The role of stress mindset in shaping cognitive, emotional, and physiological responses to challenging and threatening stress

A longitudinal person-centered investigation of the multidimensional nature of employees' perceptions of challenge and hindrance demands at work

BACKGROUND AND OBJECTIVES

This research relies on a combination of variable- and person-centered approaches to help improve our understanding of the dimensionality of job demands by jointly considering employees' global levels of job demands, exposure and their specific levels of exposure to challenge and hindrance demands.

DESIGN AND METHODS

We relied on a sample of 442 workers who completed a questionnaire twice over three months. Our analyses sought to identify the nature of the job demands profiles experienced by these workers, to document the stability of these profiles over time, and to assess their associations with theoretically-relevant outcomes (i.e., work engagement, job boredom, problem-solving pondering, work-related rumination, proactive health behaviors, and sleep quality and quantity). Furthermore, we examined whether these profiles and associations differed as a function of working remotely or onsite.

RESULTS

Five profiles were identified and found to be highly stable over time: Globally Exposed, Not Exposed, Not Exposed but Challenged, Exposed but Not Challenged, and Mixed. These profiles shared clear associations with all outcomes, with the most adaptive outcomes associated with the Exposed but Not Challenged profile, whereas the most detrimental ones were observed in the Mixed profile. However, none of these results differed across employees working onsite and those working remotely.

CONCLUSIONS

These findings have theoretical and practical implications regarding the effects of work characteristics on employees' functioning.

Can the stress be managed? Stress mindset as a mitigating factor in the influence of job demands on burnout

AIM

Despite the serious consequences of exposure to high job demands for nursing staff, few studies have identified pathways that could reduce the influence of high job demands on burnout. The current study aimed to exaime whether a stress mindset mitigates the positive relationship between job demands and burnout.

DESIGN

A cross-sectional survey was adopted and data were collected employing self-report questionnaires.

METHODS

A convenience sample of 676 nurses recruited from six regional hospitals in China were invited to complete a demographic questionnaire, the Psychological Job Demand Scale, the Stress Mindset Scale and the Burnout Scale. Hierarchical multiple regression analysis and simple slope analysis were used to examine the moderating role of stress mindset.

RESULTS

Higher job demands were positively linked to burnout, and stress mindset was negatively linked to burnout. Stress mindset moderated the positive relationship between job demands and burnout. Specifically, compared to nurses with a stress-is-debilitating mindset, the relationship will be smaller for nurses holding a stress-is-enhancing mindset.

PATIENT OR PUBLIC CONTRIBUTIONS

Based on these findings, nursing leaders should foster nurses' stress-is-enhancing mindset, which can ameliorate the adverse effect of job demands.

The roles of stress mindset and personality in the impact of life stress on emotional well-being in the context of Covid-19 confinement: A diary study

Previous studies indicate that COVID-19 confinement has led to an increase in psychological distress and a decrease in overall well-being. This longitudinal study aims to investigate how stress mindset and personality traits moderate the impact of life stress on the development of emotional well-being during the COVID-19 pandemic confinement. Our study collected daily life stress and emotions data from 134 participants over 14 consecutive days using the diary method. We used hierarchical linear modeling (HLM) to analyze the data, examining within-person and between-person effects. Life stress predicted moderate increases in positive emotions and strong increases in negative emotions over time. A stress-is-enhancing stress mindset was associated with greater positive emotions at baseline and mitigated the link between life stress and negative emotions. Among the Big Five personality traits, extraversion, openness, agreeableness, and conscientiousness were associated with higher baseline levels of positive emotions. Agreeableness and conscientiousness mitigated the link between life stress and negative emotions. Neuroticism was associated with higher baseline levels of negative emotions and moderately mitigated the link between life stress and positive emotions. The interaction between neuroticism and stress-is-enhancing mindset predicted greater negative emotions and mitigated the link between life stress and positive emotions. In contrast, the interaction between stress-is-enhancing mindset and the other four personality traits mitigated the positive link between life stress and negative emotions. Overall, these findings suggest that life stress from confinement leads to a decrease in daily emotional well-being as the confinement prolongs. Personality traits-agreeableness, conscientiousness, and a stress-is-enhancing stress mindset-act as protective roles in mitigating life stress' effect on reduced emotional well-being over time. The findings advance our knowledge in understanding the roles of personality traits and stress-is-enhancing mindset in explaining the heterogeneity in the impact of life stress on emotional well-being.

The Effects of Illegitimate Tasks on Task Crafting and Cyberloafing: The Role of Stress Mindset and Stress Appraisal

Previous studies have mainly focused on the detrimental effects of illegitimate tasks as ubiquitous workplace stressors while ignoring the appraisal measures for such tasks. The term "illegitimate" is used by employees to describe the alignment of a task with their job role rather than the inherent qualities of the task itself. Thus, drawing on the transactional theory of stress, this study examines the moderating effect of the stress mindset on the relationship between illegitimate tasks and the appraisal of such tasks. On this basis, this study further explores when cognitive appraisal mediates the effects of illegitimate tasks on coping behaviors (task crafting and cyberloafing). Data were collected from 285 employees from an energy company in Shandong, China, by using a time-lagged research design. The findings indicate that employees react differently to illegitimate tasks depending on their stress mindset. Specifically, for employees with a stress-is-enhancing mindset, illegitimate tasks induce their challenge appraisal, which leads to task crafting. In addition, illegitimate tasks induce hindrance appraisal in employees with a stress-is-debilitating mindset, which leads to cyberloafing. In practice, this research study suggests that when illegitimate tasks cannot be eliminated, organizations should consider employees' stress mindset when assigning such tasks.

Improving stress mindset through education and imagery

BACKGROUND

Research suggests interventions such as education and imagery can elicit a greater stress-is-enhancing mindset. The present study examined the individual and combined effect of stress-is-enhancing education and/or imagery delivered virtually in altering stress mindset. Three 3-minute online video interventions: (1) education, (2) imagery, (3) education with imagery were compared to each other and a control comparison.

DESIGN AND METHODS

Participants (N = 164; 103 = female; Mage = 20.03, SD = 1.39 years) completed the Stress Mindset Measure (SMM) before being randomly assigned to a group to watch a three-minute video and completing the SMM again.

RESULTS

The 2-time × 4-group ANOVA showed a significant time effect, F(1, 158) = 50.45, p < .001, ηp2 = .242, no group effect, F(3, 158) = 0.89, p = .449, ηp2 = .017, and a significant time × group interaction, F(3, 158) = 4.48, p = .005, ηp2 = .078. All three experimental groups reported greater stress-is-enhancing mindset post-intervention compared to pre-intervention. At post-intervention the education with imagery group had a significantly more stress-is-enhancing mindset compared to the control group.

CONCLUSIONS

Results suggest that online stress mindset videos may be effective with a combined stress education and imagery intervention being most effective.

High-speed train drivers' human error under fatigue and stress: the role of situation awareness and individual differences

Fatigue and stress are critical variables that impair railway train drivers' safety performance, and individual differences may influence these effects. This study investigates how fatigue and stress affect high-speed train drivers' human error and the role of individual differences. We hypothesised that situation awareness (SA) mediates the effects of fatigue and stress on human error, and individual differences (age and work experience) moderate these effects. We surveyed 1,391 male drivers from eight Chinese railway bureaus and used PROCESS Macro for data analysis. The results revealed that fatigue and stress increased human error, directly and indirectly through SA. Age and work experience moderated the effect of fatigue and stress on SA, respectively. Older drivers had better SA under high fatigue, while more experienced drivers had better SA under high stress. These findings can inform more tailored safety management strategies to lower human error and enhance the safety of high-speed train operations.

Death-is-life-enhancing: Adaptation and validation of the Norwegian Death Mindsets Measure (NDMM)

While existing psychological frameworks and their accompanying measures focus on death as anxiety-inducing and debilitating, we highlight an overlooked perspective of death-that death can be a basis for living with more meaning and presence. The present research adapts and validates the Death Mindsets Measure (DMM), which assesses the mindset that "death-is-life-enhancing," for a Norwegian context. Firstly, we translated the DMM and consulted with Norwegian bereavement experts and bereaved Norwegians on items' clarity and relevance to cultural perspectives of death. Secondly, we validated the Norwegian DMM (NDMM) on a predominantly bereaved community sample of Norwegians (N = 241). Using structural equation modeling, we confirmed the hierarchical two-factor structure of our measure. The NDMM also demonstrated high internal consistency and discriminant validity with existing death anxiety and death attitudinal measures. Finally, our measure explained additional variance in psychological well-being beyond existing death anxiety and attitudinal measures.

Applying a synergistic mindsets intervention to an esports context

Affective responses during stressful, high-stakes situations can play an important role in shaping performance. For example, feeling shaky and nervous at a job interview can undermine performance, whereas feeling excited during that same interview can optimize performance. Thus, affect regulation-the way people influence their affective responses-might play a key role in determining high-stakes outcomes. To test this idea, we adapted a synergistic mindsets intervention (SMI) (Yeager et al. 2022 Nature 607, 512-520 (doi:10.1038/s41586-022-04907-7)) to a high-stakes esports context. Our approach was motivated by the idea that (i) mindsets both about situations and one's stress responses to situations can be shaped to help optimize stress responses, and (ii) challenge versus threat stress responses will be associated with improved outcomes. After a baseline performance task, we randomly assigned gamers (n = 300) either to SMI or a control condition in which they learned brain facts. After two weeks of daily gaming, gamers competed in a cash-prize tournament. We measured affective experiences before the matches and cardiovascular responses before and throughout the matches. Contrary to predictions, gamers did not experience negative affect (including feeling stressed), thus limiting the capacity for the intervention to regulate physiological responses and optimize performance. Compared with the control participants, synergistic mindsets participants did not show greater challenge responses or improved performance outcomes. Though our adaptation of Yeager et al.'s SMI did not optimize esports performance, our findings point to important considerations regarding the suitability of an intervention such as this to different performance contexts of varying degrees of stressfulness.

A stress-is-enhancing mindset is associated with lower traumatic stress symptoms during the COVID-19 pandemic

BACKGROUND

A stress-is-enhancing mindset is associated with lower perceived stress and better coping. However, work examining the prospective associations of stress mindset on perceived traumatic stress symptoms during a stressful real-world life event is limited. The present prospective study explored whether stress-is-enhancing mindset measured before the onset of the COVID-19 global pandemic was associated with later traumatic stress symptoms in response to the COVID-19 global pandemic.

METHODS

University students (N = 179; 68% female; Mage = 19.31, SD = 0.79 years) completed the Stress Mindset Measure (SMM) prior to COVID-19 pandemic onset as part of a larger study. The Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic was completed 1 year into the pandemic.

RESULTS

SMM negatively predicted the IES-R subscales intrusion, avoidance, and hyperarousal such that a more stress-is-enhancing mindset was associated with lower intrusion, avoidance, and hyperarousal following the onset of COVID-19.

CONCLUSIONS

Results suggest a more positive stress mindset is associated with fewer traumatic stress symptoms following a traumatic life event. Altering stress mindset may be an avenue for future interventions to cope with stress.

Effectiveness of stress arousal reappraisal and stress-is-enhancing mindset interventions on task performance outcomes: a meta-analysis of randomized controlled trials

Stress arousal reappraisal (SAR) and stress-is-enhancing (SIE) mindset interventions aim to promote a more adaptive stress response by educating individuals about the functionality of stress. As part of this framework, an adaptive stress response is coupled with improved performance on stressful tasks. The goal of this meta-analysis is to evaluate the effectiveness of these interventions on task performance. The literature search yielded 44 effect sizes, and a random-effects model with Knapp-Hartung adjustment was used to pool them. The results revealed an overall small significant improvement in task performance (d = 0.23, p < 0.001). The effect size was significantly larger for mixed interventions (i.e., SAR/SIE mindset instructions combined with additional content, k = 5, d = 0.45, p = 0.004) than SAR-only interventions (k = 33, d = 0.22, p < 0.001) and SIE mindset-only interventions (k = 6, d = 0.18, p = 0.22) and tended to be larger for public performance tasks than cognitive written tasks (k = 14, d = 0.34, p < 0.001 vs. k = 30, d = 0.20, p = 0.002). Although SAR and SIE mindset interventions are not "silver bullets", they offer a promising cost-effective low-threshold approach to improve performance across various domains.

How does strength use relate to burnout among Chinese healthcare professionals? Exploring the mediating roles of beliefs about stress and basic psychological needs satisfaction

BACKGROUND

The prevalence of burnout among healthcare workers remains chronically high. Former studies have indicated that strength use is a promising approach to reduce burnout. However, relatively little is known about the psychological mechanisms underlying the ability of strength use to reduce burnout, especially among healthcare workers.

AIM

This study sought to examine the link between strength use and burnout in Chinese healthcare workers, and to explore the mediating roles of beliefs about stress and basic psychological needs satisfaction in that relationship.

METHODS

This study was conducted in two time periods, from September to October 2020 and from February to September 2022. A total of 812 healthcare workers completed a multi-section questionnaire.

RESULTS

Strength use was negatively associated with burnout and negative stress beliefs, and positively associated with positive stress beliefs, control beliefs, and basic psychological needs satisfaction. Moreover, negative stress beliefs, control beliefs, and basic psychological needs satisfaction fully mediated the relationship between strength use and burnout. Furthermore, effect contrasts revealed that the mediating effect of basic psychological needs satisfaction was stronger than that of negative stress beliefs and control beliefs.

CONCLUSION

Our findings revealed that negative stress beliefs, control beliefs, and basic psychological needs satisfaction act as mediators in the association of strength use with burnout. Furthermore, basic psychological needs satisfaction plays a more important mediating role than negative stress beliefs and control beliefs in the strength use-burnout relationship.

Mastery imagery ability moderates the relationship between heart rate reactivity to acute psychological stress and perceptions of stress and physiological arousal

Imagery has been associated with cardiovascular and psychological responses to stress; however, the mechanisms underlying this association are not fully understood. The present study examined if the ability to image mastering challenging or difficult situations moderated the relationship between heart rate reactivity and perceptions of stress and physiological arousal experienced during acute stress. Four hundred and fifty-eight participants completed a standardized laboratory stress protocol with heart rate being measured throughout. After completing an acute psychological stress task, participants rated how stressed and physiologically aroused they felt (i.e., intensity) and whether they perceived the stress and physiological arousal as being helpful/unhelpful to performance (i.e., interpretation). Mastery imagery ability was assessed by questionnaire. Moderation analyses controlling for gender demonstrated that imagery ability moderated the relationship between heart rate reactivity and interpretation of stress (β = 0.015, p = .003) and perceived physiological arousal (β = 0.013, p = .004). Simple slope analysis indicated that in those with higher imagery ability, heart rate reactivity was associated with stress and arousal being perceived as more positive toward performance. Imagery ability did not moderate the relationship between heart rate reactivity and perceived stress intensity or physiological arousal intensity (p's > .05), but imagery ability did predict lower perceived stress intensity (β = -0.217, p < .001) and perceived physiological arousal intensity (β = -0.172, p < .001). Higher mastery imagery ability may possibly help individuals perceive responses to stress as more beneficial for performance and thus be an effective coping technique.

Effectiveness of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of students with premenstrual syndrome

BACKGROUND

Premenstrual Syndrome (PMS) is a common public health issue affecting many women of reproductive age worldwide. This study has been designed to investigate of computer-based stress inoculation training (SIT) counseling approach on anxiety, depression, and stress of university students with PMS.

METHODS

A randomized trial study with two parallel arms was done from 30 October 2022 to 21 June 2023 on 100 university students aged 18 to 38 at Babol University of Medical Sciences. The participants were randomly divided into two groups intervention and control. The data collection tools included questionnaires on demographic-fertility characteristics, the Premenstrual Symptoms Screening Tool (PSST), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale (PSS-14), the Sheehan Disability Scale (SDS) and Riff's Psychological Well-being Scale (RPWS). The data were assessed using chi-square, t-student, ANOVA repeated measure, and linear regression tests. A significance level of P < 0.05 was considered for the analysis.

RESULTS

The results of the study showed that the SIT interventions decreased the PMS severity and most psychological factors so in the intervention group, SIT was able to significantly reduce anxiety, depression, perceived stress, and Sheehan's disability after intervention (P < 0.001). Based on multiple linear regression analysis, the most predictors of HADS were the PSS and SDS (β = 0.285, p = 0.009 and β = 0.236, p = 0.024, respectively).

CONCLUSION

The computer-based SIT counseling approach could reduce the severity of symptoms and psychological factors in students. Therefore, SIT intervention is recommended to manage their PMS.

TRIAL REGISTRATION

IRCT20230130057274N2.

Promoting or Prohibiting? Investigating How Time Pressure Influences Innovative Behavior under Stress-Mindset Conditions

The existing empirical evidence on the relationship between time pressure and innovative behavior is paradoxical. An intriguing yet unresolved question is "When does time pressure promote or prohibit innovative behavior, and how?" We theorize that the paradoxical effect of time pressure on innovative behavior can be elucidated by the moderating role of stress mindset, and we also explore the mediating role of thriving at work. Our research involved a field study of 390 research and development personnel from eight enterprises and research institutes in China to test our proposed model. Results indicated that the stress-is-debilitating mindset negatively moderated the association between time pressure and thriving at work, while the stress-is-enhancing mindset positively moderated the link between time pressure and thriving at work. Furthermore, the findings demonstrated that the stress-is-debilitating mindset negatively moderated the indirect impact of time pressure on employees' innovative behavior through thriving at work, while the stress-is-enhancing mindset positively moderated the indirect effect of time pressure on employees' innovative behavior through thriving at work. The theoretical and practical implications of these findings are also discussed.

Enhancing mental wellbeing by changing mindsets? Results from two randomized controlled trials

Improving mental wellbeing is often targeted with behavioral interventions, while mindset interventions might be more appealing as they require less time and effort. In addition to recent experimental studies demonstrating that attributional beliefs can be changed to improve emotional wellbeing and performance, the current study examines whether a positive change in people's beliefs about stress and life philosophy enhances emotional, social and psychological wellbeing using brief educational interventions. Two parallel double-blind randomized controlled trials were conducted. Study 1 (N = 106; 62.3% female, mean age 36.0) compared an educational video about the benefits of a stress-is-enhancing mindset versus an active control video. In Study 2 (N = 136; 57.4% female, mean age 35.7), educational texts about the benefits of a stress-is-enhancing mindset and holding a life-is-long-and-easy mindset were compared to an active control text. Results of multilevel growth curve modeling showed that a stress mindset could be significantly changed using an educational video or text, while the change in the philosophies of life mindset did not significantly differ between conditions. Furthermore, none of the manipulations were able to sustain the positive change in mindset which might explain why there was no significant increase in mental wellbeing compared to control. To have a lasting effect on people's mental wellbeing, a change in mindset might need to be embodied in everyday life. Future research should investigate simple versus intensive interventions with longer follow-up time to examine whether and how a mindset can be sustainably changed to promote flourishing mental health in the general population.

An Ego-Involving Motivational Climate Can Trigger Inflammation, a Threat Appraisal, and Basic Psychological Need Frustration in an Achievement Context

In this experimental investigation, male college students (N = 56; Mage = 19.95 years) who did not yet know how to juggle were randomly assigned to a 30-min instructional juggling session with either a caring, task-involving climate or an ego-involving climate. An inflammatory response to psychosocial stress was assessed via salivary interleukin-6 prior to (t = 0) and following (t = +30, +45, +60 min) the session. Surveys were utilized to examine positive and negative affect prior to the session and affect, psychological needs, challenge and threat appraisals, and perceived ability to juggle following the session. This is the first investigation to show that ego-involving climates can trigger inflammation, along with maladaptive psychological responses. Participants in the caring, task-involving climate responded with greater psychological need satisfaction, resource evaluations, positive affect, and perceived juggling ability. This research suggests there may be important physiological consequences to ego-involving climates, in addition to concerning cognitive, affective, and behavioral responses.

The Moderating Role of Stress Mindset on the Relationship between Drinking to Cope and Alcohol Consumption among Undergraduate College Student Drinkers

OBJECTIVE

Previous research suggests drinking alcohol to cope with negative affect, including stress, is a risk for increased alcohol consumption and alcohol-related problems. Stress mindset, the individually held belief that stress can lead to either enhancing or debilitating outcomes, has yet to be studied within the context of alcohol use. Studying stress mindset among college students as it relates to alcohol consumption may provide important insight into heavy alcohol use in this population.

METHOD

A sample of 320 undergraduates (Mage = 19.06 (SD = 0.06); 63.44% female; 65.49% White) who endorsed past-year alcohol use completed self-report measures of drinking motives, stress mindset, alcohol consumption, and alcohol-related consequences. Zero-inflated negative binomial regressions were utilized to examine the moderating effect of stress mindset on the relationship between drinking to cope and alcohol consumption.

RESULTS

Stress mindset significantly moderated the relationship between drinking to cope and alcohol consumption (IRR = 0.98, se = 0.01, p < 0.05, CI = 0.96, 1.00), such that the relationship was stronger among those with a debilitating stress mindset compared to those with an enhancing stress mindset. Stress mindset did not significantly moderate the relationship between drinking to cope and alcohol-related consequences.

CONCLUSIONS

Individuals with high drinking to cope scores and who hold a debilitating stress mindset may be at a particular vulnerability for heavy alcohol consumption. The present study furthers our understanding of predictors of alcohol use in a college sample and suggests the importance of future research focused on stress mindset among college student drinkers.

Stress is not so bad-cortisol level and psychological functioning after 8-week HIIT program during pregnancy: a randomized controlled trial

Background

Amid extensive pregnancy exercise research, the impact of High Intensity Interval Training (HIIT) on pregnant women's mental health is underexplored. Despite exercise benefits, it can trigger stress responses like elevated cortisol. This study fills the gap by investigating correlations between hair cortisol levels, mental health, and HIIT effects in pregnant women.

Methods

We conducted a randomized control trial among 38 Caucasian women in uncomplicated, singleton pregnancy (age 31.11 ± 4.03 years, 21.82 ± 4.30 week of gestation; mean ± SD). The experimental group comprised 22 women engaged in an 8-week high-intensity interval training program (HIIT). The comparative group consisted of 16 pregnant women undergoing an 8-week educational program (EDU). Before and after the interventions, all women were evaluated using the following tools: Hair cortisol level measurements, Beck Depression Inventory - II for depressive symptoms assessment, Childbirth Attitudes Questionnaire for childbirth fear measurement, 12-item Short Form Health Survey to gage health-related quality of life, International Physical Activity Questionnaire for physical activity level estimation, and a Progressive maximal exercise test to evaluate maternal exercise capacity.

Results

The key finding of our study reveals that women engaged in the HIIT intervention exhibited a distinct cortisol production pattern in contrast to the EDU group practicing standard moderate intensity physical activity. In the HIIT group, there was an increase in hair cortisol levels, while the EDU group showed a notable decrease. Remarkably, HIIT stimulated cortisol production without adversely impacting fear of childbirth and psychophysical condition during pregnancy. In fact, only the HIIT group showed a significant enhancement in mental health.

Conclusion

No links were discovered between hair cortisol levels and the severity of depressive symptoms, psychophysical well-being, or fear of childbirth. Hence, based on our research, employing cortisol levels during pregnancy as an indicator of negative stress or depression risk appears unwarranted.

Learning to embrace one's stress: the selective effects of short videos on youth's stress mindsets

BACKGROUND AND OBJECTIVES

Stress is not inherently negative. As youth will inevitably experience stress when facing the various challenges of adolescence, they can benefit from developing a stress-can-be-enhancing mindset rather than learning to fear their stress responses and avoid taking on challenges. We aimed to verify whether a rapid intervention improved stress mindsets and diminished perceived stress and anxiety sensitivity in adolescents.

DESIGN AND METHODS

An online experimental design randomly exposed 233 Canadian youths aged 14-17 (83% female) to four videos of the Stress N' Go intervention (how to embrace stress) or to control condition videos (brain facts). Validated questionnaires assessing stress mindsets, perceived stress, and anxiety sensitivity were administered pre- and post-intervention, followed by open-ended questions.

RESULTS

The intervention content successfully instilled a stress-can-be-enhancing mindset compared to the control condition. Although Bayes factor analyses showed no main differences in perceived stress or anxiety sensitivity between conditions, a thematic analysis revealed that the intervention helped participants to live better with their stress.

CONCLUSIONS

Overall, these results suggest that our intervention can rapidly modify stress mindsets in youth. Future studies are needed to determine whether modifying stress mindsets is sufficient to alter anxiety sensitivity in certain adolescents and contexts.

Body Mindsets are Associated With Pain and Threat-Related Risk Factors for Pain in Survivors of Childhood Cancer

Pain is a common consequence of childhood cancer. While most research has examined biomedical predictors of post-cancer pain, biopsychosocial conceptualisations such as the cancer threat interpretation (CTI) model hold promise for guiding comprehensive pain management strategies. Guided by the CTI model, this cross-sectional study evaluated correlates of post-cancer pain in childhood cancer survivors including threat-related risk factors (bodily threat monitoring, fear of cancer recurrence, help-seeking) and mindsets about the body. In the preceding three months, 21.8% of the survivors reported chronic pain (>3 months), and 14.3% experienced pain most days. Greater bodily threat monitoring, more fear of cancer recurrence, and more help-seeking were associated with more pain. There was heterogeneity in the mindsets that survivors of childhood cancer hold about their bodies. Holding the mindset that the 'body is an adversary' was associated with more pain, greater bodily threat monitoring, and more fear of cancer recurrence. Holding the mindset that the 'body is responsive' was associated with less bodily threat monitoring, while the mindset that the 'body is capable' was associated with greater help-seeking. A path model demonstrated a significant combined indirect effect of the 'body is an adversary' mindset on pain through bodily threat monitoring and fear of cancer recurrence. Overall, this study supported that a sub-group of childhood cancer survivors experience persistent and interfering pain and provided cross-sectional support for threat-related correlates for pain aligning with the CTI model. Body mindsets were associated with pain and threat-related correlates and may represent a novel target to support survivors with pain. PERSPECTIVE: This article presents associations of body mindsets, threat-related risk factors, and pain in survivors of childhood cancer (aged 11-25), guided by the Cancer Threat Interpretation model. The study indicates that body mindsets may be novel targets to embed in comprehensive post-cancer pain management approaches to support young survivors with pain.

Effects of a group-based music imagery program on promoting coping resources among undergraduate students: a pilot randomized controlled trial

Background

Music is well-known for its stress-reducing effects. Little is known about the potential effect of music interventions in fostering internal coping resources for stress management among undergraduate students in Hong Kong.

Objectives

This pilot study aimed to examine the efficacy of the Group-based Focus Music Imagery Program (GFMI) in promoting a stress-is-enhancing mindset, sense of coherence, and self-compassion among undergraduate students.

Methods

We used a two-arm parallel randomized controlled trial (RCT). The experimental arm received 6 weeks of GFMI with measures taken at two time points after completing baseline assessments (Weeks 6, 10). The control arm received 6 weeks of an active control program and completed the outcome measures at time points similar to the GFMI group. Data were collected using the Chinese versions of the Sense of Coherence Scale (C-SOC-13), the Self-Compassion Scale-Short Form (C-SCS-SF), the Stress Mindset Measure (C-SMM), the Perceived Stress Scale (C-PSS-10), and the Generalized Anxiety Disorder scale (C-GAD-7).

Results

Sixty-four participants were randomly assigned to either the experimental group (n = 32) or the control group (n = 32) between July 2021 and September 2022. The experimental group exhibited a retention rate of 71.9% at T1 (23 out of 32 participants), which slightly decreased to 65.6% (21 out of 32) at T2. The control group displayed a retention rate of 75% (24 out of 32) at T1, which dropped to 43.8% (14 out of 32) at T2. The GEE analyses showed insignificant differences between groups at any time point in C-SOC-13, C-SCS-SF, and C-SMM. Instead, the control group had a higher reduction in stress scores (C-PSS-10) at T1, and anxiety (C-GAD-7) at T2 than the experimental group.

Conclusion

The pilot trial provided valuable information in examining the feasibility of the trial design and intervention. Future studies with larger samples are needed to validate if GFMI can reliably promote coping resources to manage stress and anxiety in undergraduate students.

Trial registration number

https://www.researchregistry.com/, researchregistry8209.

The mediating role of proactive coping in the relationships between stress mindset, challenge appraisal tendencies, and psychological wellbeing

Objective

Stress is ubiquitous and how individuals view the nature of stress can influence psychological wellbeing. The present study aimed to investigate the mediating role of proactive coping on the relationships between stress mindset and challenge appraisal tendencies and examine how this in turn related to psychological wellbeing. A secondary aim was to investigate if there were any differences in stress mindset between athletes and non-athletes. It was hypothesised that stress mindset would be indirectly positively associated with challenge appraisal tendencies through proactive coping, that a challenge appraisal tendency would positively relate to vitality, and that vitality would negatively relate to depressive symptoms. It was also hypothesised that athletes would possess more facilitative views of stress compared with non-athletes.

Methods

Two hundred and seven individuals (n = 101 athletes, n = 106 non-athletes, Mage = 22.76 years, SD = 4.94) completed an online questionnaire pack assessing stress mindset, proactive coping, challenge appraisal tendencies, vitality, and depressive symptoms.

Results

Using path analysis, the hypothesised model demonstrated a good fit to the data and the positive relationship between stress mindset and challenge appraisal tendencies was mediated by proactive coping. Challenge appraisal tendencies were positively associated with vitality, which was negatively associated with depressive symptoms. Athletes reported a significantly greater 'stress-is-enhancing' mindset, greater vitality, and fewer depressive symptoms than non-athletes.

Conclusion

Findings offer support for the role that stress mindset has in potentially influencing psychological wellbeing and offer the novel suggestion that this mechanism may operate through proactive coping and challenge appraisal tendencies.

The essential impact of stress appraisals on work engagement

This paper explains the contradictory findings on the relationship between stress and work engagement by including appraisals as a driving mechanism through which job stressors influence engagement. In doing so, it explores whether stressors categorised as either challenging or hindering can be appraised simultaneously as both. Second, it investigates whether stress mindset explains not only how stressors are appraised, but also how appraisals influence engagement. Over five workdays, 487 Canadian and American full-time employees indicated their stress mindset and appraised numerous challenging and hindering stressors, after which they self-reported their engagement at work. Results showed that employees rarely appraised stress as uniquely challenging or hindering. Moreover, when employees harbored positive views about stress, stressors overall were evaluated as less hindering and hindrance stressors were particularly more challenging. Stress mindset appears to be critical in modulating the genesis of stress appraisals. In turn, appraisals explained the stressor-engagement relationship, with challenge and hindrance stressors boosting and hampering engagement, respectively. Finally, positive stress mindset buffered the negative effect of hindrance appraisals on engagement. Our findings clarify misconceptions about how workplace stressors impact engagement and offer novel evidence that stress mindset is a key factor in stress at work.

Solitude can be good-If you see it as such: Reappraisal helps lonely people experience solitude more positively

OBJECTIVE

Solitude is a common experience that can elicit both positive (e.g., relaxation) and negative (e.g., loneliness) emotions. But can changing the way we think about solitude improve its emotional effects? In a previous study, our team found that positively reframing solitude buffers against a reduction in positive affect when alone. Yet, it is unknown whether people who are lonely-and thus more likely to experience solitude negatively-benefit from modifying their beliefs about being alone.

METHOD

Here, we test whether reframing solitude as a beneficial experience or de-stigmatizing loneliness helps people experiencing moderate-to-severe loneliness (N = 224) feel more positive emotion and less negative emotion during solitude. We randomly assigned participants to read about either the benefits of solitude, the high prevalence of loneliness, or a control topic. Then, participants spent 10 min alone in the laboratory. State affect was assessed before and after the solitude period.

RESULTS

Across conditions, the solitude period reduced high-arousal positive (e.g., excited) and high-arousal negative (e.g., anxious) affect. Notably, people who read about the benefits of solitude experienced a significantly larger increase in low-arousal positive affect compared with the control condition.

CONCLUSION

Our findings indicate that lonely individuals can more readily reap the emotional benefits of solitude when they reframe solitude as an experience that can enhance their well-being.

The Insidious Influence of Stress: An Integrated Model of Stress, Executive Control, and Psychopathology

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.

Changing cancer mindsets: A randomized controlled feasibility and efficacy trial

OBJECTIVE

A cancer diagnosis and subsequent treatment can disrupt the full spectrum of physical, social, emotional, and functional quality of life. But existing psychological treatments are focused primarily on specific psychological symptoms as opposed to improving the overall patient experience. We studied the feasibility and efficacy of a novel digital intervention targeting patient mindsets-core assumptions about the nature and meaning of illness-designed to improve overall health-related quality of life (HRQoL) in newly diagnosed cancer patients undergoing treatment with curative intent.

METHODS

Recently diagnosed (≤150 days) adult patients with non-metastatic cancers undergoing systemic treatment (N = 361) were recruited from across the United States to participate in this decentralized clinical trial. Patients were randomized 1:1 to receive the Cancer Mindset Intervention (CMI) or Treatment as Usual (TAU). Participants in the CMI group completed seven online modules over 10 weeks (2.5 h total) targeting mindsets about cancer and the body. The primary outcome was overall HRQoL, and secondary outcomes were coping behaviors and symptom distress.

RESULTS

Patients in the CMI group reported significant (p < 0.001) improvements in adaptive mindsets about cancer and the body over time. Compared with the TAU condition, the CMI group reported significant improvements in overall HRQoL (B = 0.60; 95% CI 0.34-0.85; p < 0.001), increased engagement in adaptive coping behaviors (B = 0.03; 95% CI 0.02-0.04; p < 0.001), and reduced distress from physical symptoms (B = -0.29; 95% CI -0.44 to -0.14; p < 0.01). Effect sizes of these changes ranged from d = 0.42-d = 0.54.

CONCLUSION

A brief mindset-focused digital intervention was effective at improving physical, social, emotional, and functional HRQoL, increasing adaptive coping behaviors, and reducing physical symptom distress in newly diagnosed cancer patients.

Category-Specific Stress Mindsets: Beliefs about the Debilitating versus Enhancing Effects of Specific Types of Stressors among Young Adults

Recently, research has shown that stress mindsets, or the degree to which people believe that stress is enhancing versus debilitating, impact the ways they process and react to stress. However, young adults encounter various forms of stress, which might elicit different stress mindsets. This study investigated (1) how much young adults think about specific types of stressors as they complete stress mindset measures and (2) how stress mindsets vary across stressor types.

METHOD

Participants (n = 182) completed measures of general and category-specific stress mindsets (academic, interpersonal, identity-based, illness, societal, financial) and rated how much they thought of each category when completing the general mindset measure.

RESULTS

Academic stress was the most salient, and identity-based discrimination was the least salient as participants completed the stress mindset measure. Academic stress was perceived as the most stress-enhancing, and illness stressors were rated as the least stress-enhancing. Cisgender women reported stronger stress-is-debilitating mindsets for interpersonal and illness/injury-related stressors as compared with cisgender men.

CONCLUSION

Stress mindset ratings in research studies might be weighted toward certain types of stressors. Further, young adults' mindsets differ across different stressor categories. This nuance has implications for how we conceptualize stress mindset in interventions and research.

Stress reappraisal improves the autonomic nervous system response of test anxious individuals: Evidence from heart rate variability

BACKGROUND

Stress belief plays an important role in stress response. This study investigated whether individuals with high test anxiety/low test anxiety (HTA/LTA) held different stress belief, and tested the effect of stress reappraisal on reducing test anxiety related autonomic nervous system (ANS) response.

METHODS

51 HTA students and 49 LTA students were recruited using the Test Anxiety Scale (TAS). They completed a 10-min intelligence test (including preparation, test, and recovery phases), then were randomly assigned to reappraisal group and control group to complete the test again. Heart rate variability (HRV) was recorded throughout the protocol. Beliefs about Stress Scale was obtained before and after the experiment. Stress belief were manipulated using a 2-min film clip that orienting participant to the enhancing nature of stress. Emotional changes were assessed.

RESULTS

HTA individuals held more negative stress beliefs and showed greater emotional arousal during the test than the LTA individuals. Their negative stress belief was associated with higher TAS score and worse HRV response. (2) When facing an exam, LTA individuals exhibited increased low-frequency HRV and stable high-frequency HRV, while HTA individuals showed stable low-frequency HRV and decreased high-frequency HRV. (3) HTA individuals who underwent reappraisal showed a reduction in test anxiety and in low-frequency/high-frequency HRV ratio.

CONCLUSIONS

The ANS activity of HTA individuals is imbalanced in the test situations. Stress belief is a meaningful variable in anxiety related ANS activity. Stress reappraisal can effectively reduce test anxiety and improve the balance of ANS activity of HTA individuals.

Transforming stress program on medical students' stress mindset and coping strategies: a quasi-experimental study

OBJECTIVE

Stress is a significant concern in medical education, and identifying effective ways to deal with stress may help with students' mental health and professional development. This study aimed to examine the effects of the Transforming Stress Program (TSP) amongst first-year medical students on their stress mindset and coping strategies when confronted with stressors.

METHODS

We conducted a quasi-experimental study at the University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam. A total of 409 first-year students at the Faculty of Medicine were divided into intervention group (205 students) and control group (204 students). The 10-week TSP was delivered as an extra-curricular course. The training adopts psychoeducation based on Dialectical Behavioral Therapy with mindfulness as a fundamental practice incorporated into each component of the program. The intervention group received the training in the first semester; the control group received identical program in the second semester. Stress Mindset Measurement and Brief Coping Orientation to Problems Experienced were measured before the intervention (T0), immediately after intervention on Intervention group (T1), and six months after intervention on Intervention group (T2).

RESULTS

At T1, the intervention group showed 65% improvements in stress mindset scores and increases in coping strategies scores in six domains (Problem solving, Social support, Humor, Religion, Venting, and Self-distraction) and decreases in three (Avoidance, Substance use, and Self-blame). The effect sizes were significant in all outcomes (Cohen's d > 0.2). Measurements of the control group did not change significantly in the same period. At T2, effects of the TSP were found decreased in some domains (Avoidance, Substance use, and Self-blame) compared to T1, but largely remained significantly better than T0.

CONCLUSIONS

The TSP is a feasible and effective approach that significantly enhanced medical students' stress mindset and coping strategies. Some effects were still observable 6 months after the intervention. The relatively intensive intervention requires support of the school administration and staff.

Investigating Cortisol in a STEM Classroom: The Association Between Cortisol and Academic Performance

Science, technology, engineering, and mathematics (STEM) education can be stressful, but uncertainty exists about (a) whether stressful academic settings elevate cortisol, particularly among students from underrepresented racial/ethnic groups, and (b) whether cortisol responses are associated with academic performance. In four classes around the first exam in a gateway college STEM course, we investigated participants' (N = 271) cortisol levels as a function of race/ethnicity and tested whether cortisol responses predicted students' performance. Regardless of race/ethnicity, students' cortisol, on average, declined from the beginning to the end of each class and across the four classes. Among underrepresented minority (URM) students, higher cortisol responses predicted better performance and a lower likelihood of dropping the course. Among non-URM students, there were no such associations. For URM students, lower cortisol responses may have indicated disengagement, whereas higher cortisol responses may have indicated striving. The implication of cortisol responses can depend on how members of a group experience an environment.

Purpose in life, stress mindset, and perceived stress: Test of a mediational model

Purpose in life is associated with less perceived stress and more positive worldviews. This study examined whether people with more purpose adopt a mindset that views stress as beneficial rather than harmful and whether this mindset is one mechanism between purpose and less stress. We used a short-term longitudinal study (N=2,147) to test stress mindset as a mediator between purpose in life measured prior to the pandemic and stress measured early in the pandemic. We also tested Covid-related worry as a mechanism, given the measurement period spanned pre-pandemic to the first shutdowns in the United States. In contrast to expectations, purpose was unrelated to whether stress was conceptualized as beneficial or harmful (b=.00, SE=.02; p=.710) and thus stress mindset did not mediate the prospective association between purpose and stress. Both purpose in life (b=-.41, SE=.04, p<.001) and stress mindset (b=-.24, SE=.04; p<.001) were independent prospective predictors of stress. Purpose was related to less Covid-related worry, which was a significant mechanism between purpose and stress (indirect effect=-.03, SE=.01; p=.023). A stress-is-enhancing mindset predicted less stress but did not explain why purpose was associated with less perceived stress, whereas fewer Covid-related worries was one pathway from purpose to less stress.

Fatigue, Stress Appraisal, and Emotional Functioning Among Youth With Sickle Cell Disease: A Daily Diary Study

OBJECTIVE

The aim of this study was to assess how fatigue is related to mood among youth with sickle cell disease (SCD) by evaluating if the cognitive appraisal of stress moderates the impact of fatigue on emotional functioning consistent with the Risk-and-Resistance Model of Chronic Illness.

METHODS

Daily diaries assessing fatigue (Numerical Rating Scale), pain intensity (Numerical Rating Scale), mood (Positive and Negative Affect Schedule for Children), and cognitive appraisal of stress (Stress Appraisal Measure for Adolescents) were collected from 25 youth with SCD (ages 11-18 years) for 8 consecutive weeks resulting in 644 daily diaries for analyses.

RESULTS

When measured concurrently, higher fatigue was associated with higher negative mood controlling for pain and prior-night sleep quality. Fatigue predicted next-day negative mood through its interaction with primary and secondary appraisal of stress, consistent with stress appraisal as a protective factor. A similar pattern was observed for pain, which, like fatigue, is a common SCD-related stressor.

CONCLUSION

Fatigue and negative mood are inter-related when concurrently assessed, but their temporal association in SCD suggests that mood changes are not an inevitable sequalae of increased fatigue; fatigue influenced subsequent levels of negative mood, but only in the presence of less adaptive cognitions about stress; specifically, a higher perceived threat from stress and a lower belief in the ability to manage stress. The results suggest specific cognitive targets for reducing the negative impact of fatigue on mood in SCD.

Teachers Who are Stuck in Time: Development and Validation of Teachers' Time Poverty Scale

Purpose

Time poverty has been shown to adversely affect individuals' development as well as organizations and countries, which is also a widespread problem among teachers, affecting work performance, mental health, and even the development of students and schools. However, the advancement of education research on time poverty has been stymied by the lack of a validated measure. Therefore, to fill the theoretical gap of time poverty in education and to compensate for the absence of an instrument for measuring teachers' time poverty and the challenges of using objective measures, it is necessary to develop and verify a domain-specific measurement instrument among teachers.

Patients and Methods

An online questionnaire is designed through a Chinese data collection platform (Questionnaire Star). Study 1 and Study 2 are a cross-sectional study included 713 teachers in China and the descriptive statistics, correlation analysis and analyses of exploratory and confirmatory factors are used to develop the Teachers' Time Poverty Scale. Study 3 and Study 4 are a longitudinal study included 330 teachers, while the Time Confusion Tendency Scale and Life Satisfaction Scale is used to verify the measurement tool. SPSS 26.0 and Mplus 8.3 are used to analyze the data.

Results

Teachers' Time Poverty Scale with the single-factor structure exhibits good psychometric properties based on seven items. And teachers' time poverty can negatively and significantly predict life satisfaction and teachers' time poverty can be positively and significantly predicted by time confusion tendency.

Conclusion

Teachers' Time Poverty Scale is a useful tool that can be used in actual investigations to provide empirical support for teachers, schools, and education policy makers.

Trajectories of Perceived Stress among Students in Transition to College: Mindset Antecedents and Adjustment Outcomes

There is growing evidence of a clear association between students' perceived stress and their adjustment to life at college. However, the predictors and implications of distinct changing patterns of perceived stress during the transition to college life are less clear. To address these research gaps, the current study aims to identify distinct patterns of perceived stress trajectories among 582 Chinese first-year college students (M_age = 18.11, SD_age = 0.65; 69.40% female) across the first 6 months upon enrollment. Three distinct profiles of perceived stress trajectories, i.e., low-stable (15.63%), middle-decreasing (69.07%), and high-decreasing (15.29%), were identified. Moreover, individuals who followed the low-stable trajectory showed better distal outcomes (specifically, higher levels of well-being and academic adjustment) 8 months after enrollment than those who followed the other two trajectories. Furthermore, two types of positive mindset (a growth mindset of intelligence and a stress-is-enhancing mindset) contributed to differences in perceived stress trajectory, either independently or jointly. These findings highlight the significance of identifying different patterns of perceived stress among students during the transition to college, as well as the protective roles of both a stress mindset and a mindset of intelligence.

Too much may be a bad thing: the difference between challenge and hindrance job demands

Job demands and employee motivations are studied through a challenging-disruptive needs framework. However, studies on challenging demands show mixed results due to the difference in the level of demand and effect of moderating variables. In this study, based on the Yerkes-Dodson law and conservation of resources theory, the non-linear relationship between challenging demand and work engagement, linear relationship between hindrance demand and work engagement, and moderating effect of stress were verified. A total of 3914 people were surveyed. The results showed that hindrance demand had a negative linear relationship with work engagement. Moreover, challenging demand had a positive effect on work engagement till a certain level, but had an inverted-U relationship with a negative influence thereafter. Stress mindset moderated these relationships and the negative effects of challenging and hindrance demands weakened for a stress-enhancing-mindset. Based on these results, theoretical and practical implications and future research directions were proposed.

The influence of stressful life events on procrastination among college students: multiple mediating roles of stress beliefs and core self-evaluations

Introduction

Few studies have documented the relationship between stressful life events and procrastination, which is a prevalent and troubling problem among college students. In this regard, the current study examined the association between stressful life events and procrastination through potential mediating effects of stress beliefs and core self-evaluations.

Methods

A cross-sectional design was carried out and data were collected from a total of 794 Chinese college students with measures of stressful life events, core self-evaluations, stress beliefs, and procrastination.

Results

Stressful life events was positively associated with procrastination in college students. Stress beliefs and core self-evaluations played multiple mediating roles in this relationship.

Discussion

The study provided a novel perspective of finding the possible causes of procrastination in college students and highlighted the roles of stress beliefs and core self-evaluations.

From threat to challenge-Improving medical students' stress response and communication skills performance through the combination of stress arousal reappraisal and preparatory worked example-based learning when breaking bad news to simulated patients: study protocol for a randomized controlled trial

BACKGROUND

Breaking bad news (BBN; e.g., delivering a cancer diagnosis) is perceived as one of the most demanding communication tasks in the medical field and associated with high levels of stress. Physicians' increased stress in BBN encounters can negatively impact their communication performance, and in the long term, patient-related health outcomes. Although a growing body of literature acknowledges the stressful nature of BBN, little has been done to address this issue. Therefore, there is a need for appropriate tools to help physicians cope with their stress response, so that they can perform BBN at their best. In the present study, we implement the biopsychosocial model of challenge and threat as theoretical framework. According to this model, the balance between perceived situational demands and perceived coping resources determines whether a stressful performance situation, such as BBN, is experienced as challenge (resources > demands) or threat (resources < demands). Using two interventions, we aim to support medical students in shifting towards challenge-oriented stress responses and improved communication performance: (1) stress arousal reappraisal (SAR), which guides individuals to reinterpret their stress arousal as an adaptive and beneficial response for task performance; (2) worked examples (WE), which demonstrate how to BBN in a step-by-step manner, offering structure and promoting skill acquisition.

METHODS

In a randomized controlled trial with a 2 (SAR vs. control) x 2 (WE vs. control) between-subjects design, we will determine the effects of both interventions on stress response and BBN skills performance in N = 200 third-year medical students during a simulated BBN encounter. To identify students' stress responses, we will assess their perceived coping resources and task demands, record their cardiovascular activity, and measure salivary parameters before, during, and after BBN encounters. Three trained raters will independently score students' BBN skills performances.

DISCUSSION

Findings will provide unique insights into the psychophysiology of medical students who are tasked with BBN. Parameters can be understood more comprehensively from the challenge and threat perspective and linked to performance outcomes. If proven effective, the evaluated interventions could be incorporated into the curriculum of medical students and facilitate BBN skills acquisition.

TRIAL REGISTRATION

ClinicalTrials.gov (NCT05037318), September 8, 2021.

Creative metacognition in design thinking: exploring theories, educational practices, and their implications for measurement

Design thinking is a well-established practical and educational approach to fostering high-level creativity and innovation, which has been refined since the 1950s with the participation of experts like Joy Paul Guilford and Abraham Maslow. Through real-world projects, trainees learn to optimize their creative outcomes by developing and practicing creative cognition and metacognition. This paper provides a holistic perspective on creativity, enabling the formulation of a comprehensive theoretical framework of creative metacognition. It focuses on the design thinking approach to creativity and explores the role of metacognition in four areas of creativity expertise: Products, Processes, People, and Places. The analysis includes task-outcome relationships (product metacognition), the monitoring of strategy effectiveness (process metacognition), an understanding of individual or group strengths and weaknesses (people metacognition), and an examination of the mutual impact between environments and creativity (place metacognition). It also reviews measures taken in design thinking education, including a distribution of cognition and metacognition, to support students in their development of creative mastery. On these grounds, we propose extended methods for measuring creative metacognition with the goal of enhancing comprehensive assessments of the phenomenon. Proposed methodological advancements include accuracy sub-scales, experimental tasks where examinees explore problem and solution spaces, combinations of naturalistic observations with capability testing, as well as physiological assessments as indirect measures of creative metacognition.

Protecting healthcare workers' mental health against COVID-19-related stress: The effects of stress mindset and psychological resilience

Healthcare workers have been on the frontline of the battle against COVID-19 disease. However, this has taken a toll on them, resulting in elevated stress and poor mental health. We argue that healthcare workers' stress mindset and resilience could mitigate negative outcomes of COVID-19-related stress by helping them view this stressful situation in a more positive light and appraise it as a challenge rather than a threat. Accordingly, we hypothesized that both a stress-is-enhancing mindset about COVID-19-related stress and resilience would improve healthcare workers' appraisal of their personal resources and increase their challenge appraisals, positively contributing to their mental health. We collected data from 160 healthcare workers and performed structural equation modeling for hypothesis testing. The results indicate that both a stress-is-enhancing mindset about COVID-19-related stress and psychological resilience are indirectly related to better mental well-being and lower health-related anxiety through challenge appraisals. This study contributes to research in mental health by suggesting that protecting and promoting healthcare workers' mental health is possible by empowering them through increasing personal resources such as a positive mindset about stressful situations and resilience.

There's no time for no stress! Exploring the relationship between pharmacy student stress and time use

BACKGROUND

Health professions students experience significantly more stress than students 20 years ago. While prior studies have explored student time use and other studies have begun to explore factors influencing student stress, little is known about the relationship between student time use and stress. As more efforts are employed to promote student wellness and better understand student stress, it is imperative to recognize the implications of time as a finite resource. Thus, it is important to understand if and how time use relates to student stress so the two can be better managed.

METHODS

A mixed methods approach exploring the challenge-hindrance stressor framework was used to collect and analyze student stress and time use. First, second, and third year pharmacy students were invited to participate. Participants completed the Perceived Stress Scale (PSS10), a week-long daily time logging activity, and daily stress questionnaire. After the week-long daily time logging, students participated in a semi-structured focus group. Descriptive statistics were used to analyze quantitative data, and inductive coding along with creation of summary reports were created for the qualitative data.

RESULTS

Students reported moderate stress on the PSS10, and spending the majority of their time on activities of daily life and academic activities. Students shared that academics, co-curriculars, and working for pay increased their stress, whereas discretionary activities such as socializing and exercising alleviated stress. Finally, students reported feeling overwhelmed due to too little time to complete all necessary activities daily, including limited time to invest in discretionary activities to support their wellbeing.

CONCLUSIONS

Increased stress levels among students is a concerning trend that affects students' mental health and therefore limits their ability to perform to their greatest potential. Better understanding of the relationship between time use and stress is critical to improve the quality of life of students in the health professions. These findings provide critical insight into factors contributing towards student stress that can inform curricular strategies that support wellness within health professions education.

Where did Your Offending Come from?" It's Not Unusual for Someone to Say it was the Death of a Parent': Proposed Prisoners' Grief Overload Theory

The term overload has become recognised as a useful descriptor for the intense effect of stress following bereavement. This paper draws attention to the far-reaching effects of overload contributing to illegal activity. Both the intensity of the grief reaction and the propensity for criminal behaviour need to be contextualised in light of one another. Prisoners' Grief Overload theory is proposed. The theory will demonstrate how a grieving person's choice of maladaptive coping can damage the individual, society and the prison community in terms of safety and security, health and welfare. The phenomenon has economic, legal and political ramifications. Qualitative research undertaken in 2017 at 'HMP North of England', a male category C prison, will help illustrate theory generation.

The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships

Background

Given the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment.

Methods

Cross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment.

Results

There is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = -0.114; 95% confidence interval (CI): (-0.158, -0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c' (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths.

Conclusion

Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.

Leveraging Mobile Technology for Public Health Promotion: A Multidisciplinary Perspective

Health behaviors are inextricably linked to health and well-being, yet issues such as physical inactivity and insufficient sleep remain significant global public health problems. Mobile technology-and the unprecedented scope and quantity of data it generates-has a promising but largely untapped potential to promote health behaviors at the individual and population levels. This perspective article provides multidisciplinary recommendations on the design and use of mobile technology, and the concomitant wealth of data, to promote behaviors that support overall health. Using physical activity as anexemplar health behavior, we review emerging strategies for health behavior change interventions. We describe progress on personalizing interventions to an individual and their social, cultural, and built environments, as well as on evaluating relationships between mobile technology data and health to establish evidence-based guidelines. In reviewing these strategies and highlighting directions for future research, we advance the use of theory-based, personalized, and human-centered approaches in promoting health behaviors.

Effects of stress beliefs on the emotional and biological response to acute psychosocial stress in healthy men

BACKGROUND

Negative beliefs about stress (e.g., "stress is bad") constitute an independent risk factor for increased morbidity and mortality. One potential underlying mechanism are altered responses to acute psychosocial stress. The aim of this study was to investigate whether beliefs about stress are associated with physiological and endocrine stress response patterns.

METHODS

A total of N = 77 healthy adults were randomised to an experimental and a placebo control group and were subsequently exposed to the Trier Social Stress Test (TSST). Stress beliefs were measured before and after a psychological manipulation aiming at fostering more balanced stress beliefs or a placebo manipulation. Self-reported stress was measured four times before/after the TSST, heart rate was assessed continuously, and cortisol was assessed eight times before/after the TSST.

RESULTS

There was a significant decrease in negative stress beliefs (p < .001) and increase in positive stress beliefs (p < .001) in participants in the experimental condition, which was absent in participants in the placebo condition. The participants in the experimental group had more pronounced self-reported stress reactions (p = .028) while at the same time also showing more pronounced stress recoveries (p = .036). The findings regarding cortisol were mixed.

CONCLUSIONS

More balanced stress beliefs appeared to be associated with more efficient subjective responses to acute psychosocial stress. These findings attest to a potential mechanism translating negative stress beliefs into ill health while at the same time outlining targets for psychological interventions.

Effects of Acute Stress on Rigid Learning, Flexible Learning, and Value-Based Decision-Making in Spatial Navigation

The current study investigated how stress affects value-based decision-making during spatial navigation and different types of learning underlying decisions. Eighty-two adult participants (42 females) first learned to find object locations in a virtual environment from a fixed starting location (rigid learning) and then to find the same objects from unpredictable starting locations (flexible learning). Participants then decided whether to reach goal objects from the fixed or unpredictable starting location. We found that stress impairs rigid learning in females, and it does not impair, and even improves, flexible learning when performance with rigid learning is controlled for. Critically, examining how earlier learning influences subsequent decision-making using computational models, we found that stress reduces memory integration, making participants more likely to focus on recent memory and less likely to integrate information from other sources. Collectively, our results show how stress impacts different memory systems and the communication between memory and decision-making.

The effects of challenge and threat states on coping flexibility: evidence from framing and exemplar priming

BACKGROUND AND OBJECTIVES

Challenge and threat states have divergent effects on cognitive, affective, and behavioral responses. The present research used two experiments to investigate whether challenge and threat states influence coping flexibility differently.

DESIGN

Study 1 (N = 93) used loss-framed and gain-framed task instructions to elicit situation-specific threat and challenge evaluations, respectively, with a Null condition as a control. Study 2 (N = 86) used an online single-session Cognitive Bias Modification for Interpretation (CBM-I) paradigm to present participants with exemplars related to either positive or negative resolutions of stressful situations to engender a stress-is-a-challenge or stress-is-a-threat mindset, with a mixed condition as a control.

RESULTS

Loss-framed task instruction generated situation-specific threat evaluation, debilitated effective attention, and reduced positive affect, without altering coping flexibility measured in other scenarios. CBM-I engendered a stress-is-a-challenge mindset and maintained positive affect and coping flexibility, whereas the negative and mixed groups decreased coping flexibility. A stress-is-a-challenge mindset was positively associated with coping flexibility prior to and after exemplar priming.

CONCLUSIONS

Findings enrich the literature on stress coping and shed light on future practice by illustrating the different effects of framing and CBM-I on challenge/threat situation-specific evaluation and stress mindset, and the positive relation of stress-is-a-challenge mindset to coping flexibility.

The Relationship between a Growth Mindset and Junior High School Students' Meaning in Life: A Serial Mediation Model

A growth mindset is an individual's belief that human intelligence can be changed through continuous practice and effort. The meaning in life signifies that individuals understand or see the meaning of their own life and are aware of their own goals and the values of their own life. Previous studies have shown that a growth mindset positively promotes individual emotional health and life happiness, but its relationship with meaning in life needs to be clarified. In this study, taking the self-determination theory and the broaden-and-build theory of positive emotions as a basis, we constructed a serial mediation effect model to test the mechanism of psychological capital and core self-evaluation in the relationship between a growth mindset and the meaning in life. A total of 565 students from Chinese junior middle schools participated in this study. The growth mindset, meaning in life, psychological capital, and core self-evaluation scales were used to collect the data for the study. The results indicated the following: (1) meaning in life was significantly predicted by growth mindset (β = 0.181, p < 0.001); (2) psychological capital and core self-evaluations played a mediating role in the influence of growth mindset on junior high school students' meaning in life. The mediating role includes three mediating paths: the individual mediating effects of psychological capital, the individual mediating effects of core self-evaluations, the serial mediating effects of psychological capital and core self-evaluations. The results of this study confirm the benefits of a growth mindset, as well as the potential mechanism by which they impact meaning in life, which positively impacts junior high school students meaning in life.

Web-Based Mind-Body Tactical Resilience Training Program for First Responders: Pre-Post Study Assessing Feasibility, Acceptability, and Usability

BACKGROUND

First responders report elevated rates of mental disorders, including posttraumatic stress disorder (PTSD), yet many are reluctant to seek care. Preventative resilience training programs attempt to proactively address this issue, and there is evidence showing promise for programs targeting cognitive processes. However, these programs rarely address the physical health conditions associated with PTSD. There is emerging evidence of mind-body exercise training improving PTSD symptoms as well as its associated physical health symptoms. However, the feasibility and acceptability of delivering a web-based mind-body resilience training among first responders are not yet known.

OBJECTIVE

This study aimed to evaluate the feasibility, usability, and acceptability of a web-based mind-body tactical resilience training program designed for first responders. In addition, we explored the preliminary effectiveness of the training program on mental health outcomes, adaptive cognitive strategies, and work productivity.

METHODS

A total of 42 first responders based in the United States enrolled in the web-based training program. Participants were administered web-based surveys before enrolling in the 6-week web-based program and at the end of the program. The primary outcomes of feasibility were measured using the number of training hours, program adherence rates, and self-reported data on frequency of practice. Acceptability and usability were measured using self-reported data. Secondary outcomes were symptoms of PTSD, psychological distress, emotion regulation, stress mindset, psychological preparedness, and work performance.

RESULTS

Overall, the training program was feasible based on the median number of training hours spent on the web-based program (7.57 hours out of an expected total of 6 to 9 hours), and 55% (23/42) of the enrolled participants completed more than half of the program. Although acceptability, usability, and frequency of practice were rated as high, this was based on only 29% (12/42) of the respondents who provided follow-up data. Secondary outcomes showed a significant improvement in the adaptive cognitive strategy of the stress mindset, with a mean difference of -5.42 (SD 4.81; 95% CI -8.475 to -2.358; t₁₁=-3.898; P=.002). All other secondary outcomes were not significant. However, the secondary outcomes were exploratory only, and this study was neither designed nor powered to adequately assess efficacy.

CONCLUSIONS

These findings suggest that a mind-body tactical resilience training program delivered in a web-based format is feasible and acceptable among first responders; however, further refinements may be required to improve adherence rates. Further research using a larger, more rigorous trial design is warranted to examine the effectiveness of this type of training as a possible prevention or treatment strategy for this population.