Daily Stress Research Articles

TRANSCUTANEOUS LASER IRRADIATION OF BLOOD IN SIMULTANEOUS MODE (S-ILIB) FOR FATIGUE RECOVERY

The modified transcutaneous laser irradiation on blood (ILIB), a systemic modality of photobiomodulation therapy (PBMT), consists of a laser application on the radial artery or other artery in the body, to improve systemic functions and physiological dynamics of the body. The available therapeutic strategies for the management of fatigue due to daily life stress are mainly focused on lifestyle changes associated with nutrition and exercise. Thus, the present study aims to report a series of cases in which transcutaneous modified ILIB therapy in simultaneous mode (S-ILIB), was used to treat fatigue symptoms. Four healthy patients, without any type of significant comorbidity, reported fatigue related to stress. They were treated by the new PBMT protocol with the modified ILIB technique. The intensity or perception of fatigue was rated using a visual analogue scale (VAS). The "simultaneous technique" used in the present study consisted of laser irradiation in four sites of the body: 1- the radial artery region of the right arm; 2- the radial artery region of the left arm; 3- the right dorsal pedis artery; and 4- the left dorsal pedis artery. For PBMT, two laser device were used at 660 nm, on contact mode, with 100 mW of power. The patients reported a clear recovery in the energy sensation after the S-ILIB session. The PBMT protocol seems to be a promising therapy for managing energy recovery in fatigue-stress-related daily routines; however, complementary studies are required to establish the safest and most efficient protocol

Self-Compassion, Stressor Exposure, and Negative Affect: A Daily Diary Study of Older Adults.

Self-compassion has been identified as a psychological resource for aging well. To date, self-compassion among older adults has typically been conceptualized as a trait variable. This study examined whether day-to-day (state) variability in self-compassion was associated with negative affective reactivity to daily stressors. Daily diary assessment methods were used to examine the potential moderating role of between- and within-person self-compassion on the relationship between daily stressors and negative affect. A community-based sample of 107 older adults aged 65+ completed questionnaires once daily over 14 days. Multilevel modeling revealed that 37% of the variance in self-compassion occurred within persons. Daily self-compassion moderated the relationship between daily stressor exposure and daily negative affect. On days with greater stressor exposure than usual, older adults showed less negative affective reactivity on days when self-compassion was higher, compared with days when self-compassion was lower. No moderating effects were observed for between-person (trait) self-compassion. These findings suggest that self-compassion in older adults should be conceptualized as both state and trait variables and that state self-compassion may be protective in the stress-reactivity pathway. Future research should investigate whether brief self-compassion interventions might help older adults to avoid or downregulate negative emotions in response to stressors.

The moderating role of catastrophizing in day-to-day dynamic stress and depressive symptoms.

The way individuals handle daily stressors can significantly influence their mental health. Those who struggle with emotion regulation are especially vulnerable to the negative effects of stress. This study explored the role of catastrophizing, a maladaptive emotion regulation strategy, in shaping the relationships between daily stress responses and depressive symptoms. A total of 75 healthy college students participated in the study. We adopted an Ecological Momentary Assessment protocol over 14 consecutive days to capture the day-to-day dynamics of stress reactivity and recovery. Our findings indicate that individuals with higher levels of catastrophizing exhibited increased daily stress reactivity and delayed daily stress recovery, consequently raising their likelihood of experiencing amplified depressive symptoms. In contrast, those with lower levels of catastrophizing did not experience the same negative effects of increased daily stress reactivity on their mental health. These results enhance understanding of how real-life stressors contribute to the development of mental health issues and underscore the importance of adaptive emotion regulation for improved overall health and well-being.

Moderating Effect of General Self-Efficacy on the Relationship between Pregnancy Stress, Daily Hassles Stress, and Preterm Birth Risk in Women Experiencing Preterm Labor: A Cross-Sectional Study.

This study investigated the moderating role of general self-efficacy (GSE) on how stress caused by pregnancy and daily hassle affect the risk of preterm birth (PTB) in women experiencing preterm labor. This cross-sectional study included 196 pregnant women experiencing preterm labor before 37 weeks of gestation. We used IBM SPSS Statistics 27 and employed Hayes process macro version 4 (model 1) and hierarchical regression to analyze the moderating effect of GSE on the relationship between pregnancy stress, daily hassle stress, and PTB risk. Stress caused by pregnancy and daily hassle was positively correlated to PTB risk (r = .54, p < .001; r = .25, p < .001, respectively). While GSE did not significantly correlate with pregnancy stress, it negatively correlated with daily hassle stress (r = - .19, p = .009). GSE significantly moderated the relationship between combined stressors and PTB risk. As GSE levels increased, escalation in PTB risk in response to increasing stress levels was a more pronounced, highlighting a complex interaction between higher GSE levels and response to escalating stress levels. This model accounted for 39.5% of the variance in the PTB risk. Higher GSE may amplify the impact of stress on PTB risk, rather than mitigate it, which suggests a more nuanced role of GSE in the stress response of pregnant women at risk of preterm labor. GSE should be considered in care strategies, and managing its impact on stress perception and responses in pregnant women is crucial.

Too little, too much, and "just right": Exploring the "goldilocks zone" of daily stress reactivity.

Hormetic models of stress resilience describe nonlinear relations for exposure to adversity and health outcomes, where exposure induces salutary changes up to a threshold, with changes becoming deleterious afterward. Here we apply a hormetic model of stress to reactivity to daily stressors, examining whether mental and physical health benefits arise from low-to-moderate reactivity but then decrease at higher levels. Data are from the second wave of the National Study of Daily Experiences (NSDE). Adults (N = 2,022; Mage = 58.61, SD = 12.12, age range: 35-86; 57% female) completed telephone interviews detailing their stressors and affect on eight consecutive evenings. A series of multilevel structural equation models estimated within-person associations between daily stressors and negative affect (i.e., stress reactivity), and between-person linear and quadratic effects of stress reactivity on mental and physical health outcomes (i.e., life satisfaction, psychological distress, and number of chronic conditions). Findings reveal a significant quadratic effect for each outcome, indicating a U-shaped pattern (inverse U for positively valenced life satisfaction), such that low and high levels of stress reactivity were associated with poorer health and well-being, whereas moderate levels of daily stress reactivity predicted better health outcomes. These findings suggest that individuals who display either very low- or very high-stress reactivity may benefit from interventions that target their emotion regulation skills and coping resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Daily Spillover Stressors: Incivility, Work–Family Conflict, and Temporary Smartphone Dependence

Daily Spillover Stressors: Incivility, Work–Family Conflict, and Temporary Smartphone Dependence

Daily external stress, internal stress, dyadic coping, and relationship functioning of Turkish couples during the COVID-19: A daily diary study.

Stressors arising from the current COVID-19 pandemic have pernicious effects on relational functioning. However, the systemic transactional model (STM) addresses the buffering role of dyadic coping in couples' relationships. Therefore, the current study aimed to examine the possible buffering role of dyadic coping and investigate the negative consequences of external stressors related to the COVID-19 pandemic and internal stressors on relationship satisfaction and intimacy on within- and between-person levels. Data were collected from 100 couples through daily diary questions over 14 consecutive days. The mean age for females was 32.45years (SD=8.11), and for males, it was 34.79years (SD=8.79). The findings showed several significant within-person moderation effects. Specifically, simple slope analysis revealed that the associations between internal stress and relationship satisfaction, and intimacy were positive for both partners who reported particularly more dyadic coping on a given day. Conversely, interaction effect of dyadic coping with external stress has not been found significant on within-person level. Between-person effects revealed that dyadic coping buffers the negative association between external stress and relational outcomes and the negative effect of internal stress. The current study expanded the literature of the STM of dyadic coping within the context of an acute external crisis. In line with STM predictions, couples may benefit from interventions focused on enhancing coping strategies to navigate major and minor stressors, especially during significant life challenges, thereby maintaining high relationship quality.

Authentic leadership & PsyCap’s role in tackling, events that impact well-being and environmental sustainability

There is a growing level of awareness among organizational leaders, that stress-induced mental health challenges are on the rise globally. High stress levels are often attributed to a spectrum of causes, from natural and human-made crises to the rapid pace of technological advancements and societal shifts. The number of causes necessitates an examination of not just the cumulative effect of these event constellations, but also their complex interactions, which may amplify stress in ways that are not yet fully understood. These dynamics appear to be contributing to a worrying trend of increased mental illness, anxiety, and depression, notably among professionals on the front lines of these societal changes, like medical practitioners and first responders. For example, there were more fire fighters who committed suicide last year in the US versus those who lost their lives protecting others. Additionally, these professionals are directly exposed to the increasing cases of mental illness, anxiety, and depression among the public, an exposure that further amplifies their own stress levels. Some of the factors contributing to these high levels of stress include natural disasters and human-caused events, as well as some of the most transformative discoveries and innovations in human history. We begin this paper, by examining how a constellation of consequential events are shaping our global society’s well-being, e.g., the COVID 19 pandemic, AI innovation and Climate Change. Next, we examine evidence-based interventions that may offer potential avenues for addressing these high levels of stress. For instance, development interventions focused on authentic leadership that can enhance leader and follower’s psychological capital or PsyCap, resulting in lowering levels of stress, especially when operating in work roles that have higher level of daily stress. These positive forms of leadership help to address the numerous challenges that individudals, organizations and communities face today and well into the future. A clear emphasis in our work is also placed on examining how positive forms of leadership and organizational behavior, can impact two very different, but critically important outcomes, including the individual and collective mental health and well-being in organizations, communities and societies. Consequently, the overall goal here is to recognize the problems we face across a broad range of first responder professions, while offering specific solutions to address those problems.

An unfavorable indoor environment as mediator between fuel poverty and health: an exploration

Abstract Aim The objective of this study is to gain insight into the extent to which an unfavorable indoor environment mediates the association between fuel poverty and health. Method Data from the 2022 Dutch Health Survey were enriched with some registration data from the 2020 Monitor Fuel Poverty, resulting in a study population of 16,210 adults. Using Structural Equation Modeling in R, the mediation effect of an unfavorable indoor environment on the relationship between fuel poverty and various health outcomes was examined. An unfavorable indoor environment was defined as moisture, mold, and/or inadequate ventilation, as indicators of housing quality. Analyses were adjusted for various demographic factors: age, gender, property ownership (tenants or not), level of education, household with or with no children, and level of urbanity of the residence. Results Fuel poverty is negatively associated with the absence of mental health issues and with social capital and positively associated with the risk of anxiety or depression, a negative self-rated health, physical limitations in daily life, loneliness, and stress. These associations are partially mediated by an unfavorable indoor environment (mediation proportion: 5.5–10.8%). In a subgroup analysis of tenants of housing corporations, the mediation proportion ranges from 8.3 to 20.1%. Conclusion An unfavorable housing quality with moisture, mold, and/or inadequate ventilation is a mediating factor in the relationship between fuel poverty and health. Addressing the health effects of fuel poverty requires a comprehensive and structural approach, of which the indoor environment is an integral part. Connecting fuel poverty, housing quality, and health is necessary in both research and policy addressing fuel poverty.

Evaluating Daily Water Stress Index (DWSI) Using Thermal Imaging of Neem Tree Canopies under Bare Soil and Mulching Conditions

Water stress on crops can severely disrupt crop growth and reduce yields, requiring the accurate and prompt diagnosis of crop water stress, especially in semiarid regions. Infrared thermal imaging cameras are effective tools to monitor the spatial distribution of canopy temperature (Tc), which is the basis of the daily water stress index (DWSI) calculation. This research aimed to evaluate the variability of plant water stress under different soil cover conditions through geostatistical techniques, using detailed thermographic images of Neem canopies in the Brazilian northeastern semiarid region. Two experimental plots were established with Neem cropped under mulch and bare soil conditions. Thermal images of the leaves were taken with a portable thermographic camera and processed using Python language and the OpenCV database. The application of the geostatistical technique enabled stress indicator mapping at the leaf scale, with the spherical and exponential models providing the best fit for both soil cover conditions. The results showed that the highest levels of water stress were observed during the months with the highest air temperatures and no rainfall, especially at the apex of the leaf and close to the central veins, due to a negative water balance. Even under extreme drought conditions, mulching reduced Neem physiological water stress, leading to lower plant water stress, associated with a higher soil moisture content and a negative skewness of temperature distribution. Regarding the mapping of the stress index, the sequential Gaussian simulation method reduced the temperature uncertainty and the variation on the leaf surface. Our findings highlight that mapping the Water Stress Index offers a robust framework to precisely detect stress for agricultural management, as well as soil cover management in semiarid regions. These findings underscore the impact of meteorological and planting conditions on leaf temperature and baseline water stress, which can be valuable for regional water resource managers in diagnosing crop water status more accurately.

Daily crowding stress has limited, yet detectable effects on skin and head kidney gene expression in surgically tagged atlantic salmon (Salmo salar)

To ensure welfare-friendly and effective internal tagging, the tagging process should not cause a long-term burden on individuals given that tagged fish serve as representatives for the entire population in telemetry applications. To some extent, stress is inevitable within regular aquaculture practices, and thus, the consequences of long-term stress should be described in terms of their effects on internal tagging. In fish, stressors activate the Hypothalamus-Pituitary-Interrenal (HPI) and Brain-Sympathetic-Chromaffin Cell (BSC) axes, leading to neuroimmunoendocrine communication and paracrine interactions among stress hormones. The interrelation between wound healing and stress is complex, owing to their shared components, pathways, and energy demands. This study assessed 14 genes (mmp9, mmp13, il-2, il-4, il-8a, il-10, il-12, il-17d, il-1b, tnfa, ifng, leg-3, igm, and crh) in the skin (1.5 cm from the wound) and head kidney over eight weeks. These genes, associated with cell signaling in immunity, wound healing, and stress, have previously been identified as influenced and regulated by these processes. Half of a group of Atlantic salmon (n = 90) with surgically implanted dummy smart-tags were exposed to daily crowding stress. The goal was to investigate how this gene panel responds to a wound alone and then to the combined effects of wounding and daily crowding stress. Our observations indicate that chronic stress impacts inflammation and impedes wound healing, as seen through the expression of matrix metalloproteinases genes in the skin but not in the head kidney. This difference is likely due to the ongoing internal wound repair, in contrast to the externally healed wound incision. Cytokine expression, when significant in the skin, was mainly downregulated in both treatments compared to control values, particularly in the study's first half. Conversely, the head kidney showed initial cytokine downregulation followed by upregulation. Across all weeks observed and combining both tissues, the significantly expressed gene differences were 12 % between the Wound and Stress+ groups, 28 % between Wound and Control, and 25 % between Stress+ and Control. Despite significant fluctuations in cytokines, sustained variations across multiple weeks are only evident in a few select genes. Furthermore, Stress+ individuals demonstrated the most cytokine correlations within the head kidney, which may suggest that chronic stress affects cytokine expression. This investigation unveils that the presence of stress and prolonged activation of the HPI axis in an eight weeklong study has limited yet detectable effects on the selected gene expression within immunity, wound healing, and stress, with notable tissue-specific differences.

A qualitative study of cultural concepts of distress among Rohingya refugees in Cox’s Bazar, Bangladesh

BackgroundRohingya refugees residing in Bangladesh have been exposed to profound trauma in addition to ongoing daily stressors of living in the refugee camps. Accurate assessments of mental health burden and their impact among this population require culturally sensitive tools that remain lacking in this context. The purpose of this study was to characterize salient cultural concepts of distress (CCDs), their causes, consequences, and approaches to treatment, among Rohingya refugees living in Cox’s Bazar, Bangladesh, to help inform future measurement and intervention design.MethodsBetween December 2020 and March 2022, 106 free-listing interviews and 10 key informant interviews were conducted with community members to identify and better understand common CCDs. Rohingya research staff analyzed the interview transcripts by tabulating the frequency of unique CCDs in the free-listing interviews and the unique attributed causes, signs, consequences, and treatment strategies for each CCD in the key informant interviews.ResultsIn total, five CCDs were identified: tenshon (tension), bishi sinta (excessive thinking), feshar (pressure), gum zai nofara (unable to sleep), and shoit-shoit lagon (feeling restless and/or trapped). Although the five CCDs had overlapping symptoms, they also had unique presentation, consequences, and preferred strategies for treatment that may impact service-seeking behavior. Three out of the five CCDs were considered life-threatening, if severe and left untreated.ConclusionThe five CCDs identified are culturally salient ways of experiencing and communicating distress within this community but are not adequately captured in existing mental health assessments for this population. This may negatively impact programmatic efforts among the group.

Psycho-social Stressors Experienced by Young war Refugees in Developed Countries: A Scoping Review.

Refugees escaping political unrest and war are an especially vulnerable group. Arrival in high-income countries (HICs) is associated with a 'new type of war', as war refugees experience elevated rates of psycho-social and daily stressors. The purpose of this scoping review is to examine literature on psycho-social stressors amongst young war refugees in HICs and impact of stressors on intergenerational transmission of trauma within parent-child dyads. The secondary objectives are to identify the pre-migration versus post-migration stressors and provide a basis to inform future research projects that aim to lessen the burden of stress and inform evidence-based improvements in this population. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension (PRISMA-ScR) guided the reporting of this review that was performed using a prescribed scoping review method. Extracted from five databases, 23 manuscripts published in 2010 or later met the inclusion criteria. Three themes emerged: pre-migration stressors, migration journey stressors and uncertainty, and post-migration stressors. While post-migration environments can mitigate the health and well-being of war refugees, socio-cultural barriers that refugees often experience at the host country prevent or worsen their psycho-social recovery. To assist the success of war refugees in HICs, therapeutic interventions must follow an intersectional approach and there needs to be a wider application of trauma informed models of care. Findings of this review may help inform future intervention studies aiming to improve the psycho-social health of this population.

Reduced heart rate variability is related to fluctuations in psychological stress levels in daily life.

Laboratory-based studies have shown that psychological stress caused by response to various stressors triggers acute changes in the cardiovascular system. A better understanding is needed of the emerging evidence on temporal associations between psychological stress and cardiovascular responses in natural settings. This study examined the association of psychological stress and heart rate variability (HRV) in daily life, at high resolution over 2weeks, taking the effect of physical activity into account. Participants (n=34) completed ecological momentary assessments (EMA) 6 times per day, reporting levels of perceived stress, low-arousal negative affect (LNA), and high-arousal negative affect. Chest-mounted heart-rate monitors were worn to assess HRV. Multilevel models were used to examine the association between psychological stress levels and preceding/subsequent HRV. Reduced time domain HRV measures (mean and standard deviation of R-wave to R-wave intervals) during the prior hour predicted higher levels of perceived stress. Frequency domain HRV measures higher low to high frequency (LF/HF) and lower HF to total power (HF nu) ratios during the preceding 10min predicted higher perceived stress levels, suggesting the dominance of sympathetic nervous system activity. EMA reports of higher perceived stress levels were associated with reduced time domain HRV measures during the following 10min. On the other hand, higher LNA were related to increased HRV measures, such as lower LF/HF and higher HF nu during the following hour.The dynamic associations observed may have therapeutic implications for 'just-in-time' interventions in the management of daily stress and cardiovascular health.

Risk and protective correlates of suicidality in the military health and well-being project

Suicidality disproportionately affects Veterans, and in 2020 the Military Health and Well-Being Project was conducted in part to study the link between risk and protective constructs with suicidality among Veterans. In the present study, we investigate the relative contribution of risk (i.e., military self-stigma, daily stress, combat exposure, substance use, traumatic brain injury, and moral injury) and protective constructs (i.e., social integration, social contribution, public service motivation, purpose and meaning, and help-seeking) with suicidality. Using cross-sectional Pearson correlation and linear regression models, we studied the independent and relative contribution of risk and protective correlates in a sample of 1469 Veterans (male: n = 985, 67.1 %; female: n = 476, 32.4 %; transgender, non-binary, prefer not to say: n = 8, 0.5 %). When we investigated protective constructs individually as well as simultaneously, social contribution (β = −0.39, t = −15.59, p < 0.001) was the strongest protective construct against suicidality. Social integration (β = −0.13, t = −4.88, p < 0.001) additionally accounted for significant reduction in suicidality when all protective constructs were considered together. When we investigated the contribution of risk constructs towards suicidality, moral injury was most strongly associated with suicidality (r = 0.519, p < 0.001), yet when studied simultaneously for their relative contribution none of the constructs accounted for a significant amount of the variance in suicidality (|t|s ≤ 1.98, ps ≥ 0.07). These findings suggest that among Veterans it is possible that social contribution is protective against suicidality and could be a possible treatment target for the prevention or reduction of suicidality among Veterans.

Habitual behavioural control moderates the relation between daily perceived stress and purging.

Evidence suggests that interpersonal stress plays a role in maintaining binge eating and purging (e.g., self-induced vomiting, misuse of laxatives). Stress is especially likely to promote engagement in maladaptive behaviour if the behaviour is habitual; therefore, individuals whose binge eating and/or purging are habitual may be particularly likely to engage in these behaviours in the context of interpersonal stress. We aimed to investigate this hypothesis in a sample of women with binge eating and/or purging using ecological momentary assessment (EMA). Women (N=81) with binge-eating and/or purging symptoms completed a self-report measure assessing habit strength of binge eating and purging followed by a 14-day EMA protocol assessing daily perceived interpersonal stress and binge-eating and purging episodes. Habit strength of purging moderated the within-person effect of interpersonal stress on purging frequency, such that higher daily stress was associated with greater same-day purging frequency when purging was more habitual. Contrary to expectations, the interactive effect of habit strength of binge eating and daily interpersonal stress on same-day binge-eating frequency was non-significant. Findings suggest that individuals with habitual purging may be vulnerable to engaging in purging when they are experiencing high levels of interpersonal stress.

Lifestyles and Academic Stress in University Students of Health Sciences: A Mixed-Methodology Study.

The global health emergency generated by the COVID-19 pandemic (caused by the SARS-CoV-2 virus) led to the implementation of extraordinary measures such as confinement and isolation in many countries to mitigate the spread of the virus. (1) This study analyzes the lifestyles and academic and perceived stresses of university students of health sciences during the period of online learning due to the COVID-19 pandemic. The relationship between lifestyles and academic stress was examined. (2) A parallel mixed-method convergent study was conducted, with a correlational non-experimental design. Quantitative and qualitative data were collected and analyzed in parallel, with parametric and nonparametric testing for quantitative data and Miles and Huberman's approach to qualitative analysis. The qualitative findings complemented the quantitative results. The number of students who participated in this study was 2734, from six programs in health, nursing, medicine, clinical laboratory, physiotherapy, dentistry, and clinical psychology at the University of Chimborazo, Ecuador. (3) Overall, the health science students had "Unhealthy or health-compromising lifestyles", medical students being the ones who have healthier lifestyles. However, more than 80% experienced and perceived stress during the period of online learning and social isolation due to the pandemic, women being the ones who experienced it at a higher level. (4) The online learning modality during the COVID-19 pandemic modified lifestyles and generated stress in health science students, due to changes in daily routines, sedentary lifestyle, and stress, as a result of social isolation. Therefore, the students prefer face-to-face teaching, perceived as enabling more enriching interactions with their teachers and peers and the opportunity to develop essential practical skills in their health practice.

Demystifying Mental Health by Decoding Facial Action Unit Sequences

Mental health is indispensable for effective daily functioning and stress management. Facial expressions may provide vital clues about the mental state of a person as they are universally consistent across cultures. This study intends to detect the emotional variances through facial micro-expressions using facial action units (AUs) to identify probable mental health issues. In addition, convolutional neural networks (CNN) were used to detect and classify the micro-expressions. Further, combinations of AUs were identified for the segmentation of micro-expressions classes using K-means square. Two benchmarked datasets CASME II and SAMM were employed for the training and evaluation of the model. The model achieved an accuracy of 95.62% on CASME II and 93.21% on the SAMM dataset, respectively. Subsequently, a case analysis was done to identify depressive patients using the proposed framework and it attained an accuracy of 92.99%. This experiment revealed the fact that emotions like disgust, sadness, anger, and surprise are the prominent emotions experienced by depressive patients during communication. The findings suggest that leveraging facial action units for micro-expression detection offers a promising approach to mental health diagnostics.

Virtual reality for postsurgical pain management: An explorative randomized controlled study

BackgroundVirtual reality (VR) is a promising tool in a multimodal analgesic approach; however, evidence regarding virtual reality for postsurgical pain is limited. This study investigates the initial effectiveness and feasibility of self-administered virtual reality in postsurgical pain management. MethodsPatients reporting a postsurgical pain score ≥4 were randomized for control or VR, stratified for 3 interventions with varying levels of immersion and interaction. Subjects were instructed to use virtual reality as add-on treatment at least 3 times a day for 10 minutes on days 2 till 4 postoperatively. Primary outcome was the mean daily pain intensity. Results of pain scores were related to patient and intervention characteristics, to explore which characteristics interact with virtual reality effects. Secondary outcomes were analgesic use, anxiety, stress, and feasibility. ResultsOne hundred patients were included in the analyses: 37 in the control group and 63 for VR. VR did not demonstrate a significant effect on self-reported pain scores (P = .43), nor were specific patient or intervention characteristics associated with greater VR effects. Analgesic usage did not differ between groups. However, there was a trend toward greater cumulative percentages of patients achieving a 30% pain reduction, and significantly lower daily experienced stress (P = .01) and anxiety (P = .03) levels in VR intervention groups. VR was used less than prescribed, mainly because of illness and pain. Adverse events included disorientation, nausea, and fatigue. ConclusionsThis explorative study did not demonstrate initial effectiveness of VR as add-on pain treatment regarding pain and analgesic use; however, VR positively affected stress and anxiety. VR is safe and suitable for a wide target audience, and feasibility differed between interventions. Personalizing and improving VR technology may enhance its effectiveness.

The relation between stress-induced dopamine release in the ventromedial prefrontal cortex, fronto-striatal functional connectivity, and negative urgency: A multimodal investigation using [18F]Fallypride PET, MRI and experience sampling

Negative urgency (NU), or the tendency to act rashly when stress of negative affect is high, could be the result of an insufficient control of the ventromedial prefrontal cortex (vmPFC) over the striatum, through an impaired dopamine (DA) transmission. Therefore, we investigated in vivo human stress-induced DA release in the vmPFC, its relation with fronto-striatal functional connectivity (FC), and NU in daily life. In total, 12 female healthy participants performed a simultaneous [18 F]fallypride PET and fMRI scan during which stress was induced. Regions displaying stress-induced DA release were identified and used to investigate stress-induced changes in fronto-striatal FC. Additionally, participants enrolled in an experience sampling study, reporting on daily life stress and rash actions over a 12-month-long period. Mixed models explored whether stress-induced DA release and FC moderated NU in daily life. Stress led to a lower FC between the vmPFC and dorsal striatum, but a higher FC between the vmPFC and contralateral ventral striatum. Participants with a higher FC between the vmPFC and dorsal striatum displayed more NU in daily life. A higher stress-induced DA release in the vmPFC was related to a higher stress-induced change in FC between the vmPFC and striatum. Participants with a higher DA release in the vmPFC displayed more NU in daily life. In conclusion, stress could differentially impact fronto-striatal FC whereby the connectivity with the dorsal striatum is especially important for NU in daily life. This could be mediated by a higher, but not a lower, stress-induced DA release in the vmPFC.