Stress and Eating Behaviors Pre- and Post COVID-19 Pandemic Declaration in Two Independent Samples of College-Aged Adults

Stress is related to altered olfactory perception and eating behaviors. The current study investigated the association between chronic stress, food reward and perception of food and non-food odors among college students. Sixty-one participants completed the Perceived Stress Scale (PSS) and the Brief Daily Stressors Screening Tool (BDSST). The detective threshold and suprathreshold perception (pleasantness, intensity, and familiarity) of two food (chocolate, strawberry) odors and a non-food (rose) odor were measured. Food reward and macronutrient preference were measured using the computerized Leeds Food Preference Questionnaire and the Macronutrient and Taste Preference Ranking task, respectively. Reward-related eating, emotional eating and eating-related inhibitory control were measured by the Dutch Eating Behavior Questionnaire (DEBQ) and the Reward-Based Eating Drive Scale (RED) scales. Neither the perceived stress or the severity of daily life stressor exposure was related to odor sensitivity, however, the PSS score was significantly correlated with pleasantness for strawberry odor (r = 0.329, p = 0.013). Chronic stress (PSS and BDSST scores) was significantly correlated with the DEBQ emotional eating and reward-related eating measured by RED (all ps < 0.01). Moreover, the BDSST score was negatively correlated with subjective liking for low-calorie sweet foods (r = -0.46, p < 0.001). Together, our preliminary results suggest disassociated effect of chronic stress on odor perception and eating behaviors.

Objective: The aim of our study was to investigate the perceived stress level and emotional eating behaviors of sports college students during the COVID-19 pandemic. Materials and Methods: This study was conducted on 122 volunteer students studying at the Faculty of Sports Sciences of Bolu Abant Izzet Baysal University. The data was collected online through the socio-demographic data form, the Perceived Stress Scale, and the Emotional Eating Scale. Results: The perceived stress scale score average of the students was 28.93±7.54, with 37.7% (n=46) having a low stress level, 58.2% (n=71) having a moderate stress level and 4.1% (n=5) having a high stress level. There was no significant difference between the groups in terms of emotional eating behavior scores (p=0,132). Both perceived stress level scores (P=0.044) and emotional eating behavior scores (p=0.001) of female students were significantly higher compared to male students. Both perceived stress scale scores (p=0.002) and emotional eating behavior scores (p=0.029) of the students with BMI 25. Conclusion: COVID-19 pandemic had a number of negative effects on students' stress levels and emotional eating behaviors. It is thought that quarantine measures that is applied to prevent transmission and spread of the disease, concerns about the disease and school education may contribute to these negative effects. During COVID-19 pandemic it is important to keep the immune system strong by preventing mood changes and related emotional eating behavior.

BACKGROUND AND AIMSSleep disorders, depression and anxiety are commonly reported in patients with systemic lupus erythematosus (SLE). Public health emergencies such as pandemics can also increase these psychosocial distresses. Early diagnosis and treatment of these disorders will substantially affect patients' quality of life and medication adherence. The aim of this study was to evaluate both medication non-adherence and the incidence of perceived stress, anxiety, depression, sleep quality and insomnia during the COVID pandemic in patients with SLE.METHODThis was a cross-sectional, descriptive survey study. A total of 211 participants, including 160 SLE patients aged 18 years and older and 51 healthy volunteers who were similar in age and gender, were included. A questionnaire of socio-demographics and COVID-19 status, Medication Compliance Reporting Scale (MARS-5), Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HAD-A and HAD-D), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) scales was assessed. The participants were interviewed face to face, and the answers were recorded by the researcher.RESULTSThe mean age of the patients was 41.85 ± 12.97 years and 142 (88.7%) of the patients were female. There was no significant difference between the patient and control groups in terms of the history of COVID-19 infection, symptoms and hospitalization. Fifty-nine (36.9%) patients had high perceived stress, 16 (10.0%) had anxiety, 45 (28.1%) had depression, 77 (48.1%) had poor sleep quality and 62 (38.8%) patients had insomnia. PSS (23.64 ± 7.86 versus 19.73 ± 4.80, P = .001), HAD-D (5.60 ± 3.40 versus 4.08 ± 2.21, P = .003), PSQI (6.31 ± 3.62 versus 4.43 ± 2.20, P = .001) and ISI (6.81 ± 4.98 versus 4.53 ± 2.83, P = .002) scores were significantly higher in the patient group than controls. Patients with PSS score ≥ 25 were categorized as patients with a high PSS score. Presence of anxiety, depression, poor sleep quality and insomnia were significantly higher in patients with a high PSS score. Medication non-adherence was detected in 79 (49.4%) of the patients. Interestingly, there was no difference in MARS-5 scores between high and low PSS groups. Comparison of baseline characteristics and clinical data of the patients according to PSS score is shown in Table 1. The high PSS score was positively correlated with HAD-A, HAD-D, PSQI and ISI scores. Regression analysis revealed that high perceived stress is an independent predictor of depression [Exp(β) 95% CI: 1.488 (1.245–1.779), P < .001], and anxiety [Exp(β) 95% CI: 1.235 (1.026–1.487), P = .026].CONCLUSIONSLE patients demonstrated increased levels of perceived stress, depression, poor sleep quality and insomnia compared to the healthy population during the COVID-19 pandemic. SLE patients with high perceived stress had more depression, anxiety, poor sleep quality and insomnia than those without. It needs to be determined whether these findings will have an impact on patient outcomes during long-term follow-up.Table 1.Comparison of baseline characteristics and clinical data of SLE patients according to Perceived Stress Scale (PSS) scoreVariableHigh PSS(n:59)Low PSS(n:101) P valueAge, years41.14 ± 12.4543.07 ± 13.83.379Female gender, n (%)52 (88.1%)90 (89.1%)1.000Smoking, n (%)6 (10.2%)14 (13.9%).623Alcohol, n (%)0 (0.0%)2 (2.0%).532Marital status, married, n (%)54 (91.5%)81 (80.2%).071History of Covid-19, n (%)16 (27.1%)15 (14.9%).065Hospitalization, n (%)5 (8.5%)2 (2.0%).102HAD-D score8.32 ± 3.054.01 ± 2.45<.001HAD-A score8.27 ± 2.525.31 ± 2.48<.001PSQI score8.27 ± 3.825.17 ± 2.96<.001ISI score9.88 ± 4.935.01 ± 4.06<.001MARS-5 score22.80 ± 2.4222.90 ± 2.11.772Presence of depression, n (%)37 (62.7%)8 (7.9%)<.001Presence of anxiety, n (%)12 (20.3%)4 (4.0%).001Poor sleep quality, n (%)45 (76.3%)32 (31.7%)<.001Insomnia, n (%)41 (69.5%)21 (20.8%)<.001

Background/Objectives: Over the course of end-stage renal disease, patients undergoing hemodialysis (HD) often face significant psychological distress. Nonetheless, little is known about perceived stress levels and related factors in HD patients. This is a cross-sectional study that explores the prevalence of perceived stress levels and the associated variables in HD patients. Methods: Participants included 223 HD patients recruited in June 2024 in Italy. Perceived stress and depression levels were measured with the Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI-II). We also collected clinical and laboratory variables to evaluate their association with PSS. Results: PSS score was moderate in 70.8% and high in 11.2% of the patients. The BDI score was significantly higher in patients with moderate or high perceived stress than in those with low perceived stress. The correlation between PSS and BDI scores was statistically highly significant, and in multivariate regression analysis, PSS score was independently associated with BDI, but not with age, sex, and serum creatinine. Patients with moderate or high perceived stress more frequently had a BDI ≥ 17. In women, with respect to men, the frequency of high and moderate perceived stress was higher. PSS does not correlate with some clinical characteristics such as functional disability (ADL and IADL scores), and the number of comorbidities (Charlson comorbidity Index). Also, we found that there was no correlation between PSS and post-dialysis fatigue prevalence/characteristics, nor between PSS and time of recovery after dialysis. Conclusions: These findings emphasize the critical need for targeted interventions addressing stress management in HD patients, especially with gender-specific approaches.

Food addiction, executive function and mood in adolescents with obesity seeking treatment

Introduction: The relationship between stress and dietary patterns is a significant factor influencing the well-being of students. Stress and emotional states can trigger physiological responses that alter eating behaviours, leading to either an increase or decrease in appetite. Objective: This study aims to investigate the association between stress, dietary patterns, and emotional eating among high school students in Amritsar, India. Methods: A cross-sectional study was conducted with 475 high school students (261 females and 214 males). The survey utilised the Perceived Stress Scale (PSS) and the Emotional Eater Questionnaire (EEQ) to assess stress levels and emotional eating behaviours. Data on general characteristics, BMI, dietary habits, and sleep patterns were also collected. Results: The average weight, height, and BMI for females were 53.18 kg, 163.50 cm, and 21.77 kg/m², respectively, while for males, these values were 61.22 kg, 167.94 cm, and 19.63 kg/m². Females had higher average stress and emotional eating scores (23.25 and 11.57, respectively) compared to males (19.95 and 9.23, respectively). A positive correlation was observed between stress scores and emotional eating tendencies. Stress levels tended to increase as students progressed to higher grades, with 12th graders experiencing the highest levels of stress. Conclusion: The findings indicate that higher stress levels are associated with increased emotional eating among high school students. Effective stress management strategies are essential to promote healthier eating habits and overall well-being in this population. Further research is needed to explore intervention strategies and the impact of cultural factors on these behaviours.

The Weight-Related Eating Questionnaire offers a concise alternative to the Three-Factor Eating Questionnaire for measuring eating behaviors related to weight loss

Background: A strong correlation exists between infertility, psychological stress, and quality of life (QoL) among women, and hence, emphasis must be made on improving the psychological context and incorporating psychological counseling as a part of infertility evaluation and management. The Perceived Stress Scale (PSS) and Modified FertiQoL tools are used to measure the stress perceived by an individual and to assess the impact of fertility problems on the QoL of women, respectively. Objectives: The objective was to assess the psychological stress and QoL among the infertile women using the Perceived Stress Scale (PSS) and Modified FertiQoL (Core) instruments, respectively, to find the correlation between psychological stress and QoL among the study participants and to find the experiences of women who received prior infertility treatment. Materials and Methods: A mixed methodology study was conducted by the Department of Obstetrics and Gynecology, Radiodiagnosis and Psychiatry on infertile women attending ESIC Medical College, Hyderabad, Telangana, between December 2020 and August 2021. A total of 274 participants who met the inclusion criteria were enrolled for the quantitative study and 10 participants for the qualitative study. Descriptive statistics (frequency, mean, and standard deviation), comparisons (Student’s t-test), and correlations (Pearson: r-value) were used for quantitative data analysis and thematic content analysis for the qualitative data. Results: The mean age of the participants was 29.17 years (range 22–39 years) with a mean duration of infertility of 6.17 years. The results showed that the mean Perceived Stress Scale (PSS) score among the participants was higher (21.07 ± 4.350) with the low mean Core FertiQoL scores (49.20 ± 7.232). It was also found that there was a significant negative correlation between PSS and total Core FertiQoL scores. The study showed a significant negative correlation between the PSS scores and total FertiQoL, emotional, and mind–body subscales (P &lt; 0.01 significant). It was found that there was a significant negative correlation between PSS scores and subscales of total FertiQoL, in women aged &gt;30 years and those with a duration of infertility of &gt;5 years. Content analysis of in-depth interviews with the women treated for infertility revealed the difficulties the women faced while seeking treatment. Conclusion: The study showed that infertility-related stress was affecting the QoL of women. Based on the recommendations, a holistic approach to the management of infertile women was made, and counseling sessions, yoga, and meditation were started for infertile women.

Purpose: Few studies have investigated the potential relationship between self-compassion and eating behaviors. Self-compassion has been shown to improve one’s ability to respond more effectively to various situations and stressors by embracing the constructs of self-kindness, common humanity and mindfulness. This study examined correlations between self-compassion, eating behaviors and stress in first-time college freshmen.Methods: First-time freshmen (N=1477), ages 18-22 years (63% female), self-reported measures of Perceived Stress Scale (PSS), Three-Factor Eating Questionnaire (TFEQ), and Self-Compassion Scale (SCS). Associations among PSS, SCS and TFEQ scores were examined with Pearson correlations by gender. Differences by gender were explored with t-tests.Results: There were significant (p &lt; 0.01) correlations between disinhibition and negative SCS constructs (self-judgment, r = 0.29; isolation, r = 0.23; over-identification, r = 0.28) and restraint and self-judgment in females (r = 0.26). Females scored significantly higher than males on PSS and negative SCS subscales (p &lt; 0.05).Conclusion: Interventions increasing self-compassion and reducing stress may optimally support psychological and behavioral wellbeing as students transition into college. Future research needs to understand how self-compassion interventions may attenuate the inimical cycle of dietary restraint and disinhibition in university students.

Background:Adverse cardiovascular events during pregnancy (e.g., pre-eclampsia) occur at higher rates among individuals with pre-pregnancy overweight or obesity (body mass index [BMI]≥25kg/m2) and have been associated with postpartum depression. However, it is unclear whether cardiovascular health (CVH), defined more holistically than the absence of cardiovascular conditions in pregnancy, relates to postpartum psychological functioning. The present study examined whether changes in CVH during the perinatal period predicted postpartum psychological functioning among individuals with pre-pregnancy BMI≥25kg/m2.Methods:Individuals (N=226; Mage=28.43±5.4 years; MBMI=34.17±7.15kg/m2) were recruited when their pregnancies were 12-20 weeks gestation (M=15.64±2.45 weeks) for a longitudinal study of health and well-being. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS) and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6-months postpartum. BMI and CVH behaviors were coded according to the American Heart Association’s Life’s Essential 8 to create a CVH score at both timepoints. Linear regression analyses were performed to examine whether change in CVH related to postpartum CES-D and PSS scores. Because sleep was only measured in a subset of participants (n=114), analyses were conducted with and without sleep included. Baseline CVH, CES-D and PSS scores, and demographic factors were included as covariates in all models.Results:Improved CVH was associated with lower postpartum CES-D (β=−0.18, p<0.01) and PSS (β=−0.13, p=0.02) scores when excluding sleep. Compared to those whose CVH improved by >1SD from pregnancy to 6-months postpartum, individuals whose CVH worsened by >1SD scored 6.42 points higher on the CESD (MCESD=15.25±10.92 vs. 8.52±6.90) and 6.12 points higher on the PSS (MPSS=24.45±8.29 vs. 17.83±8.70). However, when including sleep, these relationships were no longer significant (ps>0.4).Conclusions:Improvements in CVH from early pregnancy to 6-months postpartum were associated with lower postpartum depressive symptoms and perceived stress. However, these relationships were no longer significant when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.

Mixed simulation course increases participants' positive stress coping abilities

Purpose: In this study, it was aimed to investigate young female nursing students’ emotional eating, uncontrolled eating and mindful eating behaviors, perceived stress levels and the relationship between these variables. Material and Methods: The sample of the study consisted of 106 3rd and 4th grade female nursing students aged 20-28 years studying in a nursing faculty in the 2020-2021 academic year. Data were collected using Three-Factor Eating Questionnaire (TFEQ), Mindful Eating Questionnaire (MEQ), and Perceived Stress Scale (PSS). Results: While the mean score the participants who did not eat regularly obtained from the uncontrolled eating subscale was significantly higher, the mean scores the participants who were on a diet obtained from the MEQ, and cognitive restriction, emotional eating subscales and their mean BMI values were significantly higher (p

Background: The link between perceived stress, insomnia, and dementia in diabetic patients can provide new insights into understanding the causes of dementia and developing more effective treatment strategies. Objectives: To estimate the Insomnia Severity Index (ISI) scores, Perceived Stress Scale (PSS) scores, and cognitive function levels by Revising Hasegawa’s Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE) Scale and to correlate and compare them with patients of normal cognition and mild cognitive impairment (MCI). Methodology: The cross-sectional study was conducted after taking institutional ethical clearance and informed consent from 150 participants. The diabetic elderly patients attending the diabetic clinic were interviewed and MMSE, ISI, PSS, and HDS-R scores were evaluated. Results: Elderly diabetic patients with MCI had higher levels of stress and insomnia compared to those with normal cognitive function. The PSS and ISI scores for the MCI group were 22.4 ± 6.99 and 14.43 ± 5.29, respectively, whereas the scores for the normal group were 17.1 ± 4.54 and 9.05 ± 4.16. Both PSS and ISI scores were found to be negatively correlated to HDS-R scores. Increases in age, blood pressure, blood sugar levels, and Hb1c levels were found to be significant factors for the development of dementia. Conclusion: Elderly diabetic patients with MCI had higher levels of stress scores and ISI as compared to those with normal cognitive functions. Stress scores and insomnia severity scores were negatively correlated with cognitive function.

Differences in perceived stress during ovarian stimulation between women with infertility and those pursing oocyte cryopreservation

Chronic stress and cortical responsiveness to suprathreshold heat: fMRI-based evidence for stress management in pain rehabilitation