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Perceived Stress in a Probability Sample of the United States

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... The average PSS score of the 2021 farmers was 18.72 (SD 7.03), which is significan higher than the normative population mean (13.0, (SD 6.34); p < 0.001) [59], but not sign icantly different from the 2016 sample mean (18.9 (4.9); p = 0.48) [15]. Of the 2021 part pants, the mean PSS score for women (20.46, ...
... The mean PSS scores for man and woman genders in the 20 sample (17.46 and 20.46) were significantly higher than the normative population mea (13.7, SD 6.60 and 12.1, SD 5.90; p < 0.001) [59]. [41]. ...
... The average PSS score of the 2021 farmers was 18.72 (SD 7.03), which is significantly higher than the normative population mean (13.0, (SD 6.34); p < 0.001) [59], but not significantly different from the 2016 sample mean (18.9 (4.9); p = 0.48) [15]. Of the 2021 participants, the mean PSS score for women (20.46, ...
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Farmers in Canada faced higher levels of mental distress than the general public prior to the Coronavirus Disease 2019 (COVID-19) pandemic and are generally less likely than the public to seek help. However, the mental health impacts of COVID-19 on farmers in Canada remain unexplored. Our objective was to investigate mental health outcomes among farmers in Canada by gender and within the context of COVID-19. We conducted a national, online, cross-sectional survey of farmers in Canada (February–May 2021). The survey included validated scales of anxiety, depression, perceived stress, burnout (emotional exhaustion, cynicism, professional efficacy), alcohol use, resilience, and questions regarding participants’ perceived changes in these outcomes during the pandemic. Data were also collected on the impact of COVID-19 specific social and economic factors on mental health, help-seeking, and sense of community belonging through the pandemic. Descriptive statistics were summarized, and Chi-square analyses and t-tests were conducted to compare survey results between genders and to data collected in our similar 2016 survey and normative population data. A total of 1167 farmers participated in the survey. Participants scored more severely across scales than scale norms and the general Canadian population during COVID-19. Scale means were consistent between the 2016 and 2021 samples. Most participants with moderate to severe scores for any outcome reported worsening symptoms since the pandemic began. Women fared significantly worse than men across measures. Over twice as many women reported seeking mental health or substance use support during the pandemic than men. Participants rated the mental health impacts of all social and economic factors related to COVID-19 examined significantly (p < 0.05) differently than the Canadian public. The pandemic has negatively impacted the mental health of farmers in Canada and in ways that differ from the general population. National level and gender-specific mental health supports are needed to help improve the mental health of farmers in Canada.
... Apart from the general population, validation studies on the PSS have also been carried out in different subpopulations, including patients with health problems, psychiatric patients, and different occupational groups. The PSS has three versions with 14, 10 and 4 items, among which the 10-item version (i.e., PSS-10) demonstrates superior psychometric properties and is recommended by the original authors [10]. Across different populations, the PSS-10 demonstrates a stable two-factor structure [5,8,9]. ...
... There are six forward-scoring items (1, 2, 3, 6, 9 and 10) that constitute the first factor, while the remaining four reverse-scoring items (4, 5, 7 and 8) constitute the second factor. The original PSS-10 and its different translated versions demonstrated adequate internal consistency, test-retest reliability, and construct validity [10]. The reported internal consistency of the scale indicated by Cronbach's alpha ranged from.71 to .91, while the test-retest reliability has been generally observed at r > .70 ...
... among different populations [19][20][21]. Concurrent validity of the PSS-10 was assessed using several tools, such as the depression scale, anxiety scale, the Impact of Event Scale, the General Health Questionnaire (GHQ) and the life event scale, which collectively indicated moderate to strong correlation [10,20]. The Bengali version of the scale endorsed by the original authors [12] has never been reported in terms of its psychometric properties for a general population sample. ...
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With validation studies conducted all over the world, the 10-item Perceived Stress Scale (PSS-10) has become a robust and widely used instrument for assessing the appraisal of stress. The present study was aimed at validation and testing for psychometric properties of the PSS-10 on the Bangladeshi population. Three hundred and fifteen adult (aged 18-64 years) from eight divisional districts of Bangladesh participated in this study. A good fit of the two-factor structure of the scale was indicated by multiple indices (χ2/df, root mean square error of approximation, comparative fit index, and standardized root mean square residual) on confirmatory factor analysis. The full scale demonstrated internal consistency, test-retest reliability and construct validity. The two factors also demonstrated acceptable psychometric properties. The psychometric properties of the Bengali PSS-10 demonstrated in this study suggest the PSS-10 as a valid and reliable instrument for use in Bangladesh and among Bengali-speaking populations.
... The DS14 responses including negative affectivity (NA) and social inhibition (SI) were indicated on a fivepoint Likert scale from 0 (false) to 4 (true), with scores range 0-28 for each subscale, a standardized cut-off of ≥10 on both subscales indicated type-D cases [22]. PSS was rated by a five-point response (0 = never, 1 = almost never, 2 = sometimes, 3 = fairly often, 4 = very often); scores ranged from 0-40, a high score indicating a high degree of perceived stress, and no cut-offs were predefined [23]. ...
... The current study was on Asian people and enrolled 30 patients receiving suitable bladder treatment combined with CBT intervention. The mean PSS10 score was 21.6 points for patients in this study, with higher perceived stress than the general public at approximately 11.9 to 12.6 points [20,23,27]. Negative affectivity and social inhibition of these patients on the DS14 scale were >20 points; suggesting that illness-related cognition affected illness-related coping behaviors, distress, symptom severity, and QoL [28]. ...
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(1) Background: Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) not only induces physiological damage but also greatly affects psychological stress. Multidisciplinary therapy has been recommended for IC/BPS treatment, but clinical trial data of combined bladder therapy and cognitive behavioral therapy (CBT) are lacking. This study evaluated CBT efficacy in patients with IC/BPS. (2) Methods: Patients with IC/BPS were randomized to the bladder monotherapy (BT) or combined CBT (CBT) group. The primary endpoint was the self-reported outcome by global response assessment (GRA). Secondary endpoints included IC symptoms and problem index, bladder pain score, Beck’s anxiety inventory (BAI), and depression inventory, and objective parameters were also compared. (3) Result: A total of 30 patients receiving BT and 30 receiving CBT therapy were enrolled. Significant improvement of the BAI at 8 (p = 0.045) and 12 weeks (p = 0.02) post-treatment was observed in the CBT group, with significantly greater GRA scores at 12 weeks (p < 0.001). Repeated measures analysis of variance showed a significant effect within the CBT group on IC/BPS patients’ self-reported treatment outcomes (p = 0.001) and anxiety severity BAI scores (p = 0.033). (4) Conclusion: A multimodal treatment of CBT combined with suitable bladder treatment more effectively improves anxiety severity and treatment outcomes in patients with IC/BPS.
... The 10-item Chinese Perceived Stress Scale (CPSS-10) was developed by Cohen (1988), and the Chinese version is proven to be reliable (Ng, 2013). It assesses the perceived stress level of individuals in the last month. ...
... The total scores range from 0 to 40, with a higher score indicating a higher stress level. The cut-off for CPSS-10 is 26 (Cohen, 1988). In the present study, the Cronbach's alpha was 0.877. ...
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Background Disturbances in circadian rhythms are common among night-shift workers and result in poor sleep quality. Nevertheless, the heterogeneity of circadian rhythms and their relationship with sleep quality is less explored in nursing interns. Therefore, we aimed to identify the latent subtypes of circadian rhythm, explore their relationship with sleep quality, and evaluate their moderating role between perceived stress and sleep quality in nursing interns. Materials and methods In all, 452 nursing interns were recruited between October 2020 and January 2021 from Be Resilient to Nursing Career (BRNC), which is a multicenter, prospective cohort of a career growth program for nursing students. They were assessed using the 10-item Chinese Perceived Stress Scale, Circadian Type Inventory, and Pittsburgh Sleep Quality Index. Latent profile analysis and moderation analysis were performed. Results Overall, 72.3% of the nursing interns reported poor sleep quality. We identified three latent subtypes of circadian rhythms, namely, Vigorousness (40.1%), Inadaptability (18.6%), and Flexibility (41.1%). Females (OR = 1.97, 95% Cl: 1.01–3.83, P = 0.047) with normal body mass index (OR = 1.62, 95% CI: 0.95–2.76, P = 0.078) were prone to Flexibility. Circadian rhythm types significantly moderated the association between perceived stress and sleep quality ( P < 0.05). Conclusion Nursing interns suffer from poor sleep. There exists heterogeneity of circadian rhythm subtypes in nursing interns, and attention should be paid to those with Inadaptability type. The association between perceived stress and sleep quality is significantly moderated by circadian rhythm subtypes.
... Perceived Stress Scale-10 (PSS). The PSS-10 [40] consists of 10 items that measure how much unpredictable, uncontrollable, and overloaded aspects of one's life are perceived to be. The questionnaire is organized on a five-point Likert scale ranging from 0 (never) to 4 (very often). ...
... Health worker scores between 27 and 40, on the other hand, were considered high perceived stress. The internal reliability of the PSS-10 appears to be adequate [40]. ...
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Background: Although the COVID-19 pandemic had an impact on the general population, health care workers (HCWs) constituted one of the groups that were most adversely affected by the associated risks, owing to the significant consequences on their mental health. This study examined these psychological effects on HCWs who cared for COVID-19 patients who were admitted to the intensive care unit in an Italian hospital. Methods: Subjects were administered several self-reported questionnaires: Kessler 10 Psychological Distress Scale (K10), Perceived Stress Scale-10 (PSS), Impact of Event Scale Revised (IES-R), and Post-traumatic Growth Inventory (PTGI), as well as two open-ended questions oriented toward understanding their positive and negative emotional experience and differentiating between two phases of the emergency. Results: Overall, 45% of HCWs showed medium-to-high anxiety/depressive symptoms, whereas 60% presented with medium-to-high levels of perceived stress. In addition, 37% of subjects developed symptoms of PTSD and 50% showed post-traumatic growth in the “appreciation of life” and “new possibilities” dimensions. With regard to the open-ended questions, three themes were identified: quality of workplace relationships, sense of emotional-relational competence, and sense of clinical-technical competence. In addition, two macrocategories of responses were identified in the answers: growth and block. Conclusions: The mental health of HCWs who are involved in the front line of COVID-19 was significantly impacted by this experience, showing high levels of post-traumatic stress and anxiety and depressive symptoms more than 1 year after the emergency began. A qualitative analysis of staff experiences can be a useful guide for structuring interventions and prevention.
... To capture the concept of general stress, we measured stress using the perceived stress scale, a 4-item scale that assesses generalised perceptions of stress from external situations and internal triggers that cause stress for an individual. 27 Questions ask about how often respondents felt they were unable to control important things in their life, how often they felt confident about the ability to handle personal problems, how often they felt things were going their way and how often they felt difficulties were piling up so high they could not overcome them. Responses for each of the four questions range from '0' (never) to '4' (very often) and questions ask about the frequency of feelings related to events in the previous month. ...
... Responses for each of the four questions range from '0' (never) to '4' (very often) and questions ask about the frequency of feelings related to events in the previous month. 27 The Cronbach alpha value is 0.69 and scores are highly correlated with stress, depression and anxiety. 28 Statistical analysis Structured equation modelling (SEM) was used to investigate direct and indirect effects in the relationship between neighbourhood factors, stress and glycaemic control. ...
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Objectives: Understanding the pathway by which neighbourhood factors influence glycaemic control may be crucial to addressing health disparities in diabetes. This study aimed to examine if the pathway between neighbourhood factors and glycaemic control is mediated by stress. Design: Structured equation modelling (SEM) was used to investigate direct and indirect effects in the relationship between neighbourhood factors, stress and glycaemic control, with standardised estimates to allow comparison of paths. Participants: Data was obtained from 615 adults with type 2 diabetes in the Southeastern United States. Primary and secondary outcome measures: The primary outcome variable was glycaemic control determined by glycated haemoglobin (HbA1c) within the prior 6 months. Neighbourhood factors included neighbourhood violence, aesthetic quality of the neighbourhood, access to healthy food, and social cohesion. Stress was measured using the perceived stress scale. Results: In the final model (χ2(158)=406.97, p<0.001, root mean square error of approximation=0.05, p-close 0.38, Comparative Fit Index=0.97, Tucker-Lewis index=0.96, the coefficient of determination=1.0), violence (r=0.79, p=0.006), neighbourhood aesthetics (r=0.74, p=0.02) and social cohesion (r=0.57, p=0.04) were significantly associated with higher perceived stress. Stress (r=0.06, p=0.004) was directly associated with higher glycaemic control. Significant indirect effects existed between violence and higher HbA1c (r=0.05, p=0.04). After controlling for other neighbourhood factors, there was no significant relationship between access to healthy food and either stress or glycaemic control. Conclusions: While a number of neighbourhood factors were directly associated with stress, only neighbourhood violence had a significant indirect effect on glycaemic control via stress within the tested pathway. Future studies should examine individual-level stress management interventions and should consider community-level interventions targeting neighbourhood violence as strategies for addressing disparities in diabetes.
... Cohen's perceived stress scale adapted to the pandemic environment was used for the study. [8]. An individual's reaction to frightening situations or unfavorable changes in the external environment is known as perceived stress. ...
... This scale was chosen because it fits the study's objectives, which include documenting the felt stress brought on by Covid19. Based on the auditors' own testimonies about their firsthand observations of felt stress at work during the pandemic time, the solution has been developed, a 5-point Likert scale [8]. ...
Chapter
The study intends to investigate how much stress people working in the auditing industry in the Republic of Serbia perceive to be brought on by Covid19. An adjusted Cohen’s perceived stress scale was used. The answers to the questionnaire were analyzed by the method of descriptive statistics and by applying a simple regression analysis on the ratio of the age of the respondents and the evaluation of the answers to the tested statements. The main finding is that Covid19 significantly worsened stress levels and mental health of auditors. They believe that Covid19 significantly increased their stress levels during daily planning and implementation of work and personal obligations. This study can be used as a concept and a guide by external audit firms and internal audit departments to help those engaged in audit work to overcome stressful situations and master stress management techniques through training and interviews with professionals and by developing a stronger organizational culture.KeywordsAuditorAuditPandemicCovid19Stress
... The Perceived Stress Scale-10 (PSS-10) [32] was used to measure general symptoms of stress. In the PSS, respondents rate their perception of life events during the last month and total score ranges from 0 to 40 with higher values representing a high stress level. ...
... In the PSS, respondents rate their perception of life events during the last month and total score ranges from 0 to 40 with higher values representing a high stress level. The short version (10 item) has shown good reliability and validity [32,33]. ...
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Purpose Pain and stress-related ill-health are major causes of long-term disability and sick leave. This study evaluated the effects of a brief psychosocial program, which previously has been tested for an at-risk population of employees. Methods The Effective Communication within the Organization (ECO) program, where supervisors and employees were trained in communication and problem solving, was compared to an active control consisting of psychoeducative lectures (PE) about pain and stress in a cluster randomized controlled trial. First-line supervisors were randomized to ECO or PE, and a total of 191 mainly female employees with self-reported pain and/or stress-related ill-health were included. The hybrid format programs consisted of 2–3 group sessions. Sick leave data was collected from social insurance registers, before and 6-months after the program. Secondary outcomes (work ability, work limitations, pain-disability risk, exhaustion symptoms, perceived stress, perceived health, quality of life, perceived communication and support from supervisors) were assessed at baseline, post intervention, and at 6-months follow-up. Results No effects were observed on primary or secondary outcome variables. Pain symptoms were common (89%), however a lower proportion (30%) were identified as at risk for long-term pain disability, which might explain the lack of evident effects. The Covid-19 pandemic affected participation rates and delivery of intervention. Conclusion In this study, preventive effects of the ECO program were not supported. Altogether, the findings point at the importance of selecting participants for prevention based on screening of psychosocial risk. Further research on workplace communication and support, and impact on employee health is warranted.
... Stress. Stress was measured using the Perceived Stress Scale (Cohen and Williamson 1988). The PSS-10 is a widely used instrument for measuring the extent to which life situations are perceived as stressful. ...
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The current research aimed to evaluate UK student mental health during the first 4 months of the COVID-19 pandemic. Specifically, we were interested in exploring factors that contribute to students’ anxiety levels about COVID-19. Demographics, mental health symptomatology and well-being-related variables were tested as predictors of COVID-19 anxiety. A cross-sectional online survey was completed by 1,164 UK university students (71.8% females). Measures included self-reported data on stress, social phobia, anxiety, depression, psychotic-like experiences, hopefulness, group membership, social identity, belonging, loneliness, COVID-19 related variables and demographics. The majority of participants were between 18 and 24 years old (92.2%), White British (57.9%) and in the first or second year of their course study (63.12%). A series of multiple linear regressions revealed that being female, experiencing more stress and anxiety, and greater worry about COVID-19 and its effects on social relationships were significant in explaining students’ pandemic-related anxiety. Students’ level of pandemic-related anxiety was independent of ethnicity, socioeconomic background and pre-existing mental health problems. Worrying about the future was the most common pandemic-related stressor, but it was not a significant predictor of COVID-19 anxiety. Our findings are in line with previous findings that females and students experiencing more stress have been disproportionately affected by the COVID-19 pandemic. Our findings could inform the delivery of targeted stress-management interventions that might prove beneficial for student wellbeing.
... A formal ethical approval was not sought for this study since an anonymous survey was used for data collection. The research instrument was developed with the application and adoption of existing scales such as "Perceived Stress Scale" (Cohen and Williamson, 1988;Cohen et al., 1983), "Symptom Checklist-90 Scale/SCL 90-R" (Derogatis, 1977;Gonz alez de Rivera et al., 1989) and "Quality-Work-Competence" scales. The survey instrument contains five main sections such as "Demographic Profile," "Perceived Stress Scale," "Anxiety and Depression (SCL-90-R)," "Quality-Work-Competence (QWC) Scale," and "Level of Material and Technical Security/Access." ...
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The study investigates stress and organizational climate factors affecting mental health of women school and university teachers in pre‐COVID‐19 and COVID‐19 periods in the context of Central Asia considering the case of Kazakhstan. The results of quantitative empirical study show that the pandemic has caused an increase in perceived anxiety and depression among women teachers. Women teachers in urban areas experienced greater anxiety and depression than rural teachers. The moderation interaction predictor indicates that the effect of perceived stress becomes less negative with increased level of Material and Technical Security or Access to Technological Resources. In conditions of COVID-19 the effect of Material Technical Security/Access to Technological Resources on Mental Health becomes significant when women teachers have a better Social Climate at work. Its effect on Mental Health becomes significant when women teachers are more engaged in the decision making process with clearly defined organizational goals according to the Participatory Management policy and when women teachers more frequently receive Performance Feedback.
... To measure stress levels, the participants completed the 10-item version of the Perceived Stress Scale (PSS-10) [40,41]. With this measure, participants rate statements such as "In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?" on a Likert scale from 0 (Never) to 4 (Very Often). ...
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(1) Background: The COVID-19 pandemic has collectively increased stress levels, with individuals making difficult choices between protecting themselves and helping others. Previous research has shown that people engage in more prosocial, or helping, behavior as they age and in moments of acute stress, but it is unclear how c stress has influenced perceived changes in prosocial behavior in the later stages of the pandemic and whether this varies across the lifespan. (2) Methods: The current study explored how perceived stress, age, and gender impact participants’ reports of perceived changes in their prosocial behavior due to the pandemic using survey questions administered through an online subject pool (n = 201). (3) Results: Hierarchical linear regression results revealed results indicated a significant main effect of perceived stress (β = −0.166, p = 0.021) and age (β = −0.217, p = 0.003) but not gender (β = −0.062, p = 0.370) on perceptions of how one’s prosocial behavior was affected by the COVID-19 pandemic. (4) Conclusions: Study findings showed that older adults and individuals with higher levels of perceived stress reported a decrease in their prosocial behavior, which supported our hypotheses. These findings provide unique insight into the influence of a long-term health crisis on different groups of people’s participation in prosocial behavior, with implications for mental health and community engagement during a pandemic.
... To begin, students would take the Perceived Stress Scale (PSS) (Cohen, Kamarck, & Stein, 1983) -a validated and reliable measure of perceived stress in one's current life situation (Cohen & Williamson, 1988). The PSS (Appendix A) is a brief assessment "designed to tap the degree to which respondents find their lives unpredictable, uncontrollable and overloading" (Örücü & Demir, 2008, p. 104). ...
Article
College students are struggling. Anxiety and depression are negatively impacting academic performance and eroding students’ social, physical and emotional well-being. In addition, counseling centers are struggling to keep up with demand. This paper considers a way to alleviate anxiety and depression on college campuses by teaching students how to reduce counterproductive thinking, develop mindfulness and realistic optimism, and enhance their coping and resilience skills. A recommendation to create an evidence-based curriculum informed by cognitive behavior therapy, positive psychology, and research on resilience is discussed. Embedding this curriculum in existing resident assistant (RA) training is suggested as a first step in a process to teach these skills to the general student body. As influential peer leaders and role models, RAs have the potential to spread their skills and knowledge to other students. A method to assess the training is provided and next steps are suggested. By teaching students to think more accurately, students might manage adversity with less stress, anxiety and depression, and thus we might begin to stem the tide of overwhelming anxiety and depression on college campuses.
... •Language Proficiency: For both languages, participants completed objective (picture naming; Rossion & Pourtois, 2001), and subjective proficiency assessments (LHQ-3; Li et al., 2020).•Additional Background Measures: Participants reported basic demographic details, weekly use of video games and musical instruments, language switching frequency, family education (SES), and perceived stress (PSS-10;Cohen, 1988). •Behavioral Task: 2-color (blue/brown) Simon task administered online using the Gorilla online experiment builder(Anwyl-Irvine et al., 2020).•Analysis: ...
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Studies on the effects of bilingualism typically include measurements of one or more dimensions of language experience including proficiency, dominance, and immersion. Differences across these dimensions are assessed using a combination of both objective and subjective measures. Proficiency, how well a person can understand and communicate in a given language, is the most widely-used metric for measuring bilingual language status (Surrain & Luk, 2017) is most often assessed subjectively through self-report (Li et al., 2006). Inconsistencies in the collection of subjective language proficiency data has led to high variability across studies, preventing direct comparisons from being made. In response to this issue, instruments including the Language History Questionnaire (LHQ; Li et al., 2020), Language Experience and Proficiency Questionnaire (LEAP-Q; Marian et al., 2007), and Language and Social Background Questionnaire (LSBQ; Anderson et al., 2018) have been developed in the interest of increasing cross-study consistency. Despite these common practices in the assessment of language proficiency, whether people are accurate in their assessments is contested (Zell & Krizan, 2014). While evidence supports that subjective and objective measures of language proficiency are correlated (e.g., Grant & Li, 2019), no studies have explored whether use of either measure impacts on model results when investigating bilingual advantages in executive function. In order to explore this question, a sample of Mandarin-English bilingual young adults (n = 73) was recruited from a Sino-Foreign university located in Mainland China. All participants were native Mandarin speakers exhibiting high heterogeneity in English language proficiency. Participants were asked to complete both subjective (LHQ-3; Li et al., 2020) and objective assessments (English picture naming; Rossion & Pourtois, 2001) of language proficiency and a Simon task administered online. For both languages, subjective ratings of proficiency were lower than objective scores. Crucially, while proficiency measures were only weakly correlated, model fit and results did not differ when either measure was included. Results support that both objective and subjective assessments of proficiency may be equivalent when modeling bilingual effects on executive function. Beyond contributing to our understanding of how differences in bilingual language experience impact on executive function, findings from this work have implications for the fields of healthcare and education. Given that assessment of language proficiency is a crucial component of some clinical intake interviews and international university applications, our findings further reinforce the importance of objective proficiency measures. Additionally, our findings highlight a potential need for student support to address what we interpret as possible self-confidence issues underlying the discrepancy between objective and subjective measures of proficiency. The observation that students subjectively assessed both native and second language proficiency as significantly lower than objective scores may have resulted as a consequence of the extreme academic pressures on students in Mainland China.
... Baseline assessment of psychosocial characteristics included perceived stress [41,42], experiences of discrimination [43], neighborhood problems [44,45] and neighborhood vigilance [46,47], presence of a valid driver's license (ever, current) and number of times suspended or revoked [48], criminal justice involvement [49], resilience [50], depressive symptoms [51], generalized anxiety symptoms [52], and adverse childhood experiences [53]. ...
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Background The standard of care in tobacco treatment is to continue individuals who smoke on the same cessation medication, even when they do not stop smoking. An alternative strategy is to adapt pharmacotherapy based on non-response. A handful of studies have examined this approach, but they have adapted pharmacotherapy only once and/or focused on adaptation distal rather than proximal to a failed quit attempt. Few studies have included racial/ethnic minorities who have less success in quitting and bear a disproportionate share of tobacco-related morbidity and mortality. Methods The current study is comparing the efficacy of optimized (OPT) versus enhanced usual care (UC) for smoking cessation in African Americans (AA) who smoke cigarettes. AAs who smoke (n = 392) are randomized 1:1 to OPT or UC. Participants in both groups receive 7 sessions of smoking cessation counseling and18-weeks of pharmacotherapy with long-term follow-up through Week 26. OPT participants receive nicotine patch and up to two pharmacotherapy adaptations to varenicline and bupropion plus patch based on carbon monoxide verified smoking status (≥6 ppm) at Weeks 2 and 6. UC participants receive patch throughout the duration of treatment. We hypothesize that OPT will be more effective than UC on the primary outcome of biochemically verified abstinence at Week 12. Discussion If effective, findings could broaden the scope of tobacco dependence treatment and move the field toward optimization strategies that impro ve abstinence for AA who smoke. Trial registration NCT03897439.
... Eating behavior and perceived stress. Eating behavior and perceived stress were assessed using widely used and validated psychometric questionnaires: 51-item Three Factor Eating Questionnaire (TFEQ) [4] and 10-item Perceived Stress Scale (PSS) [29]. The questionnaires were selfadministered and completed with computer platform during all measurement points except at 18 months. ...
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Background: To better support participants to achieve long-lasting results within interventions aiming for weight loss and maintenance, more information is needed about the maintenance of behavioral changes. Therefore, we examined whether perceived stress predicts the maintenance of changes in eating behavior (flexible and rigid restraint of eating, disinhibition, and hunger). Methods: The present study was a secondary analysis of the PREVIEW intervention including participants with overweight (BMI ≥ 25 kg/m2) at baseline and high risk of type 2 diabetes (n = 1311). Intervention included a 2-month low-energy diet phase and a 34-month subsequent weight maintenance phase. The first 6 months were considered an active behavior change stage and the remaining 2.5 years were considered a behavior maintenance stage. Eating behavior was measured using the Three Factor Eating Questionnaire and stress using the Perceived Stress Scale. The associations between stress and eating behavior were analyzed using linear mixed effects models for repeated measurements. Results: Perceived stress measured after the active behavior change stage (at 6 months) did not predict changes in eating behavior during the behavior maintenance stage. However, frequent high stress during this period was associated with greater lapse of improved flexible restraint (p = 0.026). The mean (SD) change in flexible restraint from 6 to 36 months was -1.1 (2.1) in participants with frequent stress and -0.7 (1.8) in participants without frequent stress (Cohen's ds (95% CI) = 0.24 (0.04-0.43)). Higher perceived stress at 6 months was associated with less flexible restraint and more disinhibition and hunger throughout the behavior maintenance stage (all p < 0.001). Conclusions: Perceived stress was associated with features of eating behavior that may impair successful weight loss maintenance. Future interventions should investigate, whether incorporating stress reduction techniques results in more effective treatment, particularly for participants experiencing a high stress level.
... This study used the Korean Perceived Stress Scale (PSS-K) based on the PSS-10 (Perceived stress scale) by Cohen and Williamson (1988) adapted by Baek (2010). This scale consists of 10 items, and the scores of the responses are summed up to determine the level of stress in 4 levels, with higher total score indicating a higher level of perceived stress. ...
Article
Background and objective: This study investigated the preferences and repurchase intentions (loyalty) of respondents to 8 coleus ( Coleus scutellarioides ) cultivars potentially useful for tropical style streetscapes.Methods: A survey was conducted on 148 general respondents, and the responses from 136 respondents were analyzed excluding 12 inappropriate copies.Results: Through demographic analysis on plant gardening experience, plant preference tendency, and plant-related event, we discovered that plant preference tendency was lowest in the 20s and highest in the 60s and above, indicating that plant preference tendency significantly increased with age. Out of 6 factors on perceived importance of plants, environmental and emotional relaxation for improved quality of life were high. As a result of examining the emotional responses felt by looking at the images of 8 coleus cultivars, there was a statistically significant difference among cultivars. Major emotional words were 'calm' and 'comfortable'. There was a positive correlation between loyalty to coleus, preference, Korean version of WHOQOL-BREF, plant gardening activity level, and the importance of plants, and a negative correlation with PSS-K (Korean Perceived Stress Scale). We conducted a multiple regression analysis including dummy variables to examine the effect of plant gardening activity level, PSS-K, and Korean version of WHOQOL-BREF on loyalty of survey respondents. The results showed that the effect was greatest in the order of plant-related event, physical health domain, age (50's), covers, environment domain, male, and age (30's).Conclusion: Our results demonstrated that coleus could mitigate the psychological stress and depression. As 'Lime Delight' with simple green color showed the highest preference among cultivars, we recommend a green cultivar from the psychological point of view rather than combination planting of multi-colored cultivars.
... The four-item version of the Perceived Stress Scale (PSS-4) was used to assess stress levels on a five-point Likert-scale, assessing the occurrence of symptoms from 1=never to 5=very often (Cohen & Williamson, 1988). The negatively coded (reversed) items were recoded before analysis. ...
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Background The ongoing COVID-19 pandemic has had an unprecedented impact on the lives of people globally and is expected to have profound effects on mental health. Here we aim to describe the mental health burden experienced in Sweden using baseline data of the Omtanke2020 Study. Method We analysed self-reported, cross-sectional baseline data collected over a 12-month period (June 9, 2020–June 8, 2021) from the Omtanke2020 Study including 27,950 adults in Sweden. Participants were volunteers or actively recruited through existing cohorts and, after providing informed consent, responded to online questionnaires on socio-demographics, mental and physical health, as well as COVID-19 infection and impact. Poisson regression was fitted to assess the relative risk of demonstrating high level symptoms of depression, anxiety, and COVID-19 related distress. Result The proportion of persons with high level of symptoms was 15.6 %, 9.5 % and 24.5 % for depression, anxiety, and COVID-19 specific post-traumatic stress disorder (PTSD), respectively. Overall, 43.4 % of the participants had significant, clinically relevant symptoms for at least one of the three mental health outcomes and 7.3 % had significant symptoms for all three outcomes. We also observed differences in the prevalence of these outcomes across strata of sex, age, recruitment type, COVID-19 status, region, and seasonality. Conclusion While the proportion of persons with high mental health burden remains higher than the ones reported in pre-pandemic publications, our estimates are lower than previously reported levels of depression, anxiety, and PTSD during the pandemic in Sweden and elsewhere.
... Escala de Estrés Percibido de Cohen (PSS-4) (Cohen et al., 1983;Cohen & Williamson, 1988): Se usó la versión adaptada de Herrero y Meneses (2006) de 4 ítems de escala Likert de 4 opciones de respuesta (0: nunca -4: siempre). La confiabilidad alfa de Cronbach de la escala es de .74 ...
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La investigación tuvo como propósito comparar estrés, malestar psicológico, bienestar psicológico y satisfacción con la vida según las modalidades de trabajo en madres de familia. Se realizó un estudio descriptivo y comparativo, con diseño no experimental, enfoque cuantitativo y de corte transversal. Las participantes fueron 436 madres ecuatorianas, divididas en tres grupos: trabajo presencial, teletrabajo y trabajo no remunerado. El análisis estadístico ANOVA indicó diferencias significativas en las variables de malestar psicológico (F = 4.67; p < .01), bienestar psicológico (F = 7.64; p < .001) y satisfacción con la vida (F = 8.69; p < .001), siendo el grupo de trabajo no remunerado el que muestra mayores niveles de malestar psicológico y menores niveles en bienestar y satisfacción, y el teletrabajo con mejores puntuaciones en bienestar y satisfacción y bajos niveles en malestar psicológico. Se encontró en el estrés diferencias entre los grupos (F = 5.13; p = .02) al analizarlo con la covariable seguimiento educativo a través del ANCOVA. El grupo de trabajo no remunerado presentó niveles más altos en estrés al aumentar las horas de seguimiento educativo. Se concluye que la modalidad de trabajo está relacionada con el malestar psicológico, bienestar psicológico y satisfacción con la vida. Los niveles de estrés varían en función de la modalidad y aumentan cuando se destina más horas de seguimiento educativo.
... The degree of the impact of the exogenous variables on the endogenous variables was measured with the f-square. The f-square values were considered as 0.02 (weak effect), 0.15 (moderate effect) and 0.35 (strong effect) [98]. L1 had a non-visible effect on L4, while L1 had the strongest effect on L2, with an f-square of 1.964, as shown in Table 5. Q-square statistics, or cross-validity redundancy, measure the quality of the path model. ...
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Teacher education has a large and favorable impact on a teacher’s performance. Effective training brings improvement in the productivity and performance of employees due to the acquisition of new knowledge and skills. The National Vocational and Technical Training Commission organized an in-service vocational teachers’ training program through blended learning approaches in Pakistan. This study aimed at finding out the effectiveness of that in-service vocational teachers’ training program. The four levels of the Kirkpatrick model were used as the theoretical framework. A survey approach was used to collect data from 629 in-service vocational teachers who took part in the training program through blended learning approaches. Partial least square structural equation modeling was applied to find the hierarchal relationship among the four levels of the Kirkpatrick model. The results of the current research revealed that trainees were satisfied at all four levels of the Kirkpatrick model, including the reaction, learning, behavior and results. A hierarchal relationship between the four levels of the Kirkpatrick model was also found for the evaluation of the training program. The direct effect of the reaction had a positive and significant relationship with learning, learning with behavior and behavior with the results. The results of the specific indirect relationship among the four levels clearly depicted that behavior was mediated through learning and the results, learning was mediated through the reaction and behavior and behavior was mediated through the reaction and results. This study is useful for vocational education institutions and skill development policymakers to design in-service training programs for in-service teachers. Future studies can be conducted about the adaptation of instructions for the in-service vocational teachers’ training program through blended learning approaches.
... The Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983) is a measure that assesses perceived life stress in the past month on a 5-point scale that ranges from 0 = "never" to 4 = "very often." The original PSS included 14 items , and a shortened, 10item version (PSS-10) has also been created based on a factor analysis of PSS-14 scores in a large U.S. probability sample (Cohen & Williamson, 1988 college, psychiatric, and medical populations, although a review paper has concluded that psychometric properties for the PSS-10 are generally stronger (Lee, 2012). ...
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The Dissociative Symptoms Scale (DSS) was developed to assess moderately severe types of dissociation (depersonalization, derealization, gaps in awareness and memory, and dissociative reexperiencing) that would be relevant to a range of clinical populations, including those experiencing trauma-related dissociation. The current study used data from ten ethnically and racially diverse clinical and community samples (N = 3,879) to develop a brief version of the DSS (DSS-B). Item information curves were examined to identify items with the most precision in measuring above average levels of the latent trait within each subscale. Analyses revealed that the DSS-B preserved the factor structure and content domains of the full scale, and its scores had strong reliability and validity that were comparable to that of scores on the full measure. DSS-B scores showed high levels of measurement invariance across ethnoracial groups. Results indicate that DSS-B scores are reliable and valid in the populations studied.
... Perceived stress was measured by ten items from the Perceived Stress Scale (PSS-10). PSS-10 (Cohen & Williamson, 1988) measures the degree to which different daily situations are considered as stressful, using responses ranging from Never to Very often. PSS-10 is often used as an estimate of perceived stress. ...
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Leaders of today need to achieve well in terms of task performance, perceiving low stress, and having high levels of work engagement. One may ask whether trait-based leadership resource factors can be identified and how such resource factors might relate to task performance, perceived stress, and work engagement. Our aim was to test the hypothesis, derived from Hobfoll’s motivational Conservation of Resources (COR) theory, that there are trait-based leadership resource factors, which are differentially correlated to the leaders’ task performance, perceived stress, and work engagement. Leaders (N=344) aged from 23 to 65 years (M=49, SD=8.6; 58% women) completed an online questionnaire including measures of task performance, perceived stress, work engagement, personality traits, trait emotional intelligence, empathy, performance-related self-esteem, compassionate and rational leadership competence, and coping resources for stress. Using exploratory factor analysis, we identified four trait-based leadership resource factors. With Bonferroni adjustment, and controlling for sex, age, number of years in the current managerial position, self-deceptive enhancement, and impression management, only Rational Mastery was significantly positively correlated with task performance. Rational Mastery, Efficient Coping, and Modesty were negatively correlated with perceived stress, and all factors except Modesty, but including the fourth (Good-Heartedness) were positively correlated with work engagement. Organizations striving for sustainable work conditions should support trait-based leadership, which depends not only on a task-oriented resource such as rational mastery, but also on human-oriented resources such as efficient coping, modesty, and good-heartedness, all of them being differentially related to task performance, perceived stress, and work engagement.
... The Perceived Stress Scale (PSS-10) is a self-report measure of perceived stress in adults [32]. The scale consisted of 10 items asking about feelings of stress experienced in the past month (e.g., "In the last month, how often have you felt confident about your ability to handle your personal problems?"). ...
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The COVID-19 pandemic prompted chaotic changes in the daily lives of K-12 teachers, resulting in increased stress and other mental health problems. Limited evidence regarding the relationship between physical activity, sleep, and perceived stress among teachers during the COVID-19 pandemic exists. Therefore, the purpose of this study was to investigate the association between physical activity, sleep quality, and perceived psychological stress among teachers during the COVID-19 pandemic. An online survey measuring physical activity, sleep quality, and perceived psychological stress was distributed across 47 US states between September and October of 2020. Data provided by 635 teachers (mean age: 42 ± 18 years, 74.6% female) were included in the present analysis. Results suggested a negative association between physical activity and perceived psychological stress. Mediation analyses indicated that teachers engaging in high levels of physical activity were more likely to have good quality sleep and, in turn, were less likely to report high levels of perceived stress. Physical activity and sleep-related interventions could help curtail the rising levels of psychological distress amongst K-12 teachers during stressful times such as the COVID-19 pandemic. Teachers, especially those that self-report as female and/or young, report high levels of stress. These high levels of stress are a serious challenge for school districts in terms of attracting and retaining qualified teachers in K-12 classrooms.
... As the analytical approach utilized inferential testing in a quasi-exploratory manner (i.e., in the absence of narrowly defined and pre-specified hypotheses but within an existing conceptual framework to explore relationships between measures of weekday/weekend sleep timing and demographic and health variables), alpha was adjusted for multiple comparisons by Bonferroni correction to account for inflation of study-wide error rate in inferential tests (alpha = 0.00125; [32]). Accordingly, and for parsimony, p < 0.001 was deemed as indicating statistical significance for all inferential tests used, and effect sizes were interpreted according to Cohen [33]. Hierarchal regression analysis was used to examine the relative associations of demographic, sleep and cardiometabolic factors with absolute weekday-weekend day sleep offset differences as the dependent factor, after testing of the assumptions of multicollinearity, homoscedasticity and normality of distribution of residuals. ...
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Variability in the timing of daily sleep is increasingly recognized as an important factor in sleep and general physical health. One potential driver of such daily variations in sleep timing is different work and social obligations during the “working week” and weekends. To investigate the nature of weekday/weekend differences in the timing of sleep offset, we examined actigraphy records of 79,161 adult participants in the UK Biobank who wore an actiwatch for 1 week. The time of sleep offset was found to be on average 36 min later on weekends than on weekdays, and when this difference was expressed as an absolute value (i.e., irrespective of sleep offset being either later or earlier on weekends), it was 63 min. Younger age, more socioeconomic disadvantage, currently being in employment, being a smoker, being male, being of non-white ethnicity and later chronotype were associated with greater differences in sleep offset between weekdays and weekend days. Greater differences in sleep offset timing were associated with age-independent small differences in cardiometabolic health indicators of BMI and diastolic blood pressure, but not HbA1c or systolic blood pressure. In a subset of participants with Type 2 Diabetes Mellitus, weekday/weekend sleep offset differences were associated weakly with BMI, systolic blood pressure and physical activity. Overall, this study demonstrates potentially substantive differences in sleep offset timings between weekdays and weekends in a large sample of UK adults, and that such differences may have public health implications.
... Individuals with total scores below 14 are considered to have low levels of perceived stress, scores between 14 and 26 suggest moderate levels of stress, and scores of 27 and higher suggest high levels of stress. In the general population, the PSS-10 has demonstrated an adequate construct validity and good reliability (Cronbach's α between 0.78 and 0.91; S. Cohen & Janicki-Deverts, 2012; S. Cohen & Williamson, 1988). For autistic adults specifically, the instrument has shown good internal consistency, with Cronbach's α of 0.87 (Bishop-Fitzpatrick et al., 2017. ...
Article
Lay abstract: More and more research shows us that autistic individuals are at risk of experiencing mental health problems in response to the COVID-19 pandemic. However, little is known about why this is the case. At two timepoints during the pandemic, we asked 149 autistic and 147 non-autistic adults about feelings of anxiety, depression, and stress, and about characteristics that may explain why some (autistic) people have a larger chance of developing anxiety and depression during this pandemic. In our study, autistic adults experienced more anxiety and depression than non-autistic adults. Across autistic and non-autistic individuals, the people who experienced more stress at timepoint 1 experienced more anxiety and depression 4 months later. This was especially the case for those individuals who use maladaptive coping styles, such as denial or venting, and for those who have difficulties dealing with uncertain situations. Our findings show the burden of the COVID-19 pandemic on the mental health of autistic adults. Interventions to support autistic adults during and after the pandemic are needed, and they may want to focus on the negative impact of stress and teach autistic (and non-autistic) adults more adaptive ways to cope with stressful circumstances.
... The Perceived Stress Scale (PSS-10) is a 10-item self-report questionnaire designed to evaluate stress levels based on individual perceptions of stress in the past month (Cohen et al. 1983;Cohen 1988). Each item in the PSS-10 is rated on a 5-point Likert scale ranging from never (0 points) to very often (4 points). ...
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Stress is a process that involves the perception of and response to pressure and is often related to eating behaviour. For college students, academic stress could be one factor that affects eating behaviour. So far, no longitudinal study has directly compared the same respondents’ stress levels and eating behaviours in different years of study. Thus, this study aimed to examine changes in stress levels and eating behaviour during college students’ third and final years and determine the correlation between stress levels and eating behaviour. We asked 89 undergraduate students (27 males and 62 females) to complete a questionnaire on their stress levels using the Perceived Stress Scale (PSS-10) and their eating behaviour. Our results showed that students had significantly higher stress levels during the final year than in their third year. Our results also showed that during the student’s final year, there was a significant increase in eating when feeling stressed, overeating, eating fast food, and skipping meals compared to their third year. There was also a significant decrease in healthy food consumption during the final year compared to the third year. During the third year of study, stress levels were increased by academic workload pressure; meanwhile, during the final year of study, they were affected by sex and undergraduate thesis pressure. These results indicate that differences in academic pressure in different years of study can influence stress levels and eating behaviour in college students.
... Participants were asked additional questions about the number of other languages they used, how often they switched languages (scale from 1-7), the number of hours they spent playing video games or musical instruments each week, and parental education level as an index of SES. Finally, to control for potential modulatory effects of stress on executive function (Plieger & Reuter, 2020), participants completed the 10-item version of the Perceived Stress Scale (PSS-10; Cohen, 1988). ...
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Effective communication in multilingual environments requires bilinguals to constantly monitor linguistic cues. It is hypothesized that the constant need to monitor may result in improved attention. However, previous investigations have reported mixed, often null results, with positive findings attributed to non-linguistic variables. To address these issues, we investigated whether higher levels of bilingualism were associated with improved attentional function in a sample of culturally and socioeconomically homogenous Mandarin–English speaking bilingual adolescents. Participants completed the Attention Network Task to assess attentional network function. Data were analyzed using linear mixed-effects models in order to account for nontrivial differences. Mixed results provide partial support for domain general cognitive benefits associated with higher levels of bilingualism. Both improved and reduced performance differed based on the specific dimension of bilingualism and the attentional network assessed. Findings support the conclusion that separable dimensions of bilingual language experience assert different influences on attentional network function.
... The R-square value of consumers' behavioural intention to purchase green products was 0.580. The structural model was tested using bootstrapping [84], to [85]. Accordingly, the findings (Table 5) indicated that F-square 0.940, 0.603, 0.440 of social media information, intolerance of uncertainty, and personal relevance show a high effect size, while F-square 0.215, 0.125 of COVID-19 pandemic, and behavioural intention to purchase green product point out to medium effect size. ...
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This study examined the fear of COVID-19 pandemic and its impact on consumer behavioural intention to purchase green products. The data was collected from consumers of Malaysia in hypermarkets. A total of 491 respondents were analyzed using the partial least square technique. The results indicated that the fear of the COVID-19 epidemic has a significant impact on health concerns, social media information, intolerance of uncertainty, and personal relevance, which in turn affect consumers’ behavioural intention to purchase green products. With a serial mediating effect the results identified that fear of COVID-19 epidemic is associated with behavioural intention to purchase the green product. The findings of this study are crucial for understanding the swings in the green product purchase behaviour due to the ongoing uncertainty of COVID-19 crisis.
... The several criteria outlined by Hair et al. (2011) for evaluating the structural model primarily include the R2 values and the level of significance of the path coefficients. On the other hand, Cohen (1988) emphasise that the value of R2 should exceed 0.26 of the endogenous latent variable for a model to be considered reasonable. Figure 1 shows R2 to be at 0.705, indicating the perceived usefulness, ease of use, and attitude towards the use of mobile wallets accounted for 70.5 per cent of the variance in the intention to use mobile wallets. ...
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The coronavirus outbreak has necessitated physical distancing to be ruled out as a measure to control the virus transmission. The pandemic has also called forth an alternative among Malaysians to continue their livelihood, including opting for mobile wallets during routine business transactions. Despite the growing number reported during the COVID-19 pandemic, the 40% increase has yet to reach the optimum level of usage, indicating that mobile wallet use will remain relatively low. Therefore, this study seeks to investigate mobile wallet usage amidst the COVID-19 pandemic by using the Technology Acceptance Model (TAM). The present research was conducted nationwide, involving a sample size of 452 who completed the distributed questionnaires. The analysis of data utilised the Smart Partial Least Square (SmartPLS). The results show a significant relationship between perceived usefulness and attitude towards mobile wallet usage. The respondents believe that using mobile wallets would be beneficial to them. In addition, perceived ease of use is also found to be significant, and the respondents believe that they do not require much effort to use a mobile wallet. The attitudes towards using mobile wallets have also observed a significant relationship with the intention of Malaysians to use them. For future research, it is recommended that the study is conducted with larger sample size and that the integration of a qualitative approach is considered to better understand the usage of mobile wallets in a similar context.
... Perceived stress was measured using the 10-item Chinese version of the Perceived Stress Scale Short Form (PSS-10), which assesses the degree of subjective stress in a person's life and how they perceive their ability to cope with stressful situations [66,67]. Among the 10 items, 4 items were positively worded; a representative item was: "How often did you feel confident about your ability to handle your personal problems?", ...
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Although previous studies have shown that perceived stress is positively related to problematic smartphone use, knowledge of mediating and moderating mechanisms underpinning this relationship is quite limited. In this study, we explored whether experiential avoidance mediated the relationship between perceived stress and problematic smartphone use and whether trait mindfulness moderated this mediating process. A total of 763 Chinese college students completed the measures of perceived stress, experiential avoidance, problematic smartphone use, and trait mindfulness. The results indicate that perceived stress was positively related to problematic smartphone use and this relation was partially mediated by experiential avoidance. Furthermore, moderated mediation analysis showed that trait mindfulness moderated the linkage between perceived stress and problematic smartphone use via experiential avoidance. This link became weaker for college students with higher levels of trait mindfulness. The results highlight the value of identifying the underlying mechanisms between perceived stress and college students’ problematic smartphone use.
Article
Background and aims Intense use of smartphones is associated with mental health problems and low well-being. However, little is known about the mental health and well-being of non- and low-level users. This study investigated the possibly non-linear associations between time spent using a smartphone, including non-users, and mental health and well-being among young adults. Methods Between 2016 and 2018, 5315 young Swiss men (M = 25.45 years old, SD = 1.25) completed a questionnaire assessing smartphone use, daily time spent using a smartphone, mental health and well-being, (i.e. depression, social anxiety, attention deficit hyperactivity disorder, life satisfaction, stress) and potential confounding variables (social capital, personality, education). The associations of smartphone use and time spent using a smartphone (linear and quadratic associations) with mental health and well-being were tested using regression models. Results Non-users (4.3%) reported worse mental health and well-being than smartphone users on all outcomes. Time spent using a smartphone was linearly associated with higher rates of social anxiety, depression, attention deficit hyperactivity disorder and lower levels of life satisfaction. The association with stress was non-linear, with significant linear and quadratic coefficients of time spent using a smartphone. Associations were partially attributable to confounding variables (i.e. social capital, personality, and education). Conclusions Non-users and intense users of smartphones have lower levels of mental health and well-being than low-level users. Although society and mental health professionals are deeply concerned about the potentially negative consequences of the ever-increasing use of smartphones, the present study suggested that not using a smartphone may also indicate problems.
Article
While the negative psychological effects of the COVID-19 pandemic have been noted in the general population and among undergraduate students, little is known about the impact on graduate students. We surveyed kinesiology graduate students ( N = 272) enrolled in American Kinesiology Association member institutions regarding their well-being. Overall, graduate students reported poor mental health and high perceived stress. Cisgender women reported worse outcomes than their counterparts. No significant differences were found among sexual orientation or racial and ethnic identity. In open-ended responses, graduate students identified both increased and decreased well-being and delineated methods that helped or would have helped their well-being during the pandemic. Faculty and administrators must put intentional effort into recognizing mental health disparities, provide open and clear communication, and increase access and visibility of resources to support the mental health and well-being of graduate students.
Article
This study examined the multidimension assumption of the often-used 33-item, six-factor Smartphone Addiction Scale (SAS) by employing four confirmatory factor models (i.e., one-factor, first-order six-factor, second-order six-factor, and bifactor). Survey data were collected from 1155 undergraduate students in a US public university. Findings showed that the bifactor model was the best fitting model and SAS is a unidimensional instrument. The composite scores made for the six domain-specific factors, often seen in the literature, were not reliable measures for the construct of smartphone addiction and can result in misleading or even incorrect inferential test results. The most reliable and contributing items identified by the bifactor model were selected to form a short, more efficient version of SAS. A Rasch model was performed to test the psychometric properties of the shortened SAS. The new shortened SAS contains 10 items (SAS-10) and had good reliability, construct validity, and no presence of bias towards students in different gender or academic achievement groups. Additional evidence suggests a 4-category rating scale is enough to capture the construct of smartphone addiction. Finally, SAS-10 correlated to numerous external criterion variables similarly to how the extant literature would predict. SAS-10 is provided in appendix C.
Chapter
Night eating syndrome (NES) is an eating disorder (ED) characterized by a disrupted circadian rhythm that results in aberrant sleep, mood, and eating behaviors. The core features of NES include evening hyperphagia (i.e., consumption of ≥25% of total daily calories after the evening meal) and/or nocturnal ingestions of food after awakening from sleep. The conceptualization of NES has been informed by the medical model paradigm of disease, which assumes the presence of a distinct, underlying mechanism that causes symptoms. Utilizing this paradigm presents challenges for research and practice related to NES, as the causal mechanisms of NES are relatively unknown and conceptualization of NES has varied considerably over the past few decades. In response to the limitations of the medical model paradigm, recent work on EDs has focused on reconceptualizing ED psychopathology using the network approach to psychopathology. This approach focuses on identifying (a) functional, causal interactions among symptoms and (b) symptoms most important to specific disorders. This chapter provides an exploration on the conceptualization of NES when examined through this network approach. First, this chapter examines the history of NES conceptualization through a medical model lens. Next, it offers an overview of network analysis, emphasizing the methodology used to model the network approach to psychopathology. Findings from recent work on NES using network analysis are also presented. Finally, research and clinical implications from this study will be provided, as well as future directions for network analysis of NES.
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The Brief COPE (Coping Orientation to Problems Experienced) inventory is 14 faced scales used to assess coping strategies. It has been administered on different population samples and translated into several languages. Nonetheless, the Italian validation of its situational format is missing, and the present study aimed to fill this gap. To this end, the original English version of the scale was translated into Italian and administered to a sample of 682 Italian healthcare workers (HCWs), during the first wave of COVID-19. The Exploratory and Confirmatory Factor Analysis (EFA and CFA) were performed and led to the validation of the Italian Brief COPE (I-Brief COPE) scale, consisting of 21 items, loading properly on 6 factors, which range from activation (F1) to deactivation (F2), via social support (F3), humorous reframing (F4), religious/spiritual reliance (F5), substances use (F6). The six factors identified represent, according to our analyses, the relevant dimensions of coping in a stressful situation such as COVID-19. The results of this study reveal that the I-Brief Cope can be considered as a valid tool for measuring coping strategies in facing stressful, unpredictable, and damaging events.
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The purpose of this study was to evaluate the stress levels and coping mechanisms of Physical Education Teachers. This descriptive-correlational study was conducted on 52 physical education teachers through the use of purposive sampling. Two sections of a valid and reliable questionnaire were used to collect data: Perceived Stress Levels and Coping Mechanisms. The collected data sets were analyzed using Pearson correlation to determine the relationship between perceived stress and coping mechanisms in physical education teaching and multiple regression analysis to identify multicollinearity issues among the dependent variables. The results indicated that respondents experienced low levels of stress while teaching Physical Education. Moreover, this study revealed that the coping mechanism in terms of confronting coping, escape avoidance, and positive reappraisal was significantly associated with their perceived stress in physical education teaching. Three propositions were developed as a result of this research, which led to the development of the Complementary-Contrary (Comple-ntary) Response Theory in teaching Physical Education during the pandemic.
Article
Functional Neurological Disorder (FND) results in altered motor, sensory and cognitive function in the absence of evident organic disease. It often co-occurs alongside dissociative disorders and dissociation has been found to be high in patients across FND subtypes (particularly in those with Non-Epileptic Attack Disorder; NEADs). However, the presence of dissociation in FND is varied and there are contradictory definitions and suggestions for elevated levels. Here, three studies show that dissociation is a prominent, defining feature of people with FND compared to those who are healthy or have other, similar long-term health conditions, and that this heightened dissociation is not explained by a history of trauma (study 1, N = 121), mood (study 2, N = 589) and is not associated with social isolation/social exclusion (study 3, N = 542). As dissociation appeared to occur in FND in the absence of the usual contributing factors, and as higher levels of dissociation were associated with increased disability and illness impacts, understanding its role is of fundamental importance to developing our understanding of FND. These findings have further applications, beyond the theoretical, in clinical settings and in research; the implications for further research are discussed.
Article
Background and purpose To better understand the effects of an intervention, Mindfulness for Healthcare Professional (MIHP), and how it may improve healthcare professional student (HCP) functioning, a constructivist grounded theory exploration was conducted. Materials and methods Ten participants with the lowest or highest changes on quantitative measures of burnout and perceived stress at the end of MIHP were interviewed at a long-term follow-up. A theoretical framework was developed from the resultant themes to describe the mechanisms by which MIHP had effects on work-relevant functioning. Results Three overarching themes emerged as mechanisms of change both from their presence in those participants reporting an improvement in stress and their missingness from those participants who reported no change: developing a mindfulness practice, integrating practice into daily life, and enhanced awareness. These mechanisms led to optimized work-relevant functioning: 1) emotional competencies, including nonjudgement, emotion regulation, and burnout prevention; and 2) patient-centered care, including improved listening, patience, and efficiency at work. Conclusion The resultant framework is discussed in the context of previous literature on MIHP and mindfulness theory more broadly. Implications for future disseminations of MIHP encourage the use of group interventions with emphasis on developing at-home practice and informal mindfulness integrated into daily work.
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Objective This study aims to investigate the longer-term effects of accelerated intermittent theta burst stimulation (aiTBS) in smoking cessation and to examine whether there is a difference in outcome between active and placebo stimulation. The present study constitutes an ancillary study from a main Randomized Controlled Trial (RCT) evaluating the acute effects of aiTBS in smoking reduction. Method A double-blind randomized control trial was conducted where 89 participants were randomly allocated to three groups (transcranial magnetic stimulation (TMS)&N group: active aiTBS stimulation combined with neutral videos; TMS&S group: active aiTBS stimulation combined with smoking-related videos; Placebo group: placebo stimulation combined with smoking-related videos). Nicotine dependence, tobacco craving, perceived stress and motivation to quit smoking were measured after completion of 20 aiTBS sessions and during various follow ups (post one week, post one month and post six months). Results Our results show that the positive effect on nicotine dependence and tobacco craving that occurred at the end of treatment lasts at least one month post treatment. This effect seems to dissipate six months post treatment. No significant differences were found between the three groups. Conclusion Both active and placebo stimulation were equally effective in reducing nicotine dependence and tobacco craving up to one month after the end of treatment.
Article
Background: Motivational interviewing is a set of interviewing techniques that are employed to promote behavioral change. However, motivational interviewing is a costly intervention that requires training, and its effectiveness relies greatly on the skills and training of specialists. To overcome these limitations, this study developed and implemented a modified version of motivational interviewing. Aim: This study was conducted to investigate the effect of a modified motivational interviewing (MMI) intervention on university students' psychological, cognitive, and nutritional health indicators. Methods: This randomized controlled trial study was conducted using an experimental, repeated-measures, two-group design. The authors developed a modified version of motivational interviewing, and its effect was investigated among university students. The final sample size in this study was 94 university students (intervention = 48 and control = 46). Psychological, cognitive, and nutritional health indicators were measured at baseline and 1 month postrandomization and 3 months postrandomization. Repeated-measures multivariate analysis of variance was used to analyze the data. Results: The results of the multivariate analysis revealed a significant effect of the MMI intervention on the linear combination of the dependent variables: Pillai's trace = 0.28, F (9, 84) = 3.59, p = .001. The univariate analysis showed that the effect of the MMI intervention was significant on four dependent variables (namely, uncontrolled eating, emotional eating, perceived stress, and mindfulness). Conclusion: The MMI intervention improved university students' perceived stress, uncontrolled eating, emotional eating, and mindfulness. Further research should be conducted to validate the results reported in this article.
Article
Background and purpose A wellness program was piloted for student pharmacists in their advanced pharmacy practice experience (APPE) year. The purpose is to describe the program implementation and its impact on APPE students' perceived stress and perception of support by school personnel. Educational activity and setting A three-session virtual wellness program was designed for APPE students. Attendance was optional for the pilot year. An online survey assessing demographics, perceived stress (measured by the validated Perceived Stress Scale [PSS]), factors contributing to stress, and perceived support before the first session and after the third session was sent to all APPE students. Findings Twenty (37%), 13 (24%), and 10 (18.5%) students attended the first, second, and third session, respectively. A total of 49 students completed the post-program survey. Of these, ten (20.4%) attended one session, ten (20.4%) attended two sessions, and two (4.1%) attended three sessions. Students reported moderate stress. Female students endorsed higher PSS scores and career-related stress. PSS scores were lower among students who attended at least one session vs. those who did not attend any sessions and were negatively correlated with total sessions attended. Attendees were likelier to feel supported by staff and preceptors and perceived that concerns were heard by administration and preceptors. Summary An APPE wellness program was successfully developed. Students who attended at least one session reported less stress and greater support from school personnel vs. those who did not attend any sessions. These findings are promising as wellness efforts are integrated into pharmacy training.
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Poly cystic ovarian syndrome (PCOS) is a heterogeneous disorder common among reproductive age women. The study was focused to compare the clinical findings and nutritional status of women with PCOS in 18-29 and 30-45 year age groups. Overall, 120 PCOS subjects in the age group of 18-45 years were selected for the study. Rotterdam criteria was used for identification of the subjects for the study. Socio economic status of the subject revealed that majority of the subjects (49 %) belonged to upper lower class IV. There was a significant mean difference in BMI (p=0.007), Oligo an ovulation (p=0.02) between the two groups. The mean Scores of hirsutism and physical activity was significantly higher in the 18-29 age group (p<0.05). Nutrient intake was assessed by three day food record and food frequency questionnaire (FFQ) and calculated using Diet Cal software. The mean intake of calorie, carbohydrate and fat was remarkably higher in both age groups whereas the intake of micronutrients such as calcium, zinc, iron and retinol was lower compared to EAR. Vitamin D intake was lower than the EAR in all the selected subjects. The comparison of nutritional status of the two age groups disclosed that there was a significantly higher mean intake of calorie (p=0.045), fibre (p=0.006), iron (p=0.022), magnesium (p=0.017), chromium (p=0.016) and potassium (p=0.041) in the 30-45 year age group. Food consumption pattern affirmed that there was a remarkable difference in the intake of processed foods, soft drinks, sweets, fish, leafy vegetables, pickle between the two age groups.
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Background: Birthing people with pre-pregnancy body mass indices (BMIs) ≥ 25 kg/m², particularly those without prior breastfeeding experience, are at increased risk for suboptimal lactation outcomes. Antenatal milk expression (AME) may be one way to counteract the negative effects of early infant formula supplementation common in this population. Methods: This ongoing, randomized controlled trial in the United States evaluates the efficacy of a telelactation-delivered AME education intervention versus an attention control condition on lactation outcomes to one year postpartum among 280 nulliparous-to-primiparous, non-diabetic birthing people with pre-pregnancy BMI ≥ 25 kg/m². The assigned study treatment is delivered via four weekly online video consultations between gestational weeks 37-40. Participants assigned to AME meet with study personnel and a lactation consultant to learn and practice AME. Instructions are provided for home practice of AME between study visits. Control group participants view videos on infant care/development at study visits. Participants complete emailed surveys at enrollment (340/7-366/7 gestational weeks) and 2 weeks, 6 weeks, 12 weeks, 6 months, and 12 months postpartum. Surveys assess lactation and infant feeding practices; breastfeeding self-efficacy, attitudes, and satisfaction; perception of insufficient milk; onset of lactogenesis-II; lactation support and problems; and reasons for breastfeeding cessation. Surveys also assess factors associated with lactation outcomes, including demographic characteristics, health problems, birth trauma, racial discrimination, and weight stigma. Health information and infant feeding data are abstracted from the pregnancy and birth center electronic health record. Milk samples are collected from the intervention group at each study visit and from both groups at each postpartum follow-up for future analyses. Qualitative interviews are conducted at six weeks postpartum to understand AME experiences. Primary outcomes of interest are breastfeeding exclusivity and breastfeeding self-efficacy scores at two weeks postpartum. Outcomes will be examined longitudinally with generalized linear mixed-effects modeling. Discussion: This is the first powered trial evaluating the effectiveness of AME among U.S. birthing people and within a non-diabetic population with pre-pregnancy BMI ≥ 25 kg/m². This study will also provide the first evidence of acceptability and effectiveness of telelactation-delivered AME. Trial Registration: ClinicalTrials.gov: NCT04258709
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El envejecimiento de la población y la cultura actual en torno a los cuidados han propiciado un aumento del número de abuelas cuidadoras, ya sea de sus nietos o nietas, de sus ascendentes, o incluso de ambas generaciones simultáneamente. Con el objetivo de conocer más en profundidad las consecuencias psicológicas de este fenómeno, se llevaron a cabo entrevistas estructuradas a 115 mujeres del suroeste de España que eran abuelas, a la vez que hijas o nueras de una generación anterior. Se ha realizado un análisis de cluster bietápico para clasificar a estas mujeres según su inteligencia emocional. Las mujeres han quedado distribuidas casi al 50% en dos grupos claramente diferenciados. El primer grupo, caracterizado por mayor flexibilidad, tolerancia al estrés y control de los impulsos, aglutina una mayor proporción de mujeres residentes en entornos urbanos y con mayor nivel de estudios, y muestra niveles significativamente más altos de salud psicológica y felicidad. En cambio el segundo grupo de mujeres, caracterizadas por menor inteligencia emocional, obtiene puntuaciones significativamente más altas en estrés y ansiedad. Este estudio pone de manifiesto la importancia de incluir la promoción de estas habilidades de inteligencia emocional en programas de prevención y promoción de la salud en este colectivo.
Article
Objective To evaluate the real-world effectiveness of integrative medicine treatment on quality of life using the Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER). Design A prospective, longitudinal, observational evaluation of patient reported outcomes for quality of life. Setting Participants were patients from 17 integrative medicine clinics who received personalized, integrative medicine treatments between August 2013 and October 2017. Main Outcome Measures Participants completed the Patient Reported Outcomes Measurement Information System (PROMIS)-29, Perceived Stress Scale-4 (PSS-4), and the Patient Activation Measure (PAM) at index (baseline) visit and at 2, 4, 6, and 12 month follow-up assessments. Electronic health record data included diagnostic and billing codes/descriptions. A linear mixed-effects model was used to test whether outcomes changed from index through 12 months Results During enrollment, 4,883 participants began the assessment, 3,658 completed the index measures, and 2,374 (65%) completed at least 1 follow-up assessment, had electronic health record data and at least 1 integrative medicine visit. Most participants (mean age=51.4 years) were white (88.4%), female (79.7%), and college-educated (78.5%). Significant improvements (p<0.001) were observed at 12-months on all PROMIS-29 measures, PSS-4, and PAM. At 12 months, clinically meaningful improvements were found for 38% and 28% on PROMIS-29 Mental and Physical Health Summary scores respectively. Conclusions PRIMIER is the largest study to assess the real-world effectiveness of integrative medicine. Results indicate a statistical and clinical improvement across all measures at 12 months. Future research could explore whether dosing, timing or combinations of integrative medicine interventions have differential impacts on quality of life.
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This study aims to determine difference in life satisfaction, job satisfaction and perceived stress of private and public sector university employees. It was hypothesized that life satisfaction, and job satisfaction of public sector university employees would be more and their perceived stress would be less than private sector university employees. As additional variables, employees' difference was also assessed on the variables of marital status, birth order, educational level and economic position of the employees.120 employees including 60 from public and 60 from private sector universities participated in this study. Participants were asked to complete study scales. Result analysis of t-test clearly shows insignificant difference between public and private sector employees on all the variables. Hence, it is clear that public and private sector employees' life satisfaction, job satisfaction and perceived stress is similar and they do not differ on these factors. The research has positive implications as it makes it clear and suggest to those interested in adopting teaching as profession in public sectors only that they may without any hesitation apply in private sector universities also.
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Constrained fourth-order latent differential equation (FOLDE) models have been proposed (e.g., Boker et al. 2020) as alternative to second-order latent differential equation (SOLDE) models to estimate second-order linear differential equation systems such as the damped linear oscillator model. When, however, only a relatively small number of measurement occasions T are available (i.e., T=50), the recommendation of which model to use is not clear (Boker et al. 2020). Based on a data set, which consists of T=56 observations of daily stress for N=44 individuals, we illustrate that FOLDE can help to choose an embedding dimension, even in the case of a small T. This is of great importance, as parameter estimates depend on the embedding dimension as well as on the latent differential equations model. Consequently, the wavelength as quantity of potential substantive interest may vary considerably. We extend the modeling approaches used in past research by including multiple subjects, by accounting for individual differences in equilibrium, and by including multiple instead of one single observed indicator.
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The relationship between social support and well-being is well established in social psychology, with evidence suggesting that these benefits are especially prominent among women. When faced with an environmental stressor, women are more likely to adopt a tend-and-befriend strategy rather than fight-or-flight. Furthermore, female friendships tend to be higher in self-disclosure and more frequently relied on for social support, which is associated with physical and psychological benefits. Women are also more effective at providing social support, further augmenting those benefits. We begin with an overview of the characteristics of women's social ties and how they can be especially useful in times of stress. We then transition to the benefits of female social networks even in the absence of negative events and incorporate research from health and social psychology to consider the positive implications of having strong social bonds and the negative implications of lacking such bonds. Additionally, we consider cross-cultural differences in tendencies to seek out social support and its subsequent benefits, as well as the need for more research with culturally diverse samples. It remains unclear the extent to which patterns of social support benefits for women vary cross-culturally. This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.
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This study aims to determine the level of stress and the coping style through positive mental health status among student nurses. Further, it aimed to look into the relationship between the level of stress and positive mental health. The study was conducted at the University of Hail, College of Nursing using the descriptive cross-sectional approach. Data was gathered in three months from November to January 2020 through a self-administered questionnaire. There were 175 student nurses who participated in the study as a result of simple random sampling. Descriptive statistics were used to describe the demographic characteristics of the nursing students, perceived stress, and positive mental health. T-test was used to determine differences in age, gender, marital status, and academic program while one-way ANOVA was used at an academic level. Pearson’s product moment of correlation was used to establish a relationship between perceived stress and positive mental health. Results revealed a moderate level of stress (Mean=24; SD=5.83) and a restrained Positive mental health status (Mean=103 SD=11.78) among the student nurses. Gender (p=.017) showed significance in terms of positive mental health status. There is no significant relationship (p=0.987) between Positive Mental Health and Perceived Stress among the nursing students in Hail, Saudi Arabia. Saudi nursing students experienced moderate to high levels of stress and a moderate level of positive mental health. Gender is significant in positive mental health. As no correlation was deemed between perceived stress and positive mental health, enhancement of coping strategies is recommended to train student nurses to handle stress and promote positive mental health.
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In Japan, the "Act on the Arrangement of Related Acts to Promote Work Style Reform" was enforced in 2019 to reduce long working hours. However, work style reforms largely depend on workers' and companies' awareness and abilities. This study aimed to develop the Work Style Reform scale to assess the competencies required for work style reform and to examine its validity and reliability. This study was conducted with a diverse sample of 1,641 Japanese workers, and 17 questions across three subscales-Work Style, Personal Style, and Work Environment-were developed. After a response bias analysis, some items were discarded based on an exploratory factor analysis; the reliability coefficients were calculated; and a confirmatory factor analysis was performed. The convergent and discriminant validity were evaluated through a multi-trait multi-method analysis. Finally, nine questions remained. Construct validity, reliability and convergent validity were sufficient for all Subscales, and discriminant validity was sufficient only for Work Style. In conclusion, while Work Style was sufficient, issues remained in other subscales. To improve the accuracy of them in the future, it is necessary to examine the validation of discriminant validity using different indicates and the addition of new items to the smallest subscale; Personal Style.
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Evidence suggests that positive affect rises from youth through young and then older adulthood, but may decline after one's mid-70s. Negative affect appears to decrease steadily from early adulthood to older adulthood, but this decline may taper off in the oldest years. The relationship between age and affect in adulthood is further complicated by the effects of moderators, such as extraversion and marital status. Despite these complexities, recent empirical studies and current theory have furthered the understanding of age and affect in adulthood, although important questions remain.
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Assessed the relationship between an individual's affective state and neuroendocrine changes over time using an experience sampling method (ESM) and salivary cortisol (CO) monitoring. Of the 88 Ss (aged 27–57 yrs), 42 were characterized as high stress (HS) and 46 as low stress (LS) based on their Perceived Stress Scale (S. Cohen et al, 1983) scores. HS Ss scored higher than the LS Ss on measures of trait anxiety, depression, anger, and psychosomatic complaints as well as on ESM measures of positive and negative affect and stressful daily events. CO showed a clear diurnal secretory pattern in both groups. On workdays, CO was elevated throughout the day in HS Ss relative to LS Ss. Several measures of distress, including both trait and concurrent state measures, correlated significantly with mean workday CO. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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We use administrative data on the quarterly employment and earnings of Pennsylvanian workers in the 1970s and 1980s matched to Social Security Administration death records covering 1980–2006 to estimate the effects of job displacement on mortality. We find that for high-seniority male workers, mortality rates in the year after displacement are 50%–100% higher than would otherwise have been expected. The effect on mortality hazards declines sharply over time, but even twenty years after displacement, we estimate a 10%–15% increase in annual death hazards. If such increases were sustained indefinitely, they would imply a loss in life expectancy of 1.0–1.5 years for a worker displaced at age forty. We show that these results are not due to selective displacement of less healthy workers or to unstable industries or firms offering less healthy work environments. We also show that workers with larger losses in earnings tend to suffer greater increases in mortality. This correlation remains when we examine predicted earnings declines based on losses in industry, firm, or firm-size wage premiums.
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Advances in the conceptualization and measurement of life stress in the past 2 decades raise several questions concerning traditional diathesis-stress theories of psychopathology. First, comprehensive measures of life stress force investigators to become more precise about the particular stressful circumstances hypothesized to interact with diatheses. Second, the influence of the diathesis on a person's life is typically ignored, which results in several types of possible bias in the assessment of life stress. Finally, information is available on diatheses and stress for specific disorders to provide a foundation for more empirically based hypotheses about diathesis-stress interactions. This possibility is outlined for depression. Such an approach provides the basis for developing broader, yet more specific, frameworks for investigating diathesis-stress theories of psychopathology in general and of depression in particular.
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The aim of the present study was to examine the effects of academic examination stress on leukocyte subset distribution in university students. Thirty-eight university students had repeated blood collections for white blood cell differentiation and flow cytometric assay of lymphocytic subsets a few weeks before and after (i.e. two baseline conditions) as well as the day before a difficult academic examination (i.e. stress condition). Flow cytometry was used to determine the number of peripheral blood mononuclear cells (PBMC). In students, who were reactors to psychological stress (criterion based on changes in the Perceived Stress Scale, PSS), but not in stress non-reactors, a significant increase in the number of neutrophils, monocytes, CD8(+), CD2(+)CD26(+), and CD2(+)HLA-DR+ T cells and CD19(+) B cells, and significant reductions in the CD4(+)/CD8(+) T cell ratio were observed in the stress condition. There were significant and positive relationships between the stress-induced changes in perceived stress (PSS scale) and number of leukocytes, neutrophils, CD2(+), CD2(+)CD26(+) and CD2(+)HLADR+ T cells, and CD19(+) B cells. There were significant and negative relationships between the stress-induced changes in the CD4(+)/CD8(+) ratio and the stress-induced changes in the PSS scale. Female students taking oral contraceptives showed significantly higher stress-induced responses in number of leukocytes, neutrophils and CD19(+) B cells than male and female students without use of oral contraceptives. The results suggest that academic examination stress induces changes in the distribution of PBMC, which indicate immune activation and which are probably orchestrated by a stress-induced production of cytokines.
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The objective of the study was to test predictive models of schizophrenia caregiver burden and infectious illness episodes for caregivers who had regular contact with their mentally ill family members. A nurse interviewer, blind to the patient's symptoms, caregiver burden, and psychosocial status, administered the Health Review to 70 caregivers. A second family interviewer, blind to caregiver health status and patient symptoms, assessed caregiver resources (eg, active coping and social support), vulnerabilities (eg, anger expression and passive coping) and burden. Concurrently, independent patient raters, blind to caregiver health and psychosocial status, assessed caregiver stressors. The Brief Psychiatric Rating Scale and the Modified Scale for the Assessment of Negative Symptoms were used to assess the severity of positive (eg, hallucinations and delusions) and negative (eg, anhedonia and asociality) symptoms, respectively. Predictive models, including measures of stressors, resources, and vulnerability factors for caregiver burden and for presence of infectious illness, were each highly significant, accounting for 40% and 29% of the variance, respectively. However, the specific measures that predicted burden and infectious illness differed. Greater burden was predicted by more severe patient negative symptoms (stressor), greater anger control and blame self-coping (vulnerability), and decreased tangible social support (resource). Presence of infectious illness episodes was predicted by more severe patient positive symptoms (stressor) and less satisfaction with social support while controlling for the frequency of reporting on the Health Review. When scores from the Brief Psychiatric Rating Scale (stressors) were categorized into quartiles, it was found that the frequency of infectious illness in the highest quartile was four times that in the lowest quartile. Other results indicated that even though burden was not associated with infectious illness, it was associated with "continuing health problems," perceived stress, and depression. These data indicate that although schizophrenia caregiver burden and infectious illness are predicted by measures of patient stressors, vulnerabilities, and resources, the specific measures predicting these outcomes differ. The results also call attention to the powerful influence of patient symptoms as a predictor of burden and the presence of infectious illness among caregivers.
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An extensive research literature in the behavioral sciences and medicine suggests that psychological and social factors may play a direct role in organic coronary artery disease (CAD) pathology. However, many in the medical and scientific community regard this evidence with skepticism. This chapter critically examines research on the impact of psychological and psychosocial factors on the development and outcome of coronary heart disease, with particular emphasis on studies employing verifiable outcomes of CAD morbidity or mortality. Five key variables identified as possible psychosocial risk factors for CAD are addressed: acute and chronic stress, hostility, depression, social support, and socioeconomic status. Evidence regarding the efficacy of psychosocial interventions is also presented. It is suggested that, taken as a whole, evidence for a psychological and social impact on CAD morbidity and mortality is convincing. However, continued progress in this area requires multidisciplinary research integrating expertise in cardiology and the behavioral sciences, and more effective efforts to communicate research findings to a biomedical audience.
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We analyzed language use to examine age differences in people's representations of their own emotions as compared with those of others. Participants (N = 365, aged 18-85 years, M = 42.8, SD = 19.2) read hypothetical emotion-eliciting scenarios and described how they themselves and the social partners involved in the scenarios would feel. Compared with those of younger adults, older adults' descriptions involved a higher frequency of positive and a lower frequency of negative emotions. Older adults were also more likely to describe a co-occurrence of positive and negative emotions, but less likely to describe the simultaneous experience of multiple negative emotions. Age effects showed similar patterns for participants' descriptions of their own emotions as compared with those of others. We discuss the implications for theoretical accounts of emotional aging.
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Physical symptoms are fascinating phenomena to examine. We all experience them, use them as signals to guide our behavior, and usually assume that they accurately represent underlying physiological activity. At the same time, we implicitly know that bodily sensations are often vague, ambiguous, and subject to a variety of interpretations. It is not surprising, then, that there is often a disparity between what we think is going on in our bodies and what is objectively occurring. In short, phenomena such as physical symptoms are the stuff of psychology. My own research into physical symptoms started by accident several years ago. In a hastily devised experiment dealing with the effects of noise on behavior, I had to write a post-experimental questionnaire that would be long enough to allow the experimenter time to calibrate some equipment for a later portion of the study. I included some physical symptoms on the questionnaire as fillers. The experiment was a total failure, with the exception of the symptom reports. People's perceptions of symptoms were easily influenced by our manipulations, even though their actual physiological state had not changed. And so began the present inquiry. Despite the pervasiveness, importance, and sheer amount of time and money devoted to discussing and curing common physical symptoms and sensations, very little empirical work has been devoted to examining the psychological and perceptual factors related to sensory experience. Occa sional papers have tested a specific theory, such as cognitive dissonance, wherein physical symptoms served as an interesting dependent measure."
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Compelling evidence for an association between major adverse life experience and subsequent major depression is reviewed. Determining individual vulnerability to life stress and the effect of stressors on treatment outcome of depression are highlighted as the next major targets for contemporary stress research. Methodological concerns in the evaluation of stressors are detailed, and available data on variables that may influence the stress-depression relationship are presented. The critical importance of multivariate models in understanding individual vulnerability and outcome is emphasized. As methods for ascertaining stressful life events and chronic stressors continue to be refined, and models addressing the complex relationship of stressors and depression continue to be developed, prediction of stressor effects in onset and outcome of major depression will become increasingly more precise.
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This chapter reviews recent research on the relationship between stressful life experiences and depression. A distinction is made between aggregate studies of overall stress effects and focused studies of particular events and difficulties. A distinction is also made between effects of life stress on first onset of depression and on the subsequent course of depression. Although the available evidence suggests that acute stressful life events can lead to the recurrence of episodes of major depression, a series of methodological problems compromise our ability to make clear causal inferences about the effects of life events on first onset of major depression or about the effects of chronic stress on either onset or recurrence of depression. The main problems of this sort are discussed, and recommendations made for ways of addressing these problems in future studies.
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Recent studies provide clear and convincing evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary artery disease (CAD). This evidence is composed largely of data relating CAD risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation, and (5) chronic life stress. Pathophysiological mechanisms underlying the relationship between these entities and CAD can be divided into behavioral mechanisms, whereby psychosocial conditions contribute to a higher frequency of adverse health behaviors, such as poor diet and smoking, and direct pathophysiological mechanisms, such as neuroendocrine and platelet activation. An extensive body of evidence from animal models (especially the cynomolgus monkey, Macaca fascicularis) reveals that chronic psychosocial stress can lead, probably via a mechanism involving excessive sympathetic nervous system activation, to exacerbation of coronary artery atherosclerosis as well as to transient endothelial dysfunction and even necrosis. Evidence from monkeys also indicates that psychosocial stress reliably induces ovarian dysfunction, hypercortisolemia, and excessive adrenergic activation in premenopausal females, leading to accelerated atherosclerosis. Also reviewed are data relating CAD to acute stress and individual differences in sympathetic nervous system responsivity. New technologies and research from animal models demonstrate that acute stress triggers myocardial ischemia, promotes arrhythmogenesis, stimulates platelet function, and increases blood viscosity through hemoconcentration. In the presence of underlying atherosclerosis (eg, in CAD patients), acute stress also causes coronary vasoconstriction. Recent data indicate that the foregoing effects result, at least in part, from the endothelial dysfunction and injury induced by acute stress. Hyperresponsivity of the sympathetic nervous system, manifested by exaggerated heart rate and blood pressure responses to psychological stimuli, is an intrinsic characteristic among some individuals. Current data link sympathetic nervous system hyperresponsivity to accelerated development of carotid atherosclerosis in human subjects and to exacerbated coronary and carotid atherosclerosis in monkeys. Thus far, intervention trials designed to reduce psychosocial stress have been limited in size and number. Specific suggestions to improve the assessment of behavioral interventions include more complete delineation of the physiological mechanisms by which such interventions might work; increased use of new, more convenient "alternative" end points for behavioral intervention trials; development of specifically targeted behavioral interventions (based on profiling of patient factors); and evaluation of previously developed models of predicting behavioral change. The importance of maximizing the efficacy of behavioral interventions is underscored by the recognition that psychosocial stresses tend to cluster together. When they do so, the resultant risk for cardiac events is often substantially elevated, equaling that associated with previously established risk factors for CAD, such as hypertension and hypercholesterolemia.
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The authors investigated the role of stress and cortisol with patients having preterm labor (PTL) and preterm birth (PTB). The relationships of maternal cortisol, perceived stress, fetal fibronectin (fFN), and genitourinary infections to PTL and PTB were studied. A prospective, longitudinal, observational study (n = 78) was conducted in a private practice in central Texas. Subjects had 4 blood draws for cortisol measurements grouped by 15-19, 20-22, 23-26, 27-30, and 31-35 weeks of gestation. Subjects had 2 vaginal swabs forfFN, chlamydia, and bacterial vaginosis screens at 23-26 and 27-30 weeks with assessment of psychosocial stress at 23-26 and 31-35 weeks. Statistical analysis was by analysis of variance, Pearson correlations, Fisher exact test, and logistic regression. There were no significant differences between the PTB, PTL, and term groups on cortisol levels at any of the gestational periods. Cortisol concentrations at any gestational stage did not correlate with gestational age at birth. A relationship of cortisol to race was observed when comparing Caucasians to other ethnic groups. A correlation (r = 0.42, P < 0.001) between the change in Perceived Stress Scale (PSS) score and gestational age was observed. The greater the decrease in PSS scores, the longer was the gestational age. A significant increase in cortisol at 19-21 weeks (P < 0.04), 23-26 weeks (P < 0.05), and 31-35 weeks (P < 0.01) was observed in patients having genitourinary infection. PTL was also significantly increased in subjects having positive genitourinary infections at either 23-26 weeks or 27-30 weeks (P < 0.01). The sensitivity of fFN to predict PTL collected at 27-30 weeks was 40%, specificity 86%, positive predictive value 55%, and negative predictive value 83%. These results indicate that cortisol is a poor predictor of either PTL or PTB. A decrease in perceived stress during the 2nd trimester was associated with an increase in length of gestation, suggesting the possibility of stress reduction as an appropriate intervention for lengthening gestational age.
Article
The main purpose of the present study was to investigate the association between perceived stress and impaired cutaneous wound healing in humans using a novel wound assessment technique, and taking into account putative mediating factors such as cortisol levels, health behaviours, and personality factors. The study made use of a prospective, within-subjects design in which 24 male non-smokers participated. Every subject received a standard 4mm-punch biopsy, and the healing progress was monitored via high-resolution ultrasound scanning. Participants completed questionnaires on perceived stress, health behaviours, and personality factors, and sampled saliva for cortisol assessment after awakening at 2 weeks prior, directly after, and 2 weeks after the biopsy. The overall results showed a significant negative correlation between speed of wound healing, and both Perceived Stress scale (PSS) scores (r=-.59; p<.01), and General Health Questionnaire (GHQ) scores (r=-.59; p<.01) at the time of the biopsy. The area under the morning cortisol response curve was negatively correlated with speed of wound healing (r=-.55; p<.05), indicating a clear elevation in the morning cortisol slope of those whose wounds were slowest to heal. A median split of the complete sample yielded that the 'slow healing' group showed higher stress levels (PSS t=3.93, p<.01, GHQ t=2.50, p<.05), lower trait optimism (t=3.25, p<.05), and higher cortisol levels to awakening (F=5.60, p<.05) compared with the 'fast healing' group. None of the health behaviours investigated (i.e. alcohol consumption, exercise, healthy eating, and sleep) were correlated with healing speed at any time point. Our data hint at a considerable influence of stress on wound healing, and suggests that elevated cortisol levels, rather than altered health behaviours, play a role in this effect.
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Numerous studies demonstrate links between chronic stress and indices of poor health, including risk factors for cardiovascular disease and poorer immune function. Nevertheless, the exact mechanisms of how stress gets “under the skin” remain elusive. We investigated the hypothesis that stress impacts health by modulating the rate of cellular aging. Here we provide evidence that psychological stress— both perceived stress and chronicity of stress—is significantly associated with higher oxidative stress, lower telomerase activity, and shorter telomere length, which are known determinants of cell senescence and longevity, in peripheral blood mononuclear cells from healthy premenopausal women. Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women. These findings have implications for understanding how, at the cellular level, stress may promote earlier onset of age-related diseases. • psychological stress • telomere length • telomerase • oxidative stress
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Improved methods of assessment and research design have established a robust and causal association between stressful life events and major depressive episodes. The chapter reviews these developments briefly and attempts to identify gaps in the field and new directions in recent research. There are notable shortcomings in several important topics: measurement and evaluation of chronic stress and depression; exploration of potentially different processes of stress and depression associated with first-onset versus recurrent episodes; possible gender differences in exposure and reactivity to stressors; testing kindling/sensitization processes; longitudinal tests of diathesis-stress models; and understanding biological stress processes associated with naturally occurring stress and depressive outcomes. There is growing interest in moving away from unidirectional models of the stress-depression association, toward recognition of the effects of contexts and personal characteristics on the occurrence of stressors, and on the likelihood of progressive and dynamic relationships between stress and depression over time-including effects of childhood and lifetime stress exposure on later reactivity to stress.
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We conducted a meta-analysis of studies examining sex differences in reported levels of stress, considering the impact of: (a) the age and representativeness of sample participants, (b) whether life events were weighted or unweighted by participants for impact or severity, (c) the major versus minor nature of the stress, and (d) the life domain of the stressor. Overall, the meta-analysis of 119 studies including 83,559 participants found that females were exposed to more stress than were males (d=.123, r=.061). However, there was considerable heterogeneity among studies, with greater effect sizes associated with: (a) life events weighted by participants for impact, (b) adolescents compared to both younger and older samples, (c) major life stressors compared to minor stressors, and (d) interpersonal relationship stressors compared to work stressors. In none of the subgroup analyses did males experience considerably more stress than females. Evaluation of a subsample of 39 studies that examined gender differences in psychological symptoms revealed that females reported more symptoms of depression, anxiety, and psychosomatic problems (d=.282, r=.139) and that the sex difference in reports of psychological symptoms accounted for approximately 4% of the variance in the sex differences in reports of stress. Possible explanations for the observed patterning of effects are discussed, as are recommendations for further research.