention, retrieve learned material, and spatial construction.

RESULTS

We found that in multivariate logistic regression analyses adjusted for grade and gender, slow motor processing was positively correlated with the prevalence of fatigue in the elementary school students and decreases in working memory and divided and alternative attention processing were positively correlated with the prevalence of fatigue in the junior high school students.

CONCLUSION

The grade-dependent development of cognitive function influences the severity of fatigue in elementary and junior high school students.