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Almarzouki AF. Stress, working memory, and academic performance: a neuroscience perspective. Stress 2024; 27:2364333. [PMID: 38910331 DOI: 10.1080/10253890.2024.2364333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/31/2024] [Indexed: 06/25/2024] Open
Abstract
The relationship between stress and working memory (WM) is crucial in determining students' academic performance, but the interaction between these factors is not yet fully understood. WM is a key cognitive function that is important for learning academic skills, such as reading, comprehension, problem-solving, and math. Stress may negatively affect cognition, including WM, via various mechanisms; these include the deleterious effect of glucocorticoids and catecholamines on the structure and function of brain regions that are key for WM, such as the prefrontal cortex and hippocampus. This review explores the mechanisms underlying how stress impacts WM and how it can decrease academic performance. It highlights the importance of implementing effective stress-management strategies to protect WM function and improve academic performance.
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Affiliation(s)
- Abeer F Almarzouki
- Department of Clinical Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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2
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Stergiou M, Robles-Pérez JJ, Rey-Mota J, Tornero-Aguilera JF, Clemente-Suárez VJ. Psychophysiological Responses in Soldiers during Close Combat: Implications for Occupational Health and Fitness in Tactical Populations. Healthcare (Basel) 2023; 12:82. [PMID: 38200988 PMCID: PMC10779181 DOI: 10.3390/healthcare12010082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
This study explores the psychophysiological responses and subjective exertion experiences of soldiers in simulated hand-to-hand combat, aligning these findings with established physiological benchmarks. Active military personnel were monitored for heart rate, blood lactate levels, subjective exertion, cortical arousal, and muscle strength during combat scenarios. The results showed significant increases in heart rate and blood lactate, indicating intense cardiovascular demands and a reliance on anaerobic energy systems. Contrary to these physiological changes, soldiers reported lower levels of exertion, suggesting a possible underestimation of physical effort or individual differences in perception and mental resilience to stress. Notably, a decrease in cortical arousal post-combat was observed, potentially signaling cognitive function deficits in decision-making and information processing in high-stress environments. This decline was more pronounced than typically seen in other high-stress situations, highlighting the unique cognitive demands of hand-to-hand combat. Additionally, an increase in muscle strength was noted, underscoring the physiological adaptations arising from intensive combat training. These findings provide valuable insights into the psychophysiological effects of hand-to-hand combat, emphasizing the complex interplay between physical exertion, cognitive function, and stress response in military contexts. The study underscores the need for comprehensive training strategies that address both physical and psychological aspects to enhance combat readiness and decision-making under stress.
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Affiliation(s)
- Maria Stergiou
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Center for Applied Combat Studies (CESCA), 45007 Toledo, Spain; (J.J.R.-P.); (J.R.-M.)
| | - José Juan Robles-Pérez
- Center for Applied Combat Studies (CESCA), 45007 Toledo, Spain; (J.J.R.-P.); (J.R.-M.)
- USAC ‘San Cristobal-Villaverde’—Ejército de Tierra, Av. de Andalucía, Km. 10, Villaverde, 28021 Madrid, Spain
| | - Jorge Rey-Mota
- Center for Applied Combat Studies (CESCA), 45007 Toledo, Spain; (J.J.R.-P.); (J.R.-M.)
| | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Center for Applied Combat Studies (CESCA), 45007 Toledo, Spain; (J.J.R.-P.); (J.R.-M.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
- Center for Applied Combat Studies (CESCA), 45007 Toledo, Spain; (J.J.R.-P.); (J.R.-M.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Tramel W, Schram B, Canetti E, Orr R. An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review. Healthcare (Basel) 2023; 11:2515. [PMID: 37761712 PMCID: PMC10530665 DOI: 10.3390/healthcare11182515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.
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Affiliation(s)
- Whitney Tramel
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Elisa Canetti
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Robin Orr
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
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Quinn ME, Shields GS. The Insidious Influence of Stress: An Integrated Model of Stress, Executive Control, and Psychopathology. Clin Psychol Sci 2023; 11:773-800. [PMID: 37701497 PMCID: PMC10497220 DOI: 10.1177/21677026221149736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Although exposure to acute stress undoubtedly contributes to psychopathology, most individuals do not develop psychopathology following stress exposure. To explain this, biological, emotional, and cognitive responses to stress have been implicated, but individual differences in executive control (i.e., top-down control of cognition and behavior) measured in response to stress has only recently emerged as a potential factor contributing to psychopathology. In this review, we introduce a model-the integrated model of stress, executive control, and psychopathology-positing how the impairing effects of acute stress on executive control can contribute to psychopathology. We link to research on biological, emotional, and cognitive processes, all of which can be impacted by executive control, to propose a framework for how poorer executive control under conditions of acute stress can contribute to psychopathology. This integrated model is intended to further our understanding of who is more susceptible to the negative consequences of stress.
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Geißler CF, Friehs MA, Frings C, Domes G. Time-dependent effects of acute stress on working memory performance: A systematic review and hypothesis. Psychoneuroendocrinology 2023; 148:105998. [PMID: 36493660 DOI: 10.1016/j.psyneuen.2022.105998] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Laboratory procedures such as the Trier Social Stress Test or the (Socially Evaluated) Cold Pressor Test have been used to investigate working memory performance under stress. Researchers so far have reported a diverse spectrum of stress effects (including the lack thereof) on working memory tasks. We conducted a systematic review of the effect acute stress on working memory performance in standardized laboratory procedures. An overview of the existing literature suggests that acute stress affects working memory in a time-dependent manner, presumably due to the differing time scales of the main stress-reactive hormones involved. Based on the empirical evidence, we hypothesize that the immediate stress-induced release of noradrenaline decreases working memory performance within the first 10 min post stress. In addition, rapid cortisol effects impair working memory at a later time-interval beginning about 25 min post stress. We outline future research directions which could further explore the implications of our insights, as for example combined pharmacological and naturalistic stressor interventions.
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Affiliation(s)
| | - Maximilian A Friehs
- School of Psychology, University College Dublin, Ireland; Lise-Meitner Research Group Cognition and Plasticity, Max-Planck-Institute for Human and Cognitive Brain Science, Germany
| | - Christian Frings
- Department of Cognitive Psychology, University of Trier, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Germany; Institute of Psychobiology, University of Trier, Germany.
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Martínez-Pascual B, Ramírez-Adrados A, Fernández-Martínez S, Gonzalez-de-Ramos C, Fernández-Elías VE, Clemente-Suárez VJ. Autonomic stress response of physiotherapy student in the different scenarios of an objective structured clinical examination. BMC MEDICAL EDUCATION 2022; 22:811. [PMID: 36434652 PMCID: PMC9694562 DOI: 10.1186/s12909-022-03903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The aim of the present research was to analyse modifications in the autonomic stress response of Physiotherapy students undergoing a 12-scenario Objective Structured Clinical Evaluation (OSCE). A total of 86 last year students of the Physiotherapy bachelor's degree (27.29 years (SD = 6.66); 36 females and 50 males) randomly assigned were monitored during the complete OSCE to measure heart rate variability (HRV) in temporal, frequency, and non-linear domains. The HRV analysed showed a large anticipatory stress response of students maintained during the entire evaluation. The stress response varied regarding OSCE station complexity and demands and the highest sympathetic response was not found in higher emotional scenarios.The autonomic modulation monitoring allows teachers to design OSCE scenarios more adapted to the students, limiting the effect of the stress response to allow a better performance.
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Affiliation(s)
- Beatriz Martínez-Pascual
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
| | - Ana Ramírez-Adrados
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
| | - Silvia Fernández-Martínez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
| | - Cristina Gonzalez-de-Ramos
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
| | - Valentín E. Fernández-Elías
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
| | - Vicente J. Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Tajo street, s/n, Madrid 28670 Villaviciosa de Odón, Spain
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Yang J, Xiang L, Zheng S, Liang H. Learning Stress, Involvement, Academic Concerns, and Mental Health among University Students during a Pandemic: Influence of Fear and Moderation of Self-Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10151. [PMID: 36011786 PMCID: PMC9408668 DOI: 10.3390/ijerph191610151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 has had a profound impact on the mental health and well-being of students. An effective method that can enable students to cope with difficult times is to help them realize their inner potential. Following the stimulus-organism-response model, this study developed a theoretical framework that deepens our understanding of an environmental stimulus (fear of COVID-19) that is experienced by students; struggle within the organism (learning stress, learning involvement, and academic concerns); and the psychological response (psychological well-being). The findings clarified how the fear of COVID-19 affects the psychological well-being of university students and revealed the moderate role of academic self-efficacy in this process. Some systematic practical advice was provided to higher education institutions to develop effective interventions to protect the mental health of college students and establish strategies to promote their inner potential.
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Affiliation(s)
- Jian Yang
- School of Journalism and Communication, Guangzhou University, Guangzhou 510006, China
| | - Ling Xiang
- School of Shipping Economics and Trade, Guangzhou Maritime University, Guangzhou 510725, China
| | - Shaobang Zheng
- School of Journalism and Communication, Guangzhou University, Guangzhou 510006, China
| | - Huijing Liang
- School of Journalism and Communication, Guangzhou University, Guangzhou 510006, China
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STOPS: A Coping Framework for Surgeons Who Experience Intraoperative Error. Ann Surg 2022; 276:288-292. [PMID: 35797637 DOI: 10.1097/sla.0000000000005447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the steps faculty surgeons take upon experiencing intraoperative error and synthesize these actions to offer a framework for coping with errors. BACKGROUND While intraoperative errors are inevitable, formal training in error recovery is insufficient and there are no established curricula that teach surgeons how to deal with the intraoperative error. This is problematic because insufficient error recovery is detrimental to both patient outcomes and surgeon psychological well-being. METHODS We conducted a thematic analysis. One-hour in-depth semistructured interviews were conducted with faculty surgeons from 3 hospitals. Surgeons described recent experiences with intraoperative error. Interviews were transcribed and coded. Analysis allowed for development of themes regarding responses to errors and coping strategies. RESULTS Twenty-seven surgeons (30% female) participated. Upon completion of the analysis, themes emerged in 3 distinct areas: (1) Exigency, or a need for training surgical learners how to cope with intraoperative errors, (2) Learning, or how faculty surgeons themselves learned to cope with intraoperative errors, and (3) Responses, or how surgeons now handle intraoperative errors. The latter category was organized into the STOPS framework: Intraoperative errors could produce STOPS: Stop, Talk to your Team, Obtain Help, Plan, Succeed. CONCLUSIONS AND RELEVANCE This study provides both novel insight into how surgeons cope with intraoperative errors and a framework that may be of great use to trainees and faculty alike.
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Shah SJ, Huang C. Can venting hamper high emotionally intelligent recipient's reattachment to work? BALTIC JOURNAL OF MANAGEMENT 2022. [DOI: 10.1108/bjm-12-2021-0479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study investigates how healthcare workers' venting - an emotion-focused form of coping during non-working hours - has unintended costs via its effect on spouses' reattachment to work if life partners are dual-earners. Research also examined anxiety as a causal mechanism that connects the receipt of venting with failure in reattachment to work. Lastly, our theory suggests that not everyone has the same experience with venting; the effect varies at different levels of emotional intelligence.Design/methodology/approachMultilevel path analysis using MPlus 8.3 was conducted to examine the daily survey data obtained from 101 spouses of healthcare workers over four consecutive workdays using the experience sampling technique.FindingsThe results suggested that receipt of venting increases anxiety and adversely influences reattachment to work through increased anxiety. The findings supported the suggested model's predictions, indicating that anxiety mediated the link between the receipt of venting and reattachment to work, and the mediation was partial. Further, emotional intelligence buffers the positive effect of receipt of venting on anxiety and the negative on reattachment to work. Lastly, the findings indicate that moderated mediation exists: the indirect effect of receipt of venting on reattachment to work is not as strong at higher levels of emotional intelligence.Originality/valueThis study is the first attempt that identified the receipt of venting as a predictor of reattachment to work. Moreover, up till now, no study has examined the mediating role of anxiety in the relationship between receipt of venting and reattachment to work. Finally, this is the preliminary effort that validated the moderating role of emotional intelligence on the above-mentioned links.
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Ramírez-Adrados A, Fernández-Elías VE, Fernández-Martínez S, Martínez-Pascual B, Gonzalez-de-Ramos C, Clemente-Suárez VJ. The Effect of Studying a Double Degree in the Psychophysiological Stress Response in the Bachelor's Thesis Defense. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031207. [PMID: 35162228 PMCID: PMC8835440 DOI: 10.3390/ijerph19031207] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023]
Abstract
The aim of this research was to analyze the effect of studying a single or double degree in the psychophysiological stress response and academic performance of university students in their bachelor's thesis defense. We analyzed the autonomic stress response, cortical arousal, subjective distress perception, and the sense of objective and subjective academic fulfilment of 84 single-degree physiotherapy students and 26 double-degree sport sciences and physiotherapy students during their bachelor's thesis defense. The results showed that the bachelor's thesis defense was a stressful event for double-degree students, showing an activation of the sympathetic nervous system and presenting a higher autonomic habituation response for the double degree students compared to the single degree students. We found higher mean grades during the whole degree and higher grades in the written and oral bachelor's thesis academic achievements for single-degree students compared to double-degree students. No significant differences were found between single-degree and double-degree students in subjective distress perception and cortical arousal. No correlation was found between academic performance variables and subjective distress perception, cortical arousal, and autonomic modulation variables. We conclude that the bachelor's thesis defense produces a large anticipatory anxiety response in single-degree physiotherapy students and in double-degree sport sciences and physiotherapy students. Double-degree students showed higher levels of habituation and adaptability to the stressful event, with a better autonomic response. Academic achievements were significantly higher among single-degree students compared to the double-degree group.
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Affiliation(s)
- Ana Ramírez-Adrados
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Valentín E. Fernández-Elías
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Silvia Fernández-Martínez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Beatriz Martínez-Pascual
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Cristina Gonzalez-de-Ramos
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain; (A.R.-A.); (V.E.F.-E.); (S.F.-M.); (B.M.-P.); (C.G.-d.-R.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
- Correspondence: ; Tel.: +34-902-232-350; Fax: +34-911-413-585
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Kabir H, Hasan MK, Mitra DK. E-learning readiness and perceived stress among the university students of Bangladesh during COVID-19: a countrywide cross-sectional study. Ann Med 2021; 53:2305-2314. [PMID: 34889699 PMCID: PMC8667940 DOI: 10.1080/07853890.2021.2009908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/18/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has compelled all educational institutions from the conventional campus-based education system to e-learning worldwide. However, adapting to this new platform, e-learning readiness may cause perceived stress among students. This study aimed to examine the association between e-learning readiness and perceived e-learning stress and the relationship between sociodemographic and e-learning related factors. RESULTS A cross-sectional study was employed, where 1145 e-learning enrolled university students were surveyed. The result indicated that nearly 91% of students reported moderate (76.07%) to the higher level (14.85%) of perceived e-learning stress, whereas more than half of them (58.17%) were at the sub-optimum level of readiness. Furthermore, it was found that students with the sub-optimum level of readiness compared to optimum had a significantly higher chance of reporting moderate and high level of perceived e-learning stress. Besides, parents' highest education, residence, students' preference in (e-learning or learning format), and having any eye problems were associated with perceived e-learning stress. CONCLUSIONS A sudden introduction of e-learning during the COVID-19 catastrophe has brought about challenges, including the students' readiness, that might exacerbate the perceived stress level in different ways. This study reported that most of the students were at sub-optimal levels of readiness and suffered from moderate to high levels of perceived e-learning stress. The findings should integrate into the education monitoring system to enhance students' coping strategies, incite readiness, straighten, and nourish existing policies.Key messagesThe moderate and higher level of e-learning stress was 76% and 15%, respectively.Here, 58% of students were at the sub-optimum level of e-learning readiness.Students' sub-optimum level of e-learning readiness was significantly associated with the perceived moderate and high level of e-learning stress.
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Affiliation(s)
- Humayun Kabir
- Department of Public Health, North South University, Dhaka, Bangladesh
- CRP Nursing College, Savar, Dhaka, Bangladesh
| | - Md. Kamrul Hasan
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Biochemistry and Molecular Biology, Tejgaon College, National University, Gazipur, Bangladesh
| | - Dipak Kumar Mitra
- Department of Public Health, North South University, Dhaka, Bangladesh
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Bellido-Esteban A, Beltrán-Velasco AI, Ruisoto-Palomera P, Nikolaidis PT, Knechtle B, Clemente-Suárez VJ. The Effect of Psychology Objective Structured Clinical Examination Scenarios Presentation Order on Students Autonomic Stress Response. Front Psychol 2021; 12:622102. [PMID: 33841253 PMCID: PMC8024632 DOI: 10.3389/fpsyg.2021.622102] [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: 10/27/2020] [Accepted: 03/02/2021] [Indexed: 01/14/2023] Open
Abstract
The objective structured clinical examination (OSCE) is a method for assessment clinical competencies and skills. However, there is a need to improve its design in psychology programs. The aim of this study was to analyze the effect of the different scenario's presentation order with different complexity/difficulty on the autonomic stress response of undergraduate students undergoing a Psychology OSCE. A total of 32 students of Psychology Bachelor's Degree (23.4 ± 2.5 years) were randomly selected and assigned to two OSCE scenarios of different complexity. While undergoing the scenarios, participants heart rate variability was analyzed as an indicator of participant's stress autonomic response. Results indicate that the order of presentation of different complexity/difficulty scenarios affects the autonomic stress response of undergraduate Psychology students undergoing an OSCE. Students who underwent the high-complexity scenario (difficult) first, reported significantly higher autonomic stress response than students who began the OSCE with the low-complexity scenario (easy). Highly complex or difficult scenarios require good executive functions or cognitive control, very sensitive to autonomic stress responses. Therefore, OSCE design will benefit from placing easy scenarios first.
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Affiliation(s)
| | | | | | - Pantelis T Nikolaidis
- Department of Physical and Cultural Education, Hellenic Army Academy, Athens, Greece.,Exercise Physiology Laboratory, Nikaia, Greece
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Vicente Javier Clemente-Suárez
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.,Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla, Colombia
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13
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Lebares CC, Coaston TN, Delucchi KL, Guvva EV, Shen WT, Staffaroni AM, Kramer JH, Epel ES, Hecht FM, Ascher NL, Harris HW, Cole SW. Enhanced Stress Resilience Training in Surgeons: Iterative Adaptation and Biopsychosocial Effects in 2 Small Randomized Trials. Ann Surg 2021; 273:424-432. [PMID: 32773637 PMCID: PMC7863698 DOI: 10.1097/sla.0000000000004145] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To determine the effects of ESRT (an iteratively adapted and tailored MBI) on perceived stress, executive cognitive function, psychosocial well-being (ie, burnout, mindfulness), and pro-inflammatory gene expression in surgical (ESRT-1) and mixed specialty (ESRT-2) PGY-1 volunteers. SUMMARY OF BACKGROUND AND DATA Tailored MBIs have proven beneficial in multiple high-stress and high-performance populations. In surgeons, tailored MBIs have been shown to be feasible and potentially beneficial, but whether mindfulness-based cognitive training can improve perceived stress, executive function, well-being or physiological distress in surgical and nonsurgical trainees is unknown. METHODS In 2 small single-institution randomized clinical trials, ESRT, a tailored mindfulness-based cognitive training program, was administered and iteratively adapted for first-year surgical (ESRT-1, 8 weekly, 2-hour classes, n = 44) and mixed specialty (ESRT-2, 6 weekly, 90-minute classes, n = 45) resident trainees. Primary and secondary outcomes were, respectively, perceived stress and executive function. Other prespecified outcomes were burnout (assessed via Maslach Burnout Inventory), mindfulness (assessed via Cognitive Affective Mindfulness Scale - Revised), and pro-inflammatory gene expression (assessed through the leukocyte transcriptome profile "conserved transcriptional response to adversity"). RESULTS Neither version of ESRT appeared to affect perceived stress. Higher executive function and mindfulness scores were seen in ESRT-1, and lower emotional exhaustion and depersonalization scores in ESRT-2, at pre-/postintervention and/or 50-week follow-up (ESRT-1) or at 32-week follow-up (ESRT-2), compared to controls. Pooled analysis of both trials found ESRT-treated participants had reduced pro-inflammatory RNA expression compared to controls. CONCLUSIONS This pilot work suggests ESRT can variably benefit executive function, burnout, and physiologic distress in PGY-1 trainees, with potential for tailoring to optimize effects.
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Affiliation(s)
- Carter C Lebares
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Troy N Coaston
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Kevin L Delucchi
- Department of Psychiatry, University of California San Francisco, San Francisco, California
| | - Ekaterina V Guvva
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Wen T Shen
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Adam M Staffaroni
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Joel H Kramer
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, California
- Osher Center for Integrated Medicine, University of California San Francisco, San Francisco, California
| | - Frederick M Hecht
- Department of Internal Medicine, University of California San Francisco, San Francisco, California
- Osher Center for Integrated Medicine, University of California San Francisco, San Francisco, California
| | - Nancy L Ascher
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Hobart W Harris
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Steven W Cole
- Department of Psychiatry & Biobehavioral Sciences, and Department of Medicine, University of California, Los Angeles
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14
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Ramírez-Adrados A, Fernández-Martínez S, Martínez-Pascual B, Gonzalez-de-Ramos C, Fernández-Elías VE, Clemente-Suárez VJ. Psychophysiological stress response of physiotherapy last year students in his final degree dissertation. Physiol Behav 2020; 222:112928. [DOI: 10.1016/j.physbeh.2020.112928] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 12/20/2022]
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15
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Plieger T, Reuter M. Stress & executive functioning: A review considering moderating factors. Neurobiol Learn Mem 2020; 173:107254. [PMID: 32485224 DOI: 10.1016/j.nlm.2020.107254] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 12/21/2022]
Abstract
A multitude of studies investigating the effects of stress on cognition has produced an inconsistent picture on whether - and under which conditions - stress has advantageous or disadvantageous effects on executive functions (EF). This review provides a short introduction to the concept of stress and its neurobiology, before discussing the need to consider moderating factors in the association between stress and EF. Three core domains are described and discussed in relation to the interplay between stress and cognition: the influence of different paradigms on physiological stress reactivity, individual differences in demographic and biological factors, and task-related features of cognitive tasks. Although some moderating variables such as the endocrine stress response have frequently been considered in single studies, no attempt of a holistic overview has been made so far. Therefore, we propose a more nuanced and systematic framework to study the effects of stress on executive functioning, comprising a holistic overview from the induction of stress, via biological mechanisms and interactions with individual differences, to the influence of stress on cognitive performance.
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Affiliation(s)
- Thomas Plieger
- Department of Psychology, Laboratory of Neurogenetics University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany.
| | - Martin Reuter
- Department of Psychology, Laboratory of Neurogenetics University of Bonn, Kaiser-Karl-Ring 9, D-53111 Bonn, Germany
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16
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Pearman A, Neupert SD, Hughes ML. State Anxiety Is Related to Cortisol Response During Cognitive Testing for Older Adults. Gerontol Geriatr Med 2020; 6:2333721420914776. [PMID: 32284956 PMCID: PMC7139176 DOI: 10.1177/2333721420914776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/03/2020] [Accepted: 02/27/2020] [Indexed: 01/09/2023] Open
Abstract
Cognitive testing situations can be stressful for both younger and older adults,
but threats of cognitive evaluation may be particularly salient among anxious
older individuals as they tend to be more concerned than younger adults about
their cognitive abilities and age-related cognitive decline. We examined
age-related differences in the effect of anxiety on cortisol responses during
cognitive testing in a sample of 27 younger (M = 19.8) and 29
older (M = 71.2) adults. Older adults with higher anxiety also
had higher during-task cortisol (suggesting higher reactivity to testing) than
older adults with lower anxiety and young adults. There was no effect of anxiety
on cortisol for younger adults. Simultaneously examining subjective (state
anxiety) and physiological (cortisol response) indicators of threat during
cognitive testing appears to be especially important for older adults with
higher state anxiety. The results are important for understanding cortisol
reactivity, particularly in older adults. Researchers who administer cognitive
tests to older adults and clinicians who work with older adults with cognitive
concerns and/or anxiety may want to consider how they present their
material.
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Affiliation(s)
- Ann Pearman
- Georgia Institute of Technology, Atlanta, USA
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17
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Wiemers US, Hamacher-Dang TC, Yonelinas AP, Wolf OT. Pre-encoding stress induced changes in perceived stress, blood pressure and cortisol are differentially associated with recollection and familiarity. Brain Cogn 2019; 133:5-11. [DOI: 10.1016/j.bandc.2018.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/21/2018] [Accepted: 03/30/2018] [Indexed: 01/28/2023]
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18
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Delgado-Moreno R, Robles-Pérez JJ, Aznar-Laín S, Clemente-Suárez VJ. Effect of Experience and Psychophysiological Modification by Combat Stress in Soldier’s Memory. J Med Syst 2019; 43:150. [DOI: 10.1007/s10916-019-1261-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
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19
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Clemente-Suarez VJ, Palomera PR, Robles-Pérez JJ. Psychophysiological response to acute-high-stress combat situations in professional soldiers. Stress Health 2018; 34:247-252. [PMID: 28834066 DOI: 10.1002/smi.2778] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/15/2017] [Accepted: 07/27/2017] [Indexed: 11/09/2022]
Abstract
The study of psychophysiological responses of soldiers in combat situations remains a challenge, especially in melee combat-a close proximity unarmed fight-defined by high unpredictability. Gaining knowledge about psychophysiological changes in high-stress situations is required to optimise training. This study aimed to analyse modifications in autonomic modulation, cortical arousal, heart rate, muscle strength, blood lactate concentration, and rating of perceived exertion of veteran soldiers in a melee combat simulation. Twenty veteran soldiers were analysed before and after a melee combat simulation in accordance with realistic situations that occur in actual operations areas. The simulation consisted of actions performed by a binomial unit in a security and protection mission in an operations area. The melee combat caused an increase in sympathetic modulation, blood lactate concentration, heart rate, muscle strength, a decreased tendency in cortical arousal, and a lower rating of perceived exertion than the organic response measured. An intense fight-flight response was observed in soldiers by the limbic system activation, causing a misinterpretation of perceived exertion. Finally, implications for the design of simulation environments for tactics training in high-stress professions are discussed.
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Affiliation(s)
- Vicente Javier Clemente-Suarez
- Research Center in Applied Combat (CESCA), Toledo, Spain.,Applied Psychophysiological Research Group, European University of Madrid, Madrid, Spain
| | - Pablo Ruisoto Palomera
- Department of Psychology, European University of Madrid, Madrid, Spain.,Department of Basic Psychology, Psychobiology and Methodology of Human Behavior, University of Salamanca, Spain
| | - José Juan Robles-Pérez
- Research Center in Applied Combat (CESCA), Toledo, Spain.,Light Forces Head Quarter of the Spanish Army, Madrid, Spain
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20
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Tornero-Aguilera JF, Robles-Pérez JJ, Clemente-Suárez VJ. Use of Psychophysiological Portable Devices to Analyse Stress Response in Different Experienced Soldiers. J Med Syst 2018. [PMID: 29532178 DOI: 10.1007/s10916-018-0929-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Previous studies have shown that actuate stress have a negative effect on working memory, visio-spatial ability and symptoms of disassociation. We conducted the present research with the aim of to analyse the effect of experience and training in psychophysiological response, attention and memory of soldiers in combat. Variables of blood lactate, blood glucose, blood oxygen saturation, body temperature, heart rate, lower body muscular strength manifestation, autonomic modulation, cortical arousal, cognitive and somatic anxiety, and memory by a post mission questionnaire were analysed before and after a combat simulation in 49 soldiers of Spanish Army. Combat simulation produced a significant increase (p < 0.05) in blood lactate, blood glucose, blood oxygen saturation, rated perceived exertion, heart rate, cognitive and somatic anxiety. Significant increase in low frequency domain and significant decrease in high frequency domain of the heart rate variability was found in experienced and highly trained soldiers. The percentage of correct response in the post mission questionnaire indicated that elements better remembered were those related with soldier integrity and considered as a possible life threat, Significant differences in the post mission questionnaire by experience and training was also found. Correlation analysis showed that higher psychophysiological activation correlated positively with cognitive impairment and lower memory. As a conclusion, higher experienced soldiers presented higher physiological activation as well as cognitive and memory impairment than lower experienced soldier after a combat simulation and memory function was modulated by the stimulus nature.
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Affiliation(s)
- J F Tornero-Aguilera
- Research Center in Applied Combat (CESCA), Toledo, Spain.,Applied Psychophysiological Research Group, European University of Madrid, Madrid, Spain
| | - José Juan Robles-Pérez
- Research Center in Applied Combat (CESCA), Toledo, Spain.,Light Forces Head Quarter of the Spanish Army, Madrid, Spain
| | - Vicente Javier Clemente-Suárez
- Research Center in Applied Combat (CESCA), Toledo, Spain. .,Applied Psychophysiological Research Group, European University of Madrid, Madrid, Spain. .,Faculty of Sport Sciences, Tajo Street, s/n, 28670 Villaviciosa de Odón, Madrid, Spain.
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21
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Beltrán-Velasco AI, Bellido-Esteban A, Ruisoto-Palomera P, Clemente-Suárez VJ. Use of Portable Digital Devices to Analyze Autonomic Stress Response in Psychology Objective Structured Clinical Examination. J Med Syst 2018; 42:35. [PMID: 29327087 DOI: 10.1007/s10916-018-0893-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/05/2018] [Indexed: 01/16/2023]
Abstract
The aim of the present study was to explore changes in the autonomic stress response of Psychology students in a Psychology Objective Structured Clinical Examination (OSCE) and their relationship with OSCE performance. Variables of autonomic modulation by the analysis of heart rate variability in temporal, frequency and non-linear domains, subjective perception of distress strait and academic performance were measured before and after the two different evaluations that composed the OSCE. A psychology objective structured clinical examination composed by two different evaluation scenarios produced a large anxiety anticipatory response, a habituation response in the first of the evaluation scenarios and a in the entire evaluation, and a no habituation response in the second evaluation scenario. Autonomic modulation parameters do not correlate with academic performance of students.
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Affiliation(s)
| | | | - Pablo Ruisoto-Palomera
- Department of Psychology, European University of Madrid, Madrid, Spain.,Department of Basic Psychology, Psychobiology and Methodology of Behavioural Sciences, University of Salamanca, Salamanca, Spain
| | - Vicente Javier Clemente-Suárez
- Applied Psychophysiological Research Group, European University of Madrid, Madrid, Spain. .,Center of Excellence in Sports and Life Sciences, European University of Madrid, Madrid, Spain. .,Facultad de Ciencias de la actividad física y el deporte, Universidad Europea, Calle Tajo s/n, Madrid, Spain.
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22
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Jiang C, Rau PLP. Working memory performance impaired after exposure to acute social stress: The evidence comes from ERPs. Neurosci Lett 2017; 658:137-141. [DOI: 10.1016/j.neulet.2017.08.054] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 08/12/2017] [Accepted: 08/22/2017] [Indexed: 12/25/2022]
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23
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Delgado-Moreno R, Robles-Pérez JJ, Clemente-Suárez VJ. Combat Stress Decreases Memory of Warfighters in Action. J Med Syst 2017; 41:124. [PMID: 28699082 DOI: 10.1007/s10916-017-0772-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 07/02/2017] [Indexed: 11/27/2022]
Abstract
The present research aimed to analyze the effect of combat stress in the psychophysiological response and attention and memory of warfighters in a simulated combat situation. Variables of blood oxygen saturation, heart rate, blood glucose, blood lactate, body temperature, lower body muscular strength manifestation, cortical arousal, autonomic modulation, state anxiety and memory and attention through a postmission questionnaire were analyzed before and after a combat simulation in 20 male professional Spanish Army warfighters. The combat simulation produces a significant increase (p < 0.05) in explosive leg strength, rated perceived exertion, blood glucose, blood lactate, somatic anxiety, heart rate, and low frequency domain of the HRV (LF) and a significant decrease of high frequency domain of the heart rate variability (HF). The percentage of correct response in the postmission questionnaire parameters show that elements more related with a physical integrity threat are the most correctly remembered. There were significant differences in the postmission questionnaire variables when participants were divided by the cortical arousal post: sounds no response, mobile phone correct, mobile phone no response, odours correct. The correlation analysis showed positive correlations: LF post/body temperature post, HF post/correct sound, body temperature post/glucose post, CFFTpre/lactate post, CFFT post/wrong sound, glucose post/AC pre, AC post/wrong fusil, AS post/SC post and SC post/wrong olfactory; and negative correlations: LF post/correct sound, body temperature post/lactate post and glucose post/lactate post. This data suggest that combat stress actives fight-flight system of soldiers. As conclusion, Combat stress produces an increased psychophysiological response that cause a selective decrease of memory, depending on the nature, dangerous or harmless of the objects.
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Affiliation(s)
- Rosa Delgado-Moreno
- Research Center in Applied Combat (CESCA), Toledo, Spain
- Faculty of Sport Sciences, Department of Sport Science, European University of Madrid, Calle Tajo, s/n, 28670 Villaviciosa de Odón, Madrid, España
| | - José Juan Robles-Pérez
- Research Center in Applied Combat (CESCA), Toledo, Spain
- Light Forces Head Quarter of the Spanish Army, Madrid, Spain
| | - Vicente Javier Clemente-Suárez
- Research Center in Applied Combat (CESCA), Toledo, Spain.
- Faculty of Sport Sciences, Department of Sport Science, European University of Madrid, Calle Tajo, s/n, 28670 Villaviciosa de Odón, Madrid, España.
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