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Milas G, Ćavar F, Ribar M. How much stressful life events really matter? Conceptual and methodological difficulties in assessing the impact of self-reported events on adolescents' subjective stress. Stress Health 2024; 40:e3335. [PMID: 37861340 DOI: 10.1002/smi.3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/28/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023]
Abstract
Numerous studies have pointed to the strong impact of stressful life events on subjective stress and indirectly on the adolescents' mental health. However, the results of many such studies contain bias caused by the choice of measurement method or an incomplete theoretical framework. To estimate the extent of possible bias when using self-reports, we conducted research on a representative sample of 2201 Croatian adolescents aged 14-18 years. Using manipulation we examined the influence of measurement method and the number of constructs included in the model on the variance of subjective stress explained by stressful events. Structural equation modelling indicated that different measurement methods, occurrence-based and severity-based, provide a marked discrepancy in the impact size estimation. The occurrence-based method provided estimates of a much smaller proportion of the explained variance (6%-25%) compared to the severity-based approach, which estimated the explained variance in the range of 25%-55% depending on the model. The complexity of the tested models additionally contributed to the variation in the estimates. It is recommended that when using self-reports to measure stressful life events, occurrence-based and severity-based methods are used simultaneously and that impact estimates are expressed within intervals.
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Affiliation(s)
- Goran Milas
- Institute of Social Sciences "Ivo Pilar", Zagreb, Croatia
| | - Filipa Ćavar
- Institute of Social Sciences "Ivo Pilar", Zagreb, Croatia
| | - Maja Ribar
- Institute of Social Sciences "Ivo Pilar", Zagreb, Croatia
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Ruchiwit M, Vuthiarpa S, Ruchiwit K, Muijeen K, Phanphairoj K. A Synthesized Model for Applying Stress Management and Biofeedback Interventions in Research Utilization: A Systematic Review and Meta-analysis. Clin Pract Epidemiol Ment Health 2024; 20:e17450179276691. [PMID: 38660573 PMCID: PMC11037511 DOI: 10.2174/0117450179276691231229071003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 04/26/2024]
Abstract
Background Stress management and biofeedback interventions have been shown to be effective in improving mental and physical health outcomes. However, previous research studies and synthesized models for applying these interventions in research utilization are insufficient. Objective This study aimed to synthesize a model for applying stress management and biofeedback interventions in research utilization. Methods A systematic review and meta-analysis were conducted according to the PRISMA guidelines.Multiple studies were used to assess the effectiveness of applying stress management and biofeedback interventions published from 2017 to 2023. The process included identifying the research questions, conducting a comprehensive literature search, assessing study quality, extracting data, synthesizing the data, analyzing and interpreting the findings, drawing conclusions, and making recommendations. Results The results indicated a significant mean effect size without evidence of publication bias. The effect sizes of the subgroups among the study variables were not significantly different [Q = 4.02, p = .26]. However, there were significant differences regarding the mean effect sizes among the studies [Q = 63.59, p < .001] and also in terms of the test of subgroups among the participants [Q = 8.49, p = .04]. Conclusion The results emphasize the importance of evidence-based practice and highlight the need for ongoing evaluation and refinement of interventions. The proposed model was supported by related theories and research studies in order to ensure the robustness and reliability to guide practice and future research in the field of biofeedback interventions. By following this model, researchers and practitioners can ensure that stress management and biofeedback interventions are evidence-based and are effective in improving mental and physical health outcomes.
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Affiliation(s)
- Manyat Ruchiwit
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Sararud Vuthiarpa
- Faculty of Nursing, Rattana Bundit University, Pathumthani, Thailand
| | - Kampol Ruchiwit
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Kasorn Muijeen
- Faculty of Nursing, Thammasat University, Pathumthani, Thailand
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Carosella KA, Wiglesworth A, Bendezú JJ, Brower R, Mirza S, Mueller BA, Cullen KR, Klimes-Dougan B. Patterns of experience, expression, and physiology of stress relate to depressive symptoms and self-injurious thoughts and behaviors in adolescents: a person-centered approach. Psychol Med 2023; 53:7902-7912. [PMID: 37609891 PMCID: PMC10755230 DOI: 10.1017/s0033291723002003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/24/2023] [Accepted: 06/30/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Preliminary evidence shows that discordance in stress experience, expression, and physiology (EEP) in adolescents is linked to depression, suicidal ideation (SI), non-suicidal self-injury (NSSI), and brain functioning. This study employs person-centered analysis to probe the relationship between stress responses, psychopathology, and neural patterns in female adolescents who are oversampled for engagement in NSSI. METHODS Adolescent females (N = 109, ages 12-17) underwent a social stress test from which self-report measures of stress experience, observer ratings of stress expression, and physiological metrics of stress (via salivary cortisol) were obtained. Multi-trajectory modeling was employed to identify concordant and discordant stress EEP groups. Depressive symptoms, SI and attempt, NSSI engagement, frontal and limbic activation to emotional stimuli, and resting state fronto-limbic connectivity were examined in the EEP groups derived from the multi-trajectory models. RESULTS Four groups were identified, three of which demonstrated relatively concordant EEP and one which demonstrated discordant EEP (High Experience-High Expression-Low Physiology). Further, replicating past research, the High Experience-High Expression-Low Physiology discordant group exhibited higher depressive symptoms, SI, suicide attempt, and NSSI episodes (only for sensitivity analyses based on past year) relative to other EEP groups. No significant group differences in brain functioning emerged. CONCLUSION Results indicate that within-person, multi-level patterns in stress responding capture risk for dysfunction including depression and self-injurious thoughts and behaviors. Further interrogating of system-level stress functioning may better inform assessment and intervention efforts.
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Affiliation(s)
| | - Andrea Wiglesworth
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Jason José Bendezú
- Department of Psychology, The Pennsylvania State University, University Park Campus, University Park, PA, USA
| | - Rylee Brower
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Salahudeen Mirza
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Bryon A. Mueller
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kathryn R. Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, University of Minnesota Twin Cities, Minneapolis, MN, USA
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Guo Y, Yang Y, Deveaux L, Dinaj-Koci V, Schieber E, Herbert C, Lee J, Wang B. Exploring effects of multi-level factors on transitions of risk-taking behaviors among middle-to-late adolescents. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2023; 47:210-220. [PMID: 37746313 PMCID: PMC10516360 DOI: 10.1177/01650254221148117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Adolescents experiment with risk behaviors, including delinquency, substance use, and sexual activity. Multi-level social factors, such as having high-risk peers, neighborhood risks, and parental monitoring, influence adolescents' behaviors. We modeled transition patterns in Bahamian adolescents' risk behaviors across three high school years and examined the effects of multi-level factors. We collected data from 2,564 Bahamian adolescents in Grade 10 and follow-ups through Grade 12. We used latent transition model to identify adolescents' risk statuses. Further analyses used multinomial logistic regression to explore the effects of multi-level factors on assignment to those latent statuses and transitions. We identified four distinct statuses: "low risk" (47.9% of the sample at baseline), "alcohol use" (36.8%), "alcohol use and sexual activity" (5.5%), and "high risk" (9.8%). Males were more likely to be in higher-risk statuses at baseline and to transition from a lower-risk status in Grade 10 to a higher-risk status in Grade 11. Social risk factors were significantly associated with higher-risk statuses at baseline. Neighborhood risk and peer risk involvement continued to affect transitions from lower to higher risk; parental monitoring did not have a significant effect in later years. Our findings have important implications for developing targeted and developmentally appropriate interventions to prevent and reduce risk behaviors among middle-to-late adolescents.
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Affiliation(s)
- Yan Guo
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Yinmei Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Lynette Deveaux
- Office of HIV/AIDS, Ministry of Health, Shirley Street, Nassau, The Bahamas
| | | | - Elizabeth Schieber
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Carly Herbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - JungAe Lee
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation Street, Worcester, MA 01605, USA
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Dapari R, Bashaabidin MSM, Hassan MR, Dom NC, Rahim SSSA, Wan Mahiyuddin WR. Health Education Module Based on Information-Motivation-Behavioural Skills (IMB) for Reducing Depression, Anxiety, and Stress among Adolescents in Boarding Schools: A Clustered Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215362. [PMID: 36430081 PMCID: PMC9692668 DOI: 10.3390/ijerph192215362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 05/27/2023]
Abstract
Depression, anxiety, and stress (DAS) among adolescents have become a public health concern. The aim of this study was to develop, implement, and measure an IMB-based health education intervention module for reducing DAS among adolescents in boarding schools in the state of Negeri Sembilan, Malaysia. A single-blinded cluster randomised control trial (RCT) was conducted among students with abnormal DASS-21 scores. They were divided into an intervention group (three schools, 62 participants) and a control group (three schools, 57 participants). Participants in the intervention group received IMB-based health education, while participants in the control group underwent the standard care session. To determine the effectiveness of the intervention, the Generalised Linear Mixed Model (GLMM) analysis was conducted. A total of 119 students participated in this study, and no loss to follow-up was reported. Both intervention and control groups showed significantly reduced DAS scores (p < 0.005). However, the reduction of these scores was greater in the intervention group. The GLMM analysis revealed that the intervention was effective in reducing depression (ß = -2.400, t = -3.102, SE = 0.7735, p = 0.002, 95% CI = -3.921, -0.878), anxiety (ß = -2.129, t = -2.824, SE = 0.7541, p = 0.005, 95% CI = -3.612, -0.646), and stress (ß = -1.335, t = -2.457, SE = 0.536, p = 0.015, 95% CI = -2.045, -0.266) among adolescents. The IMB-based health education module was effective in reducing DAS among adolescents in boarding schools.
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Affiliation(s)
- Rahmat Dapari
- Department of Community Health, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | | | - Mohd Rohaizat Hassan
- Department of Community Health, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Nazri Che Dom
- Faculty of Health Sciences, Universiti Teknologi MARA, Bandar Puncak Alam 42300, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Wan Rozita Wan Mahiyuddin
- Institute for Medical Research, National Institute of Health, Ministry of Health, Shah Alam 40170, Malaysia
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