Validating a Self-Report Measure of Student Athletes' Perceived Stress Reactivity: Associations With Heart-Rate Variability and Stress Appraisals

Comparison of the Perceived Stress Reactivity Scale with physiological and self-reported stress responses during ecological momentary assessment and during participation in a virtual reality version of the Trier Social Stress Test

Valid approaches to conveniently measure stress reactivity are needed due to the growing evidence of its health-impairing effects. This study examined whether the Perceived Stress Reactivity Scale (PSRS) predicts cardiovascular and psychological responses to psychosocial stressors during daily life and during a virtual reality (VR) Trier Social Stress Test (TSST). Medical students answered a standardized baseline questionnaire to assess perceived stress reactivity by the PSRS. The PSRS asks participants to rate the intensity of their typical affective responses to common stressors during daily life. They were further asked to participate in a VR-TSST and in an ecological momentary assessment (EMA) over a period of three consecutive workdays during daily life. Blood pressure and self-reported stress were repeatedly, heart rate variability (HRV) continuously measured during the VR-TSST and EMA. Furthermore, participants repeatedly assessed task demands, task control and social conflict during the EMA. Data was analysed using multilevel analysis and multiple linear regression. Results indicate that the PSRS moderates associations between blood pressure (but not HRV) and demands and control during daily life. Furthermore, the PSRS directly predicted self-reported stress, but did not moderate associations between self-reported stress and demands, control and social conflict. The PSRS did not predict physiological and self-reported stress responses to the VR-TSST. This study partly confirmed convergent validity of the PSRS to stress reactivity in daily life. Furthermore, the lack of association between the PSRS and stress responses to the VR-TSST calls for future studies to search for reliable and valid ways to assess stress reactivity.

Impact of victory and defeat on the perceived stress and autonomic regulation of professional eSports athletes

Competitive sports involve physiological, technical and psychological skills, which influence directly on individuals’ performance. This study aims to investigate the levels of perceived stress and Heart Rate Variability (HRV) before and after matches with victory and defeat in professional eSports athletes. Our hypothesis was that the winners would have better autonomic and stress responses after match, thus corroborating the literature on neurocardiac connections. Fifty male eSport players were selected players from 10 different Brazilian teams. The experiment was carried out in 2 sessions. Firstly, after signing the informed consent form, 24 h before the game, anthropometric, physical activity levels and time of expertise data were recorded only for sample characterization and the players were familiarized with the perceived stress scale—10 (PSS-10) and the HRV measurements. Secondly, players performed the PSS-10 and HRV recording at rest by 10 min 60 and 30 min before the game (i.e., baseline time) and 10 min after the end of the game. Overall, concerning PSS-10 our findings show that VG had significant reduced scores in post-game time compared to baseline (BL) and pre-game times, while DG had significant increased scores in post-game time compared to BL and pre-game times. Regarding HRV, our results demonstrate that VG had significant increase in RR, SDNN, rMSSD, pNN50 and HF, and significant decrease in LF and LF/HF, while DG had a significant decrease in RR, SDNN, rMSSD and HF, and significant increase in LF and LF/HF. It was observed that VG had better HRV responses (greater parasympathetic activation) as well as lower levels of perceived stress, while DG had worst HRV responses (greater sympathetic activation) and higher levels of perceived stress.

Association Between Musculoskeletal Pain and Psychological Stress Responses in High School Baseball Players: A Cross-sectional Study

Background:

Musculoskeletal pain could represent a psychological stressor in adolescent athletes. However, few epidemiological studies have investigated this association.

Purpose:

To assess the relationship between musculoskeletal pain (shoulder, elbow, wrist, and low back) and psychological stress responses in high school baseball players.

Study Design:

Cross-sectional study.

Methods:

Participants comprised male Japanese high school baseball players who had completed a questionnaire as part of their annual medical evaluation in 2016. Experiences of shoulder, elbow, wrist, and low back pain during the previous season were investigated. Pain severity was graded as 1 (mild, playing without interference), 2 (moderate, playing with interference), or 3 (severe, could not play because of pain). The Stress Response Scale–18 was used to measure stress response: low, medium, rather high, and high. Prevalence rates of shoulder, elbow, wrist, and low back pain and their association with psychological stress responses were investigated using univariate and multivariable analyses.

Results:

A total of 944 players (223 pitchers and 721 fielders) were included in this study. Their mean age was 16.1 ± 0.6 years, and 66% were high school juniors, while 33.6% were seniors. In pitchers, the prevalence rates during the previous year of severe (grade 3) interference with playing because of elbow, shoulder, wrist, and low back pain were 21.5% (n = 48), 19.3% (n = 43), 3.6% (n = 8), and 18.4% (n = 41), respectively, whereas in fielders, the respective prevalence rates were 17.1% (n = 123), 17.9% (n = 129), 6.7% (n = 48), and 19.3% (n = 139). After adjusting for confounding factors (playing on a top-performing team, high school grade level, and all other sites of musculoskeletal pain), the authors found significant associations in pitchers between severe experiences of elbow pain and low back pain and medium to high psychological stress responses (odds ratio, 2.64 [95% CI, 1.32-5.39], P = .006 and odds ratio, 2.32 [95% CI, 1.12-4.89], P = .024, respectively). No significant associations were seen between musculoskeletal pain and psychological stress responses in fielders.

Conclusion:

In the current study, elbow and low back pain were associated with stronger psychological stress responses compared with other musculoskeletal pain in high school baseball pitchers.

Relevance of Objective Measures in Psychiatric Disorders-Rest-Activity Rhythm and Psychophysiological Measures

PURPOSE OF REVIEW

We present a review of recent methods of objective measurement in psychiatry and psychology with a focus on home monitoring and its utility in guiding treatment.

RECENT FINDINGS

For individualized diagnostics and treatment of insomnia, actigraphy can generate clinically useful graphical presentations of sleep timing and patterns. Psychophysiological measures may complement psychometrics by tracking parallel changes in physiological responses and emotional functioning, especially during therapy for trauma symptoms and emotion regulation. It seems that rather than defining universal cut-offs, an individualised range of variability could characterize treatment response. Wearable actigraphy and psychophysiological sensors are promising devices to provide biofeedback and guide treatment. Use of feasible and reliable technology during experimental and clinical procedures may necessitate defining healthy and abnormal responses in different populations and pathological states. We present a "call for action" towards further collaborative work to enable large scale use of objective measures.

Moderation of the Stressor-Strain Process in Interns by Heart Rate Variability Measured with a Wearable and Smartphone App: a Within-Subject Design Using Continuous Monitoring

Background

The emergence of smartphones and wearable sensor technologies enables easy and unobtrusive monitoring of physiological and psychological data related to an individual’s resilience. Heart rate variability (HRV) is a promising biomarker for resilience based on between-subject population studies, but observational studies that apply a within-subject design and use wearable sensors in order to observe HRV in a naturalistic real-life context are needed.

Objective

This study aims to explore whether resting HRV and total sleep time (TST) are indicative and predictive of the within-day accumulation of the negative consequences of stress and mental exhaustion. The tested hypotheses are that demands are positively associated with stress and resting HRV buffers against this association, stress is positively associated with mental exhaustion and resting HRV buffers against this association, stress negatively impacts subsequent-night TST, and previous-evening mental exhaustion negatively impacts resting HRV, while previous-night TST buffers against this association.

Methods

In total, 26 interns used consumer-available wearables (Fitbit Charge 2 and Polar H7), a consumer-available smartphone app (Elite HRV), and an ecological momentary assessment smartphone app to collect resilience-related data on resting HRV, TST, and perceived demands, stress, and mental exhaustion on a daily basis for 15 weeks.

Results

Multiple linear regression analysis of within-subject standardized data collected on 2379 unique person-days showed that having a high resting HRV buffered against the positive association between demands and stress (hypothesis 1) and between stress and mental exhaustion (hypothesis 2). Stress did not affect TST (hypothesis 3). Finally, mental exhaustion negatively predicted resting HRV in the subsequent morning but TST did not buffer against this (hypothesis 4).

Conclusions

To our knowledge, this study provides first evidence that having a low within-subject resting HRV may be both indicative and predictive of the short-term accumulation of the negative effects of stress and mental exhaustion, potentially forming a negative feedback loop. If these findings can be replicated and expanded upon in future studies, they may contribute to the development of automated resilience interventions that monitor daily resting HRV and aim to provide users with an early warning signal when a negative feedback loop forms, to prevent the negative impact of stress on long-term health outcomes.

Does Eligibility Classification Matter? Tracking Cardiac Autonomic Function during a Collegiate Soccer Season

The current study examined differences in heart rate (HR) variability (HRV) across student-athlete eligibility classifications within a men’s soccer team. The study also aimed to identify any differences in HRV while competing at home or away. Data collection covered an entire collegiate season, commencing in the preseason and concluding upon elimination from the NCAA Soccer tournament. Comparisons of HR and HRV, paired with self-reported subjective measures, were documented between student-athlete eligibility classifications, home versus away games, and based on soccer position (forward, midfielder, defender, goalkeeper). HR and HRV were similar based on student-athlete eligibility. Heart rate exhibited a small, but statistically significant decrease (β = −1.7 bpm (95% CI: −2.9, 0.57), p = 0.003) for the away games relative to home. HRV showed a statistically significant increase in the away game setting (β = 2.1 (95% CI: 0.78, 3.38), p = 0.002). No difference in HRV was observed across eligibility classification. This lack of difference may be attributed to a different perception of stress amongst male athletes. Athletes also exhibited a reduced HRV at home, likely as an indication of their readiness to compete paired with an increased self-confidence, given there was no difference in any subjective measures of mood or stress or between games played away or at home.

Stress and Coping in Esports and the Influence of Mental Toughness

This study explored stress and coping in electronic sports (esports) athletes and the influence of mental toughness (MT), as defined by two prominent conceptualizations: the 4/6Cs and Mental Toughness Index (MTI) frameworks. Participants were 316 esports athletes, ranked in the top 40% of one of five major esports: Defense of the Ancients 2, League of Legends (LoL), Counter Strike: Global Offensive, Overwatch and Rainbow Six: Siege. Participants completed the MTI, Mental Toughness Questionnaire 6 (MTQ6), Stress Appraisal Measure, and Brief COPE inventory. Results showed that MT (via both MT frameworks) was associated with perceived control, and MTQ6 subscales were associated with stress intensity. Mental toughness (both frameworks) was associated with the selection of more problem-focused and emotion-focused coping strategies and less avoidance coping strategies. The results indicate there is some overlap between the MT and stress-coping process in high-performing traditional sports and competitive esports athletes. These results suggest that esports athletes could benefit from sports psychology interventions designed for traditional sports athletes. Finally, the MTQ6 and MTI had low shared variance (20%), suggesting that the two questionnaires appear to measure different aspects of MT.