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Emal LM, Tamminga SJ, Schaafsma FG, Jakasa I, Peremin I, Kirschbaum C, van der Molen HF, Kezic S. Exploring the potential of stratum corneum biomarkers for assessing psychological distress in health care workers: An observational pilot study. Health Sci Rep 2024; 7:e1710. [PMID: 38186941 PMCID: PMC10764658 DOI: 10.1002/hsr2.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 01/09/2024] Open
Abstract
Backgrounds The detection of biomarkers of a stress response in the stratum corneum (SC) could be used as objective assessment of early stress symptoms and monitoring of stress reduction interventions in health care workers (HCWs). Aim The aim of this study is to explore SC biomarkers of immune and hormonal response and skin barrier for assessment of psychological distress (PD) in HCWs. Methods Twenty-five female HCWs and 25 non-HCWs participated. SC samples were collected using adhesive tapes at baseline and 3-5 days later (T1). We analyzed 24 biomarkers (immunological, vascular, hormones, and natural moisturizing factors). Stress symptoms were assessed using three scales of Copenhagen Psychosocial Questionnaire. The study involved: identifying SC biomarkers, correlating stress symptoms and biomarkers at baseline and T1, examining stress symptoms between the groups with a Mann-Whitney test, comparing stress symptoms and biomarkers between groups using Ordinary Least Regression and investigating temporal variability of SC biomarkers at baseline and T1 using a Wilcoxon-signed rank. Results Fourteen SC biomarkers were identified. We found correlations between general stress and "IL18" (r = 0.55) physical stress and "IL1b" (r = 0.36) and cognitive stress and "MIP3a" (r = 0.38) at baseline and general stress and cortisol (r = -0.49), physical stress and cortisol (r = -0.60) and cortisone (r = -0.67) at T1. We found no differences in stress symptoms and biomarkers between the groups, except for "MIP3a" at baseline. Differences in the biomarker levels between two time points were found for "TARC," "VEGFA," "ILRA," "IL1RA/IL1a," "NMF," and "DHEA." Conclusion The SC can be suitable biological material to assess biomarkers related to immune response, hormonal response, and skin barrier function. The SC biomarkers, showed strong, moderate and weak correlations with stress symptoms. Notably, these associations include cytokines of innate immunity and well-known stress hormones, cortisol and cortisone.
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Affiliation(s)
- Lima M. Emal
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sietske J. Tamminga
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | - Ines Peremin
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | | | - Henk F. van der Molen
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sanja Kezic
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
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Rajaee M, Karson SN, McCullough AM. Teachers on the margins: How low-income public schools burden our teachers. Work 2022; 72:949-965. [DOI: 10.3233/wor-210010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Teachers experience high work-related stress, which can lead to missed workdays and lower quality of life. OBJECTIVE: The objective of this exploratory pilot study was to assess occupational and environmental stressors in public school districts by income level to examine the influence these stressors have on teachers perceived stress and biological stress response. METHODS: Fifty-nine teachers were recruited from four school districts in Michigan (three low-income and one high-income). Participants completed a self-administered survey on teaching stressors, health, and demographics. Stress response was measured through blood pressure, heart rate, and salivary cortisol. Six salivary cortisol measurements were collected for each participant; three in the afternoon and three in the evening. Each teacher’s classroom and school underwent an environmental assessment on quality and proximity to environmental hazards. RESULTS: Teachers at low-income school districts had significantly higher afternoon cortisol levels, lower self-reported health, higher body mass index, higher perceived teaching stressors, and worked at schools within one km of a greater number of environmentally-contaminated sites, in comparison to their high-income school district counterparts. CONCLUSIONS: This research aims to inform future interventions that could lessen occupational and environmental stressors for teachers, improve teacher health outcomes and retention, and impact student success rates.
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Affiliation(s)
- Mozhgon Rajaee
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Samantha N. Karson
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Ashley M. McCullough
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
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3
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Guerreiro MPP, Dalmolin GDL, Andolhe R, Stumm EMF, Frizzo MN, Lanes TC. Salivary cortisol concentrations in hematogy/oncology nurses on working days and days off. Rev Bras Enferm 2021; 74:e20200478. [PMID: 34076197 DOI: 10.1590/0034-7167-2020-0478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/16/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to assess salivary cortisol concentrations in hematology/oncology nurses on working days and days off. METHODS a cross-sectional study carried out with 28 nurses from a university hospital. A sociodemographic, employment and health profile questionnaire was applied. For saliva collection, Salivette® tubes were used. Descriptive and analytical analysis was used. RESULTS there was no significant difference in cortisol concentrations between working days and days off (p>0.05). The high cortisol concentration was associated with not having children (0.621±0.340; p=0.046), not using medication (0.623±0.133; p=0.017) and birth control pills (0.556 ± 0.228; p=0.047) and intention to leave work (0.951±0.154; p=0.001). A positive correlation was identified between cortisol and absence from work due to health issues (0.72; p=0.05) and weight gain (0.935; p=0.02). CONCLUSION in general, cortisol concentration is within the reference parameters, with no significant difference in its secretion on working days and days off.
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Affiliation(s)
| | | | - Rafaela Andolhe
- Universidade Federal de Santa Maria. Santa Maria, Rio Grande do Sul, Brazil
| | | | - Matias Nunes Frizzo
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul. Ijuí, Rio Grande do Sul, Brazil
| | - Taís Carpes Lanes
- Universidade Federal de Santa Maria. Santa Maria, Rio Grande do Sul, Brazil
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4
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Frazier SE, Parker SH. Measurement of physiological responses to acute stress in multiple occupations: A systematic review and implications for front line healthcare providers. Transl Behav Med 2019. [PMID: 29522140 DOI: 10.1093/tbm/iby019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Optimizing performance of individuals in acutely stressful work-related situations requires a deeper understanding of the interaction between the demands of the stimuli and an individual's associated physiological response. Identifying these responses is particularly germane for healthcare professionals, who experience episodes of acute stress on a regular basis. The purpose of this review was to examine and synthesize empirical literature to identify studies assessing physiological responses to acute stress, determine common methods for measuring acute stress in near real-time, and identify common research designs employed across industries. A modified PRISMA approach was followed. Systematic searches were conducted of four databases (PsycINFO, Medline, PubMed, and Turning Research into Practice [TRIP]) to access eligibility. Reference list searches and a hand search were also conducted to identify other articles suitable for inclusion. Studies selected examined an acute physiological response while participants were engaged in a stress-inducing task. Twenty-two articles were included. Fifteen (68.2%) were centered on the human service industry while only three (13.6%) focused on healthcare professionals. Half of the studies incorporated a simulation into the research design while only two (9.1%) articles looked at physiological responses in real-world settings. Heart rate and cortisol emerged as the most common physiological measures collected. This review demonstrates that acute stress is primarily assessed retrospectively, and that there is a pragmatic gap in methodological approach, with many data collection methods inappropriate for the healthcare environment. Future research should capitalize on advancements in sensor technology to passively examine acute stress in healthcare professionals.
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Affiliation(s)
- Sarah E Frazier
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA, USA.,Graduate Program in Translational, Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA.,Carilion Clinic, Roanoke, VA, USA
| | - Sarah H Parker
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA, USA.,Carilion Clinic, Roanoke, VA, USA.,Department of Biomedical Sciences, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.,Department of Psychology, Virginia Tech, Blacksburg, VA, USA
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Landolt K, Maruff P, Horan B, Kingsley M, Kinsella G, O'Halloran PD, Hale MW, Wright BJ. Reduced professional efficacy is associated with a blunted salivary alpha-amylase awakening response. Physiol Behav 2018; 199:292-299. [PMID: 30503848 DOI: 10.1016/j.physbeh.2018.11.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/23/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
The job demands-resources model (JD-R) has shown an ability to predict worker engagement and exhaustion, yet to our knowledge, research has not been conducted that assesses the JD-R model with physiological indicators of chronic stress and burnout. Using the JD-R model, we assessed if occupational stress and burnout were related to dysregulated cortisol and salivary alpha-amylase awakening responses (sAA-AR). Professional apprentice jockeys comprising of males (n = 14) and females (n = 18) provided morning saliva samples and completed self-report measures relating to job demands and resources, burnout, and perceived mental and physical health. Data was collected at two time points coinciding with naturally occurring 'low' and 'high' stress periods during the racing calendar. The jockeys reported good physical and mental health but had elevated levels of the burnout subtypes cynicism and exhaustion. Regression analyses suggested that those jockeys presenting with reduced professional efficacy in the high stress period produced a 'flattened' sAA-AR indicative of reduced autonomic nervous system (ANS) arousal, which has been associated with burnout. Further, decreases in professional efficacy explained the relationship between increased workplace stress and decreased ANS activity in the high stress period. Our findings suggest that assessments of psychological stress or physiology in isolation are not as useful as looking at both in combination, and extend previous findings on the sAA-AR.
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Affiliation(s)
- Kathleen Landolt
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Paul Maruff
- The Florey Institute, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Ben Horan
- School of Engineering, Deakin University, Geelong, VIC 3216, Australia
| | - Michael Kingsley
- Exercise Physiology, La Trobe Rural Health School, Bendigo, VIC 3552, Australia
| | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Paul D O'Halloran
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Matthew W Hale
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia.
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Austin SB, Rosario M, McLaughlin KA, Roberts AL, Sarda V, Yu K, Missmer S, Anatale-Tardiff L, Scherer EA. Sexual orientation and salivary alpha-amylase diurnal rhythms in a cohort of U.S. young adults. Psychoneuroendocrinology 2018; 97:78-85. [PMID: 30015008 PMCID: PMC6138569 DOI: 10.1016/j.psyneuen.2018.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 12/25/2022]
Abstract
Sexual minorities in the United States are at elevated risk of prejudice, discrimination, and violence victimization due to stigma associated with their sexual orientation. These stressors may contribute to physiological stress responses and changes in the regulation of the sympathetic nervous system (SNS). To date, no studies have examined the associations among minority sexual orientation, recent stressful events, and diurnal salivary alpha-amylase (sAA) patterns. The present study included 1663 young adults ages 18-32 years (31% men, 69% women) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over the course of one day to estimate diurnal sAA patterns. Sexual orientation groups included completely heterosexual with no same-sex partners (CH; referent), mostly heterosexual/completely heterosexual with same-sex partners, and gay/lesbian/bisexual (LB or GB). Sex-stratified multilevel models were fit to evaluate the association of sexual orientation with diurnal patterns of log sAA. The association of recent stressful events was also evaluated. Among women, sexual minorities scored significantly higher than CH on perceived stress and number of stressful events in the past month (p < 0.05). Among men, sexual minorities scored higher than CH on perceived stress but not recent stressful events. In multivariable models, recent stressful events were not associated with sAA patterns, but significant sexual orientation group differences in sAA diurnal rhythm were observed among women though not among men. Compared to CH women, LB showed a blunted awakening response and elevated sAA levels across the day, both indicators consistent with SNS dysregulation. Findings suggest dysregulation of stress physiology in LB women, but not other sexual minority women or men, relative to same-sex heterosexuals. Observed dysregulation may relate to exposure among LB women to chronic stressors associated with sexual orientation stigma, although these relations and differences by sex warrant further study.
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Affiliation(s)
- S Bryn Austin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Margaret Rosario
- Department of Psychology, The City University of New York-The City College and Graduate Center, New York, NY, United States
| | - Katie A McLaughlin
- Department of Psychology, University of Washington, Seattle, WA, United States
| | - Andrea L Roberts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Vishnudas Sarda
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, United States
| | - Kimberly Yu
- Department of Psychology, Arizona State University, Tempe, AZ, United States
| | - Stacey Missmer
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Laura Anatale-Tardiff
- Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Emily A Scherer
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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7
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Kim YS, Lee SK. Analysis of Research on Nurses’ Job Stress Using Network Analysis. West J Nurs Res 2018; 41:338-354. [DOI: 10.1177/0193945918781310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study established a network related to nurses’ job stress by conducting a social network analysis of titles, keywords, and abstracts, and it identified emerging topics of research. NetMiner 4.0 visualized an interconnection between critical keywords and investigated their frequency of appearance to construe the trends in nurses’ job stress measures used in studies conducted over 55 years (1960-2015). Text Rank Analyzer examined a collection of 9,218 keywords from 2,662 studies. The analysis revealed four groups of newly emerging keywords in the research. The following five clusters were identified: concept, subject, method and tool, outcome and response, and solution and management. Thus, if new researchers refer to existing trends to establish the subject of their study, replication studies can be reduced, and the direction of the development of future research on nurses’ job stress can be predicted. Further application of new interventions, development of objective indicators, working environment, and broader participants are needed.
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8
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Karhula K, Härmä M, Sallinen M, Lindholm H, Hirvonen A, Elovainio M, Kivimäki M, Vahtera J, Puttonen S. Salivary cortisol and alpha-amylase: Is there consistency between psychosocial stress test and burdensome work shifts? JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2017; 14:1003-1010. [PMID: 28692340 DOI: 10.1080/15459624.2017.1350786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined the consistency of salivary cortisol and alpha-amylase (sAA) total daily secretion between laboratory and field circumstances. The 95 participants were shift working female health care professionals with high (n = 53) or low (n = 42) psychosocial stress (job strain) measured by the Job Content Questionnaire (JCQ). The Trier Social Stress Test including a 5-min free speech and a mental arithmetic task was conducted with four, and field measurements with three daily saliva samples of cortisol and sAA during circadian rhythm and inter-shift recovery controlled morning shift, night shift, and a day off. The associations of salivary cortisol and sAA area under the curve with respect to ground (AUCg) and area under the curve with respect to increase (AUCi) between laboratory and field were tested using OLS (Ordinary Least Squares) regression. The sAA AUCg output in the laboratory was correlated with the output during all field measurement days and similarly among high and low job strain groups (p < 0.001). SAA AUCi and salivary cortisol AUCg and AUCi were not correlated between laboratory and field measurement, neither in the whole sample nor among the low or high job strain group. In conclusion, a laboratory measure of sAA AUCg output is promising in predicting stress-related output during burdensome work shifts and leisure time, whereas sAA AUCi or salivary cortisol seem not to have this potential.
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Affiliation(s)
- Kati Karhula
- a Finnish Institute of Occupational Health , Helsinki , Finland
| | - Mikko Härmä
- a Finnish Institute of Occupational Health , Helsinki , Finland
| | - Mikael Sallinen
- a Finnish Institute of Occupational Health , Helsinki , Finland
- b Department of Psychology , University of Jyväskylä , Jyväskylä , Finland
| | - Harri Lindholm
- a Finnish Institute of Occupational Health , Helsinki , Finland
- c NokiaTECH, Digital Health , Espoo , Finland
| | - Ari Hirvonen
- a Finnish Institute of Occupational Health , Helsinki , Finland
| | - Marko Elovainio
- d National Institute of Health and Welfare , Helsinki , Finland
| | - Mika Kivimäki
- a Finnish Institute of Occupational Health , Helsinki , Finland
- e Department of Epidemiology and Public Health , University College London , London , United Kingdom
- f Faculty of Medicine , University of Helsinki , Helsinki , Finland
| | - Jussi Vahtera
- g Department of Public Health , University of Turku and Turku University Hospital , Turku , Finland
| | - Sampsa Puttonen
- a Finnish Institute of Occupational Health , Helsinki , Finland
- f Faculty of Medicine , University of Helsinki , Helsinki , Finland
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9
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Boggero IA, Hostinar CE, Haak EA, Murphy MLM, Segerstrom SC. Psychosocial functioning and the cortisol awakening response: Meta-analysis, P-curve analysis, and evaluation of the evidential value in existing studies. Biol Psychol 2017; 129:207-230. [PMID: 28870447 DOI: 10.1016/j.biopsycho.2017.08.058] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 01/13/2023]
Abstract
Cortisol levels rise immediately after awakening and peak approximately 30-45min thereafter. Psychosocial functioning influences this cortisol awakening response (CAR), but there is considerable heterogeneity in the literature. The current study used p-curve and meta-analysis on 709 findings from 212 studies to test the evidential value and estimate effect sizes of four sets of findings: those associating worse psychosocial functioning with higher or lower cortisol increase relative to the waking period (CARi) and to the output of the waking period (AUCw). All four sets of findings demonstrated evidential value. Psychosocial predictors explained 1%-3.6% of variance in CARi and AUCw responses. Based on these effect sizes, cross-sectional studies assessing CAR would need a minimum sample size of 617-783 to detect true effects with 80% power. Depression was linked to higher AUCw and posttraumatic stress to lower AUCw, whereas inconclusive results were obtained for predictor-specific effects on CARi. Suggestions for future CAR research are discussed.
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Affiliation(s)
- Ian A Boggero
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Camelia E Hostinar
- Department of Psychology, University of California, Davis, 103 Young Hall, Davis, CA 95616, United States.
| | - Eric A Haak
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
| | - Michael L M Murphy
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213, United States.
| | - Suzanne C Segerstrom
- Department of Psychology, University of Kentucky, 125 Kastle Hall, Lexington, KY 40506, United States.
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