The Longitudinal Relationship Between the Symptoms of Depression and Perceived Stress Among Chinese University Students
Depression is one of the most common mental disorders. Perceived stress is a significant trigger and has adverse effects on depression. The complex longitudinal relationship between perceived stress and depression at the symptom level has significant implications for clinical intervention but is understudied. In our study, 823 students (67% female, median age 20.38, IQR 19.42-21.43) from a university in Tianjin were randomly sampled and completed measures of PHQ-9 and PSS-10, while 393 (65% female, median age 20.42, IQR 19.46-21.45) were followed up at three points, six months apart. The longitudinal relationships were estimated using cross-lagged modelling and cross-lagged panel network modelling. Among them, 49 students (59% female, median age 19.48, IQR 18.76-20.12) participated in resting-state functional magnetic resonance imaging (fMRI) scans. Cross-lagged analyses showed that depression and perceived stress predicted each other at the global level. At the dimensional level, depression and perceived helplessness were mutually predictive, while depression and perceived coping did not. In the cross-lagged panel network analyses, we identified symptoms in the top 20% of Bridge Expected Influence as bridging symptoms, specifically 'Guilt' (PHQ6) and 'Felt nervous and stressed' (PSS3). Notably, 'guilt' consistently demonstrated the highest Bridge Expected Influence across all time points and showed the strongest predictive power for perceived stress. We found that fALFF in the left superior frontal gyrus (SFG) mediated the association between "guilt" and perceived stress. Our findings elucidate the bidirectional relationship between symptoms of depression and perceived stress, identifying guilt is the most critical symptom of depression for the followed perceived stress, with SFG activity mediating this association.
Understanding Resilience in Parents: Longitudinal Examination of Trait Resilience, Stressful Life Events, and Psychological Distress Symptoms-Insights From the FinnBrain Study
The study aimed to investigate the persistence or changes in trait resilience of parents over a 6-year period and its association with stressful life events (SLEs). Furthermore, we explored the potential protective effect of trait resilience against exposure to stressful life events and their negative mental health consequences. The study population was drawn from the ongoing FinnBrain Birth Cohort Study and included 1388 mothers and 657 fathers who completed the CD-RISC-10 questionnaire during pregnancy and again 6 years later. Data collection involved self-report questionnaires, including CD-RISC-10, EPDS, SCL-90, and a questionnaire on SLEs. Data analysis utilised linear regression and statistical assessments. Parents in the highest or lowest quartile of resilience showed greater stability in resilience scores over time compared to those in the middle quartiles. Trait resilience during pregnancy was significantly associated with resilience 6 years later. SLEs did not moderate this association. Additionally, higher trait resilience consistently associated with lower levels of distress symptoms. The investigation of SLEs may require more nuance due to their event-specific variability of impact. Furthermore, the study's sample size of individuals who experienced a high frequency of stressful life events was limited. Trait resilience appears to be rather stable, but also susceptible to some change. Because of its persistency and the positive impact on mental health it is worthwhile to be assessed as a part of comprehensive evaluation of parents' mental health.
Beyond Cumulative Scores: Distinct Patterns of Adverse Childhood Experiences and Their Differential Impact on Emotion, Borderline Personality Traits, and Executive Function
Adverse childhood experiences (ACEs) are associated with long-lasting and multifaceted consequences for mental health. Despite established dose-response effects of ACEs on mental health, the specificity of ACE pattern effects remains understudied, especially on executive function. This study aims to explore how specific patterns of ACEs, beyond just cumulative scores, differentially impact emotional symptoms, personality and cognitive function. This study recruited 2515 college students from several universities in northern China. Demographic characteristics, depression, anxiety, borderline personality traits, and executive function (Wisconsin Card Sort Test) were assessed. Latent class analysis was used to identify patterns of ACEs. Data were analysed using χ-test, ANCOVA, and multivariate linear regression methods. Pattern-oriented and cumulative-oriented approaches were compared to predict the effects of ACEs. Three distinct patterns of ACEs were identified: low adversity (LA), multiple adversity (MA), and family environment adversity (FA). FA with the highest number of ACEs was uniquely linked to executive function impairments, while both MA and cumulative ACEs significantly predicted higher anxiety, depression, and borderline personality traits. The pattern-oriented method was more sensitive to capturing the diverse outcomes of executive function impairment than cumulative scores. Our findings highlight the importance of moving beyond cumulative scores and considering specific ACEs patterns to understand their differential impact on mental health. Identifying FA as a distinct pattern with specific consequences for executive function offers valuable insights into developing targeted prevention strategies tailored to specific risk profiles.
Pandemic-Related Stress Increases PTSD and Depression Risk in Traumatic Injury Patients: A Comparative Study of Pre- and Peri-Pandemic Trauma Cases
The COVID-19 pandemic significantly impacted the psychological well-being of the general population. However, there are limited studies that examine its mental health effects on patients who have experienced traumatic injuries and tracked their recovery over time. This study aimed to: (1) compare the rates and severity of post-traumatic stress disorder (PTSD) and depression between patients who sustained traumatic injuries before the COVID-19 pandemic (pre-pandemic) and those injured during the pandemic (peri-pandemic); and (2) assess whether the degree of pandemic-related stress (e.g., worry about infection, social isolation, loss of home/job) predicted the severity of PTSD or depression symptoms. Participants (N = 198) were recruited from a Level 1 Trauma Centre in Southeastern Wisconsin following admission for a single-incident traumatic injury. Symptoms of PTSD and depression were assessed during hospitalisation and at three additional points within the subsequent 6 months. Self-report measures were used to evaluate PTSD and depression severity among patients injured before (pre-pandemic; n = 126) and during (peri-pandemic; n = 73) the pandemic. Peri-pandemic participants also completed a modified version of the COVID-19 Family Stress Screener to measure pandemic-related stress. Exploratory factor analysis was conducted to identify the dimensions of pandemic-related stress in our sample. The findings indicated that participants injured during the pandemic exhibited higher symptoms of PTSD and depression compared to those injured before the pandemic. Additionally, greater pandemic-related stress correlated with elevated levels of depression and PTSD at baseline. Our results highlight that the broader context in which patients recover from injuries can intensify the negative mental health consequences of traumatic injury. This underscores the need for enhanced access to psychological services for trauma patients, particularly during major societal stressors like a global pandemic.
Carrying Ostracism Overnight: The Cognitive Mechanism Underlying the Effect of Daily Workplace Ostracism on Next-Day Work Engagement
Integrating cognitive appraisal theory of stress and attachment theory, the current study explored the influence of daily workplace ostracism on employee short-term work engagement and examined the mediating role of negative work reflection and the moderating effects of employee attachment styles (i.e., attachment avoidance and attachment anxiety). To test the theoretical model, we employed an experience sampling method to collect daily diary data over 10 consecutive workdays, resulting in a final sample of 834 observations drawn from 133 participants. Results of multilevel path analysis indicated that daily workplace ostracism was negatively related to employee next-day work engagement through negative work reflection at night. In addition, we found that employee attachment avoidance not only moderated the within-person relationship between daily workplace ostracism and negative work reflection at night but also alleviated the indirect effect of daily workplace ostracism on next-day work engagement via negative work reflection at night. Taken together, our study contributed by unfolding the dynamic cognitive appraisal process of workplace ostracism and identifying the significant role of attachment avoidance in shaping employees' cognitive reactions to daily workplace ostracism.
The School Bullying Victimization in Adolescents With Non-Suicidal Self-Injury: The Role of Coping Strategies and Emotion Regulation
The present study aimed to investigate the relationship between school bullying victimization and non-suicidal self-injury (NSSI) frequency, taking into consideration the mediating roles of coping strategies and emotional regulation. Participants were 12-18-year-old outpatients and inpatients who met the NSSI and depressive disorder criteria according to the DSM-5. Assessments included the Multidimensional Peer-Victimization Scale, Coping Style Scale for Middle School Students, Emotion Regulation Questionnaire for Children and Adolescents, and the Functional Assessment of Self-Mutilation to examine the bullying victimization, coping strategies, emotion regulation, and NSSI behaviour. Serial multiple mediation effects of coping strategies and emotion regulation between bullying victimization and NSSI frequency were analysed using the SPSS macro PROCESS programme. A total of 2335 participants were included in this study. Bullying victimization significantly predicted NSSI frequency (B = 0.191, p < 0.001). Both coping strategies and emotion regulation were important mediators in the relationship between bullying victimization and NSSI frequency. Bullying victimization indirectly affected NSSI through two serial mediation pathways: (1) bullying victimization → problem-focused coping → cognitive reappraisal → NSSI frequency, and (2) bullying victimization → emotion-focused coping→ expressive suppression → NSSI frequency. The study revealed a positive association between bullying victimization and the frequency of NSSI among adolescents with depressive disorder. Strategies of coping and emotional regulation significantly mediated the link between bullying victimization and the frequency of NSSI. The findings suggested that supporting adolescents in adopting effective coping and emotional regulation strategies could be a crucial approach to mitigate the impact of bullying victimization on the frequency of NSSI.
Exploring the Utility of a Real-Time Approach to Characterising Within-Person Fluctuations in Everyday Stress Responses
Few studies have measured components of stress responses in real time-an essential step in designing just-in-time interventions targeting moments of risk. Using ecological momentary assessment (EMA), we characterised stress response components to everyday stressors, including reactivity (the response following a stressor), recovery (the return towards baseline), and pile-up (the accumulation of stressors) (RRPs) by quantifying the dynamics of response indicators (i.e., subjective stress, negative affect, and perseverative cognition). To determine the utility of these novel measures in capturing and characterising acute moments of the stress response, this study evaluated the proportion of variance in RRPs attributed to (1) between-person, (2) between-days, and (3) within-day (momentary) levels. Healthy adults (n = 123; aged 35-65, 79% women, 91% non-Hispanic White) participated in a 14-day study assessing stress response via EMA 6 times a day. RRPs were constructed from 10,065 EMA reports. Multilevel models with moments nested within days nested within persons were used to partition variance in the RRPs. Reactivity and recovery indicators captured the most variation within-days (i.e., across moments; range 76%-80% and 87%-89%, respectively), with small amounts of variance between-person. For pile-up, variation was mostly observed between-days (range 60%-63%) and between-persons (range 27%-31%). In contrast, raw measures of stress response reflected substantial between-person (range 32%-54%) and within-day (range 34%-53%) variance. These results demonstrated that a person-specific approach to measuring stress response components (i.e., RRPs) can capture the dynamic within-person variation in stress response, as it occurs in real time, making it well-suited for use in novel just-in-time interventions targeting moments of risk.
The Interaction of Polygenic Susceptibility to Stress and Childhood Adversity Dimensions Predicts Longitudinal Trajectories of Stress-Sensitivity
Stress-sensitivity (SS) is considered a psychobiological trait possibly resulting from the interaction of genetic and environmental factors (GxE). This study examined whether the interaction of SS-related genetic markers with interview-based dimensions of childhood adversity predicted longitudinal trajectories of low versus high SS. Participants were nonclinically-ascertained young adults comprising normative and elevated scores on schizotypy. SS trajectories were defined in a previous report based on three prospective assessments (23.5, 25, 28 years-old) of both retrospective (Perceived Stress Scale; PSS) and momentary (Experience Sampling Methodology; ESM) stress ratings. A total of n = 177 and n = 165 participants with PSS and ESM stress-sensitivity trajectories, respectively, as well as genetic data, were included in the study. GxE effects between a SS Polygenic Risk Score (PRS-SS) and a Genetic Risk Score of the Hypothalamic Pituitary Adrenal axis (GRS-HPA) with childhood adversity dimensions (Intrafamilial Adversity, Threat and Deprivation) on SS trajectories were examined. Threat was the most consistent predictor of persistently high SS. PRS-SS moderated the association of Threat with high-PSS. GRS-HPA moderated the effects of all adversity dimensions on high-PSS. The interaction of PRS-SS with Deprivation and GRS-HPA with Intrafamilial Adversity predicted trajectories of momentary social stress, but the effects were driven by those with lower genetic susceptibility. Genetic-HPA-axis moderates the effects of all adversity dimensions on persistent SS trajectories, as well as PRS-SS and Threat, particularly for retrospective stress measure. The findings highlight the complex interplay between GxE factors and suggest that PSS may better capture SS trait. Including biologically-meaningful GRS indexing SS and adversity dimensions in future studies using comprehensive stress measures would enhance our knowledge on high SS susceptibility and its relationship with diverse psychopathological outcomes.
Neurobiological and Anti-Inflammatory Effects of a Deep Diaphragmatic Breathing Technique Based on Neofunctional Psychotherapy: A Pilot RCT
We examined the feasibility of using the neofunctional deep breathing (NDB) technique to reduce the allostatic load following the Trier Social Stress Test (TSST). Forty-four healthy subjects were randomised into experimental and control groups. Following the TSST procedure, participants underwent either a single session of NDB or an attention control intervention. The Procomp Infinity Biofeedback system measured breath per minute (BPM), respiratory amplitude, HRV linear domains, skin conductance, and trapezius muscle electromyographic activity. Cortisol and cytokine salivary concentrations, perceived stress, and anxiety levels were also assessed. These parameters were combined into an allostatic load index (ALI) to measure the intervention's effect. This pilot RCT demonstrated the feasibility of the study design and practicality of the intervention. The NDB group showed reduced ALI, increased respiratory abdominal amplitude, decreased BPM, increased HRV indicating parasympathetic activation, and decreased cortisol and inflammatory cytokines. This study highlighted the feasibility of testing the NDB technique in reducing allostatic load through a neurobiological and anti-inflammatory response after exposure to psychosocial stress. This protocol can represent a non-invasive therapeutic adjutant in disorders related to a dysregulation of the HPA axis or to an inflammatory state. Trial Registration: NCT04102813.
Deployment stressors, mental health outcomes, and protective factors among wives of reserve soldiers during the Israel-Hamas War: A latent profile analysis approach
Deployment to active conflict zones significantly affects military families, with spouses often experiencing heightened stress and mental health challenges. However, research on non-US military spouses, particularly those of reserve soldiers, who may face unique stressors compared to active-duty personnel, remains scarce. This study examined perceived stress profiles among Israeli spouses of reserve soldiers during the ongoing Israel-Hamas War, and their associations with deployment stressors, mental health outcomes, and psychological protective factors. A volunteer sample of Israeli spouses of reserve soldiers (n = 293) responded to self-report questionnaires in a cross-sectional study. Using latent profile analysis of the ratings of perceived stress, three distinct profiles were identified: low (35.1%), moderate (43.5%), and high (21.3%). Higher levels of deployment stressors (e.g., fear of spouse getting physically injured) predicted membership in the moderate and high-stress profiles, while better household management was associated with lower stress profiles. The high-stress profile reported significantly greater symptoms of depression and anxiety compared to the low and moderate stress profiles. In contrast, the low-stress profile exhibited higher levels of resilience, self-compassion, and perceived social support. These findings highlight the variability in spouses' stress responses during wartime deployment and identify key factors associated with psychological adjustment. Results suggest that deployment-related fears, household management abilities, and psychological resources are crucial in shaping stress profiles and mental health outcomes among military spouses.
Urban Environmental Threat Moderates the Relationship Between Depression and Insulin Resistance Among Latinxs With Type 2 Diabetes
As the largest minoritised ethnic group in the United States, Latinxs face a greater risk for type 2 diabetes and depression. The aim of the present study was to explore whether the relationship between depressive symptoms and insulin resistance among Latinxs with type 2 diabetes was moderated by toxic stressors arising from urban environmental threat (i.e., uncomfortable or unsafe aspects of city life). A community sample of Latinx adults with type 2 diabetes (n = 121) was recruited from Hartford, Connecticut. Participants self-reported depressive symptoms and exposure to urban environmental threat using items from the Patient Health Questionnaire and Urban Hassles Index, respectively. Insulin and glucose levels assessed via fasting blood draw were used to calculate insulin resistance using the HOMA-IR formula. After controlling for demographic, financial and health-related factors, results from a regression analysis revealed a significant interaction between depressive symptoms and urban environmental threat; more severe symptoms of depression predicted greater insulin resistance, but only amongst those with frequent exposure to urban environmental threats. Findings from the current study suggest that improving urban living conditions may offer an alternate avenue for attenuating the deleterious impacts of depression on type 2 diabetes progression in Latinxs.
Chronic stress and hair cortisol concentration in mothers: A two-study investigation
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is one mechanism through which chronic stress during pregnancy and parenthood may affect parental, child, and family health. Hair cortisol concentration (HCC) may be well-suited to elucidate associations between chronic stress and HPA axis regulation because HCC reflects cortisol output over several months. However, most previous studies that examine chronic stress in conjunction with cortisol in pregnant individuals or mothers use measures that reflect HPA axis output over a relatively limited time. We report findings from two longitudinal studies that tested associations between chronic stress and HCC in women during the perinatal period (Study 1; n = 144) and mothers of young children (Study 2; n = 102). Both studies measured chronic stress with a measure developed to comprehensively assess chronic stressors in community samples. Hair samples were collected three times in Study 1 (mid-pregnancy, one month postpartum, and 12 months postpartum) and twice in Study 2, approximately one year apart. Chronic stress was associated with higher HCC in both studies. Exploratory analyses indicated that the strength of associations between chronic stress and HCC differed as a function of the life domain of chronic stress. Chronic work and family demands were associated with higher postpartum HCC in Study 1 whereas neighbourhood/housing and discrimination chronic stress were associated with higher HCC in Study 2. These findings provide evidence of a biological pathway through which chronic stress may influence health in mothers and support the utility of hair cortisol as a neuroendocrine measure of chronic stress during pregnancy and parenthood.
Correlating Personality Traits With Acute Stress Responses in Earthquake Simulations: An HRV and RESP Analysis
Earthquakes, as significant natural disasters, still cannot be accurately predicted today. Although current earthquake early warning systems can provide alerts several seconds in advance, acute stress responses (ASR) in emergency situations can waste these precious escape seconds. To investigate the correlation between personality and ASR, this study collected the temperament and character of all participants using the Chen Huichang-60 Temperament Scale and the DISC Personality Inventory. In addition, this study simulated growing earthquakes in an earthquake experience hall, collecting heart rate variability and respiration signal variations throughout the process from subjects. Multivariate analysis of variance (MANOVA) and Toeplitz Inverse Covariance-Based Clustering methods were used to analyse the differences and connections between them. Furthermore, this study employed a deep learning model that combines Convolutional Neural Networks (CNN) and Long Short-Term Memory (LSTM) to predict ASR across personalities. This model used datasets from the majority dataset of a certain personality and a single participant, respectively, and showed different performance. The results are as follows. After categorising participants based on personality test results, MANOVA revealed significant differences between the personality groups Influence-Choleric and Influence-Sanguine (p = 0.001), Influence-Phlegmatic and Steadiness-Sanguine (p = 0.023), Influence-Sanguine and Steadiness-Sanguine (p < 0.001) and Influence-Sanguine and Steadiness-Phlegmatic (p < 0.001), as well as across different earthquake stages (p < 0.01). The clustering method quantified stress responses over time for different personalities and labelled ASR levels for use in supervised learning. Ultimately, the CNN-LSTM model performed predictions of ASR using both personality and individual datasets, achieving the AUC of 0.795 and 0.72, demonstrating better prediction and classification effectiveness with the former. This study provides a new personality-based method for earthquake stress management, creating possibilities for longitudinal stress research and prediction. It aids the general public in comprehending their own acute stress and allows authorities and communities to make practical, efficient disaster evacuation plans based on the overall situation of public ASR.
The Relationship Between Perceived Discrimination and Social Adaptation of Migrant Workers' Children: The Role of Alienation and Psychological Capital
This study explores the relationship between perceived discrimination and social adaptation of migrant workers' children, as well as the mediating role of sense of alienation and the moderating role of psychological capital. A multi-stage-multi-source longitudinal study design was adopted. A total of 423 Chinese migrant workers' children (M = 13.36, Female ratio = 39.48%) were recruited, and sample data were collected at three time points for 6 months. The results indicated that the interpersonal alienation played a mediating role between discriminatory perception and social adaptation. Psychological capital moderated the relationship between perceived discrimination and interpersonal alienation. Compared to participants with high psychological capital, interpersonal alienation played a stronger mediating role between perceived discrimination and social adaptation among those with low psychological capital. Perceived discrimination could reduce the level of social adaptation of migrant workers' children through interpersonal alienation. The social adaptation of migrant workers' children could be improved by improving the level of psychological capital.
Stress Reactivity, Wellbeing and Functioning in University Students: A Role for Autonomic Activity During Sleep
Sleep is a key biological mechanism in promoting wellbeing and resilience to stress. This cross-sectional study examined connections between sleep, autonomic function, wellbeing, and stress reactivity in healthy individuals. Demographic, lifestyle, sleep, and psychological well-being information were collected from 85 healthy university students. These variables were analysed in conjunction with indices of cardiac autonomic activity, including heart rate and high frequency heart rate variability (HF HRV, an indicator of parasympathetic vagal tone) recorded during nocturnal sleep onset and in response to a cognitive stressor. Correlational analyses revealed that unrefreshing and fragmented sleep was strongly associated with lower HF HRV at sleep onset, suggestive of poorer autonomic de-arousal. Further, those with minimal increases in HF HRV from wakefulness to sleep reported worse sleep quality and greater challenges in daily activities compared to those with significant increases. This same group also demonstrated significantly greater reactivity and slower recovery when faced with a stressor the next day, as evidenced by comparison of heart rate values. Our findings suggest an association between autonomic hypervigilance and aspects of sleep quality, with potential implications for wellbeing and stress responses.
On the nature, predictors, and outcomes of work passion profiles: A generalisability study across distinct types of employees
Thus far, little research has adopted a person-centred approach to investigate the nature of work passion profiles. As a result, our understanding of the most commonly occurring combinations of harmonious passion (HP) and obsessive passion (OP) in the workplace remains limited. To achieve a more refined understanding of the nature of these work passion profiles, our first aim was thus to identify the configurations of HP and OP for work observed among five samples, including 11 subsamples, of employees (N = 7258). Then, we also considered the extent to which these profiles and their associations with theoretically-relevant predictors (work-home segmentation and organisational support) and outcomes (work engagement, work-family conflict, turnover intentions, presenteeism, and counterproductive work behaviours) generalised across all subsamples. We identified a total of five profiles with a structure that differed slightly across samples: High OP Dominant, High HP Dominant, Average HP Dominant, Low HP Dominant (i.e., low levels of passion dominated by higher levels of HP relative to OP), and Moderately Low Passion. The High OP Dominant profile was systematically the most prevalent (37.5%-54.1% of the sample), whereas the High HP Dominant was the least prevalent (2.1%-7.7%). Across all samples, work-home segmentation was related to a higher likelihood of membership into the profiles characterised by higher, relative to lower or moderate, levels of passion (HP and OP), whereas organisational support also helped employees to stay away from the High OP Dominant profile. Lastly, the least desirable outcomes were observed in the High OP Dominant profile, whereas the most desirable outcomes were observed in the High HP Dominant profile. Interestingly, work engagement levels where comparable in these two profiles. Beyond their theoretical implications for research on work passion, these results highlight how work passion has highly similar implications across contexts.
Association Between FABP7-5-HT Pattern and Anxiety or Depression in Patients With Psoriasis: A Cross-Sectional Study
Psoriasis exhibits a higher incidence of anxiety and depression. However, the diagnostic process heavily relies on subjective evaluation. Fatty acid-binding protein 7 (FABP7) and serotonin (5-HT) are considered as potential plasma biomarkers. We aimed to investigate the potentiality of plasma FABP7 and 5-HT as biomarkers for predicting anxiety and depression in psoriasis. Data were analysed from 140 patients with psoriasis in the Shanghai Psoriasis Effectiveness Evaluation CoHort (SPEECH). Unsupervised clustering was employed to group patients based on their FABP7 and 5-HT profiles. Subsequently, patients were categorised into Group 1 (lower FABP7 and higher 5-HT) or Group 2. Multivariate logistic regression was employed to investigate the correlation between the FABP7-5-HT pattern and anxiety or depression in psoriasis patients. Patients with psoriasis have a higher incidence of anxiety or depression, as well as higher levels of FABP7 and lower levels of 5-HT. After clustering patients using K-means clustering, Group 2 showed a higher body mass index, a higher incidence of hypertension, more severe psoriasis, and more significant anxiety and depression compared to Group 1. Multivariate logistic regression shows that adjusting for covariates except PASI, duration of psoriasis, and psoriatic arthritis, Group 2 had a higher risk of anxiety and depression compared to Group 1. Further adjustment for covariates yielded similar results. Pattern of FABP7-5-HT that may indicate an association with psoriasis accompanied by anxiety or depression.
The Longitudinal Association Between Negative Life Events and Problematic Social Media Use Among Chinese College Students: The Mediating Role of FoMO and the Moderating Role of Positive Parenting
Negative life events are one of the risk factors leading to problematic social media use (PSMU) among Chinese college students, but the underlying mechanism between them remains unclear. Based on compensatory internet use theory, a moderated mediation model was examined, with two dimensions of fear of missing out (FoMO) considered as parallel mediators and positive parenting as a moderator. A total of 525 college students (57.3% females, M = 21.94, SD = 1.16) participated in this three-wave longitudinal study (6 months apart). We investigated their negative life events at Time 1, FoMO at Time 2, positive parenting at Time 2 and PSMU at Time 3. The structural equation model results indicated that, after controlling for demographic variables, negative life events positively impacted students' PSMU directly and indirectly by increasing their fear of missing novel information and fear of missing social opportunities. Moreover, positive parenting moderated the mediating effect of fear of missing social opportunities but not fear of missing novel information. In conclusion, this study reflected the underlying mechanism linking negative life events to PSMU, supporting the stress-buffering model while highlighting the protective role of positive parenting.
Addressing Mental Health Symptoms Among COVID-19 Healthcare Workers: A Heart Rate Variability Biofeedback Pilot Study
Psychological stress among frontline healthcare workers (HCWs) increased during the COVID-19 pandemic, elevating mental health risks. Heart rate variability biofeedback (HRV-BF) is an evidence-based intervention with potential to reduce psychological burden on frontline HCWs; however, no studies have examined its use among this population since the pandemic began. We designed a trial to assess the effects of a brief HRV-BF intervention delivered via telemedicine on measures of anxiety, depression and stress, and heart rate variability, compared to an in-person intervention. We hypothesised that the telemedicine intervention would be non-inferior to the in-person intervention. Using a randomized comparison trial design, we tested a 10-day brief heart rate variability biofeedback intervention among frontline HCWs during the COVID-19 pandemic. They received remote, 30-min guided sessions every other day and were taught methods of heart rate variability biofeedback. Depression, anxiety and stress were assessed at baseline, 10 days, and 40 days with additional measures of anxiety measured before and after each session. HRV scores were collected at baseline, as well as during the course of the 10 days. Multilevel modelling was used to examine the change in depression, anxiety, stress and HRV scores across multiple time points and session types (telemedicine vs. in-person). There was no significant differences between telemedicine (n = 32) and in-person (n = 15) interventions on the main outcomes. Both session types showed a significant decrease in depression, anxiety and stress scores across the entire intervention, and HRV scores significantly increased across both groups. Anxiety levels also significantly decreased after each session. The non-inferiority of the telemedicine intervention to a comparable in-person intervention affirms its promise for decreasing anxiety, depression and stress among frontline HCWs and may offer a cost-effective and feasible tool to use in crises situations.
Co-rumination and intrapersonal cognitive processes predict distress: Longitudinal evidence from the COVID-19 pandemic
Perseverative thinking and catastrophizing have well established associations with fear and distress. However, less is known about the impact of interpersonal dynamics, such as co-rumination, on these intrapersonal cognitive processes and subsequent stress. The present study addresses this knowledge gap. A sample of 433 adults from across the United States was recruited online and completed measures of co-rumination, perseverative thinking, catastrophizing, and demographic characteristics early in the COVID-19 pandemic, and the COVID Stress Scales (CSS) at six month follow up. Co-rumination, perseverative thinking, catastrophizing, and CSS scores were correlated in the expected direction. Regression analyses revealed all three independently predicted CSS worry about the dangerousness of COVID-19 subscale. Co-rumination was the strongest predictor of CSS worry about the socioeconomic impact and CSS compulsive checking scales. Perseverative thinking and catastrophizing predicted CSS traumatic stress symptoms subscale. Finally, perseverative thinking was the strongest predictor of CSS xenophobia subscale. Structural equation modelling indicated that co-rumination had a significant indirect effect on CSS scores through perseverative thinking and catastrophizing. Interpersonal dynamics, such as co-rumination, are relevant for understanding stress and are promising targets for intervention research to prevent or attenuate fears and distress, in addition to traditional intrapersonal cognitive processes such as perseverative thinking and catastrophizing.
Examining hypothalamic-pituitary-adrenal axis genetic variation on cortisol and alpha-amylase reactivity during an explicit negative-evaluative stress induction
Prior work consistently links additive genetic variation in the hypothalamic-pituitary-adrenal (HPA) axis-a multilocus genetic profile score (MGPS)-to depression risk in the context of stress exposure. However, despite that HPA MGPS variants were selected based on evidence that they elevate cortisol reactivity, there are surprisingly few tests of whether an HPA MGPS elevates cortisol reactivity to lab-based stress. Similarly, despite neurobiological connections and coordination between the HPA axis and the sympathetic nervous system (e.g., in the paraventricular nucleus and locus coeruleus), no work has tested whether an HPA MGPS influences sympathetic nervous system reactivity to stress. We investigated whether an HPA MGPS moderates the relation between lab-based stress and: (1) HPA activity indexed by cortisol, and/or (2) sympathetic activity indexed by salivary alpha-amylase, sAA. Emerging adults (N = 152; mean age = 19.5, largest subsample 44.4% Black/African American) were randomly assigned to one of two Trier Social Stress Test variations, a non-evaluative control, or an explicitly negative-evaluative condition. Participants provided DNA and repeated saliva samples for sAA and cortisol. The HPA MGPS did not significantly moderate the relationship between stress condition and cortisol or sAA reactivity, respectively; moreover, post-hoc tests highlight that individual polymorphisms showed non-significant effects in opposite directions from each other, cancelling out in aggregate. Findings suggest that the HPA MGPS's associations with cortisol reactivity are not as straightforward as initially believed. We speculate that the relationships of some HPA variants to biomarker reactivity may vary between modest lab-based stressors and the explicit negative-evaluative induction used here.
The role of individual differences in environmental sensitivity in teachers' stress and burnout at work
School teachers are among workers most exposed to stress and burnout-a relevant occupational phenomenon leading to psychological and economic costs. The Environmental Sensitivity individual trait-as captured by the psychological marker of sensory processing sensitivity (SPS)-has been found to have a relevant role in stress and emotional exhaustion at work. Yet, little is still known about heightened SPS in the educational field and on underlying mechanisms occurring in the relationship between SPS, stress and burnout. The current work aimed to explore the association between SPS and burnout among teachers as well as the moderating role of perceived stress and school climate in this association. One hundred and ninety eight teachers (44.3 years; SD = 9.7, 94% F) reported on their levels of SPS, occupational burnout, perceived stress and school climate quality. In line with a vulnerability effect, we found heightened SPS largely associated with burnout. This was particularly evident in a context of high-perceived stress, suggesting that teachers high on SPS may experience more challenges in the face of elevated stress with the need of more support. When exposed to positive and supportive school climate, highly sensitive teachers showed a decrease in burnout, suggesting high SPS as a valuable strength for benefiting from positive experiences. Findings have the potential to inform the customisation of support programs, assisting both schools and work agencies in increasing their awareness of the role of individual differences in responding to both work-demand-related stress and to positive work environments.
Burnout, working alliance, and ward atmosphere: A multisite study of mental health professionals and patients with schizophrenia
This study examined the association between burnout, psychological distress, ward atmosphere, and working alliance (WA) among mental health workers treating patients with schizophrenia spectrum disorder (SSD). Data were collected from 345 patients with SSD and 151 mental health workers across 98 residential facilities (RFs) as part of the DiAPAson project from October 2020 to October 2021. Participants were excluded from the study if they exhibited patient-operator matching errors, dropped out, or had many missing Maslach Burnout Inventory (MBI) scores. The final sample included 282 patients and 155 healthcare workers. Burnout was assessed using the MBI. Psychological distress was evaluated with the 12-item version of the General Health Questionnaire. WA and ward atmosphere were evaluated with the WA Inventory and the Ward Atmosphere Scale, respectively, in both staff and patients. Sociodemographic and clinical data was also collected and analysed. Burnout was associated with a less supportive ward atmosphere, a weaker WA, and higher staff distress. Severe psychiatric symptoms evaluated with Brief Psychiatric Rating Scale in patients were also linked to staff burnout levels. Discrepancies in the perceptions of the ward atmosphere and the WA were observed between staff and patients, with patients reporting better perceptions in both domains. Our findings highlight the complex dynamics of well-being within psychiatric care settings, emphasizing the importance of role clarity, professional autonomy, and a positive ward atmosphere in mitigating burnout. Interventions focused on such factors may help support mental health professionals involved in SSD patient care. ISRCTN registry ID ISRCTN21141466.
The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping
To explore the relationships among fertility stress, dyadic coping and marital quality in couples undergoing in vitro fertilization-embryo transfer (IVF-ET). Couples receiving IVF-ET treatment at the clinic of the reproductive medicine centre of a hospital in China from February 2023 to October 2023 were selected by convenience sampling. A general information questionnaire, the Infertility Fertility Stress Scale (COMP-FPSS-SF), the dyadic coping inventory, and the marital adjustment test were used to evaluate the results. AMOS24.0 software was used to construct an actor-partner interdependence model that extended to mediation to analyze the relationships among couples' fertility stress, dyadic coping, and marital quality. The fertility stress level of IVF-ET wives was significantly higher than that of their husbands (p < 0.05). Wives' levels of dyadic coping and marital quality were significantly lower than those of husbands (p < 0.05). Fertility stress, dyadic coping, and marital quality were positively correlated between IVF-ET couples (p < 0.01). In terms of the actor effect, the fertility stress of IVF-ET couples had a significant impact on their marital quality through their dyadic coping (β = -0.188, p < 0.05; β = -0.109, p < 0.05). In terms of partner effects, wives' fertility stress significantly affected their husbands' marital quality through their own or their husbands' dyadic coping (β = -0.055, p < 0.01; β = 0.157, p < 0.01). Dyadic coping mediates the relationship between fertility stress and marital quality in IVF-ET couples. Nurses can use husbands and wives as central individuals and dyadic coping as the starting point to formulate intervention measures to reduce fertility stress and improve marital quality.
Patterns and transitions of posttraumatic stress symptoms and posttraumatic growth in trauma-exposed youth: A latent transition analysis
The present study examined the transition patterns in latent classes of Post-traumatic stress disorder (PTSD) and post-traumatic growth among a sample of youth 4-13 months after an explosion accident in China. Latent profile analyses identified consistent three classes (Resilient, Growing, and High-Symptom) at both waves. Latent transition analysis found most Resilient individuals remained stable while most Growing and High-symptom individuals transferred. Logistic regression predicting transition pathways suggests younger individuals, males, and those who lack social support are prone to experience reduced post-traumatic growth, whereas individuals with higher trauma exposure are prone to develop PTSD. Our study provides empirical evidence supporting qualitative transitions in PTSD and post-traumatic growth levels from a person-centred perspective. This adds to the current knowledge on the heterogeneity of post-traumatic responses of human beings and offers valuable guidance for post-traumatic interventions among youths.
A slow diaphragmatic breathing intervention for anxiety: How do respiration rate and inhalation/exhalation ratio influence self-reported anxiety?
The primary aim was to investigate how respiration rate and inhalation/exhalation ratio influence self-reported state anxiety during a single slow diaphragmatic breathing exercise session. Eight hundred and twenty-eight participants completed the study at two separate geographical locations (Poland and Spain). Participants performed a 10-min online guided breathing exercise. Respiration rates were sampled from a continuous uniform distribution (ranging from 6 to 12 breaths/min). Similarly, inhalation/exhalation ratios were treated as continuous variables and sampled from a uniform distribution for each participant. An application programed for this experiment displayed visual and auditory cues adjusted for each participant. Before and after the breathing exercise, each participant filled in the Current Anxiety Level Measure questionnaire. Self-trait anxiety was measured with the Clinically Useful Anxiety Outcome Scale. A linear regression model showed that respiration rate, trait anxiety, pre-test anxiety, and nationality (Polish/Spanish) were positively related to post-test anxiety levels. Adding quadratic terms of respiration rate and inhalation/exhalation ratio did not improve model fit. Polish participants exhibited higher post-test anxiety levels compared with the Spanish subsample. Age was negatively associated with post-test anxiety. No significant relationships between inhalation/exhalation ratio and post-test anxiety level were found. Slower respiration rates during a single-session breathing exercise are linearly associated with lower post-test anxiety levels in a large and varied sample. This study is the largest to date and may offer further guidance for predicting expected effect sizes for the relationships between anxiety and respiratory dynamics.
Posttraumatic growth modulates the response to negative emotions related to COVID-19: An event-related potentials study
There is increasing interest in identifying how posttraumatic growth (PTG) impacts emotional processing following traumatic events (e.g., the COVID-19 pandemic). Previous research suggests that high PTG levels may lead to enduring changes in positive emotional processing. Despite this fact, little is known regarding brain activation and responses to stressful emotional stimuli. The present study utilised event-related potentials (ERPs) to investigate whether individual differences in emotional responses toward neutral and negative emotional stimuli related to COVID-19 are related to self-reported PTG levels. A total of 77 participants were analysed: 21 in the high PTG group and 56 in the control group. The amplitude of the N2 was smaller in the high PTG group compared to the control group under both negative and neutral conditions. When viewing the negative emotion pictures (vs. neutral pictures), the N2 amplitude significantly decreased for the high PTG group in the right occipital and frontal-parietal areas, whereas no significant change was observed among the control group. In the time window Late Positive Potential (LPP) 600-1000 ms, emotional stimuli and the group interaction were significant. Viewing negative pictures (vs. neutral pictures) decreased the LPP 600-1000 ms amplitudes for the control group, mainly originating from the brain's frontal regions. However, there were no such significant differences for the PTG group. Due to the limited sample size and cultural differences, the applicability of these results to other regions or countries needs to be verified. The presented findings suggest that the impact of PTG during emotional response is reflected in both bottom-up (evidenced by the early ERP components) and top-down (evidenced by the later ERP components) processes. Individuals with high PTG may use a meditation-related emotional regulation strategy of acceptance at the basic stage and non-judgement at a later stage.
A systematic review and meta-analysis of the parental stress scale's psychometric properties
Parental stress can affect the ability of parents to cope with the challenges of raising children. The result can be a negative cycle within the family dynamic, which in turn can interfere with children's development and emotional regulation. Among the many instruments available to assess parental stress, the Parental Stress Scale (PSS) deserves particular mention. To our knowledge, there are currently no systematic reviews evaluating the psychometric properties of the PSS. The aim of this systematic review was to assess the psychometric properties of the PSS using the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) methodology and to conduct a meta-analysis. A thorough literature search was conducted from different databases. A meta-analysis to test the generalisability of PSS internal consistency across its component factors was performed. A total of 20 validation studies of the PSS were identified. Based on the COSMIN methodology, this instrument receives an 'A' rating, meaning that it is considered to be a cross-sectional instrument with the necessary scientific evidence for the assessment of the construct of parental stress. The meta-analysis testing the generalisability of its internal consistency yielded satisfactory results across the different factors. Future research should focus on those psychometric properties of the PSS that have not been studied as extensively, such as reproducibility, responsiveness, measurement error, and measurement invariance.
Confronting moral injury across health systems: Enhancing medical social workers' resilience and well-being
Research has demonstrated that encounters of potentially moral injurious events (PMIEs) may result in longstanding psychological trauma that impact healthcare workers' mental health and well-being. In this paper, we explore strategies to alleviate PMIEs for medical social workers. In-depth semi-structured interviews (30-60 min) were conducted with medical social workers (n = 75) across the state of Texas. Supported by directed content analysis, textual data were coded and categorised to finalize emerging themes. Findings demonstrate that multilevel strategies ought to be implemented into daily healthcare practice. PMIEs that impact frontline healthcare delivery can be alleviated by having formal and informal support systems (e.g., mentorship, supervision, counselling) as well as honest and transparent interprofessional collaborative care to facilitate psychological team safety. PMIEs across the healthcare organisation, perhaps due to internal policies and practices, may be reduced by implementing educational initiatives and building ethical workplace cultures that serve to explicitly reduce stigma associated with mental health and enhance worker well-being. PMIEs that derive from macro-level social policies (e.g., insurance, health disparities) may be alleviated by instituting patient advocacy initiatives and dismantling systems of oppression to lessen psychological stress and trauma. Hospital leadership ought to understand how the United States healthcare industry triggers PMIEs across the healthcare workforce. Multi-tiered practices and policies that addresses frontline delivery care, leadership and administrative responsibilities, and the healthcare industry can enhance psychologically safe workplaces and elicit macro-level institutional reform in how health systems function. These findings have important implications for healthcare policy makers, practitioners, educators, and researchers to inform future research and practice development.
Examining the applicability of virtual battle space for stress management training in military personnel-A validation study
Military personnel are often exposed to high levels of both physical and psychological challenges in their work environment and therefore it is important to be trained on how to handle stressful situations. The primary aim of this study was to examine whether military-specific virtual battle space (VBS) scenarios could elicit a physiological and subjective stress response in healthy military personnel, as compared to that of a virtual reality height exposure (VR-HE) stress task that has shown to reliably increase stress levels. Twenty participants engaged in two VBS scenarios and the VR-HE during separate sessions, while measurements of heart rate (HR), heart rate variability (HRV), respiration rate, and subjective stress levels were collected. Contrary to our initial expectations, analysis revealed that neither of the VBS scenarios induced a significant stress response, as indicated by stable HR, HRV, and low subjective stress levels. However, the VR-HE task did elicit a significant physiological stress response, evidenced by increased HR and HRV changes, aligning with previous research findings. Moreover, no discernible alterations were detected in cognitive performance subsequent to these stressors. These results suggest that the current VBS scenarios, despite their potential, may not be effective for stress-related training activities within military settings. The absence of a significant stress response in the VBS conditions points to the need for more immersive and engaging scenarios. By integrating interactive and demanding elements, as well as physical feedback systems and real-time communication, VBS training might better mimic real-world stressors and improve stress resilience in military personnel. The findings of this study have broader implications for stress research and training, suggesting the need for scenario design improvements in virtual training environments to effectively induce stress and improve stress management across various high-stress professions.