Greater Stressors Research Articles

Explaining Temporal Trends in School‐Related Stress: A Decomposition Analysis of Repeated Swedish Survey Data

ABSTRACTConcerns related to school are consistently ranked as among the greatest stressors in the lives of adolescents. Research from varying contexts report rising rates of school‐related stress among students, but we currently lack knowledge on what drives these trends. The aim of this study is to investigate the predictors of temporal trends in school‐related stress in Swedish students between 2003 and 2020. To this end, repeated surveys of 9807 Swedish students aged 16 years are analysed using Blinder‐Oaxaca decomposition techniques. The results show that the rise in school‐related stress was primarily due to growing schoolwork difficulties and social exclusion among students, indicating possibly adverse consequences of a large‐scale educational reform as well as of the COVID‐19 pandemic. In addition, rising academic aspirations contributed to the increase, in line with arguments concerning the increasing weight attached to educational success among adolescents in the ‘schooled society’.

Depression causes among medical students at KUMS: A quantitative study

Depression is an important contributor to the global burden of diseases that affect people around the world regardless of their social status and level of education. Students are more vulnerable to this condition as a result of the high level of study demand and performance pressure, especially medical students, who are more prone to extreme stress. Despite this, there have been no recent, multicentre, quantassessing medical students’ greatest stressors. Thus, the aim of this study is to explore and identify the main causes of depression among medical students at Kabul University while examining corresponding data on depression among medical students. 129 medical students at Kabul Medical Sciences were assessed using an online questionnaire form. There are approximately 3000 students currently studying medicine at KUMS from the 1st year to the practical period for MD and DMD. Approximately 400 questionnaires were distributed among the students. 129 students filled out and returned the questionnaires either by hand or by email. 52.8% of students said that the contents of the university’s books cause depression. The total percentage of depression among the medical students was found to be 65.5%. Significance with gender was seen, but no change with age was seen. The study showed that the prevalence of depression among Kabul University of Medical Science students is due to the university’s curriculum. Therefore, attempts should be made to reform the curriculum and teaching methods of the instructors by providing a comprehensive educational program at the university that eliminates the causes and factors that have a direct relationship with educational stressors among medical students. Future research should seek to identify other stressors and suggest possible methods of eradicating them.

Understanding Mass Panic and Other Collective Responses to Threat and Disaster

While mass panic (and/or violence) and self-preservation are often assumed to be the natural response to physical danger and perceived entrapment, the literature indicates that expressions of mutual aid are common and often predominate, and collective flight may be so delayed that survival is threatened. In fact, the typical response to a variety of threats and disasters is not to flee but to seek the proximity of familiar persons and places; moreover, separation from attachment figures is a greater stressor than physical danger. Such observations can be explained by an alternative “social attachment” model that recognizes the fundamentally gregarious nature of human beings and the primacy of attachments. In the relatively rare instances where flight occurs, the latter can be understood as one aspect of a more general affiliative response that involves escaping from certain situations and moving toward other situations that are perceived as familiar but which may not necessarily be objectively safe. The occurrence of flight-and-affiliation depends mainly on the social context and especially the whereabouts of familiar persons (i.e., attachment figures); their physical presence has a calming effect and reduces the probability of flight-and-affiliation, while their absence has the opposite effect. Combining the factors of perceived physical danger and the location of attachment figures results in a four-fold typology that encompasses a wide spectrum of collective responses to threat and disaster. Implications of the model for predicting community responses to terrorist attacks and/or use of weapons of mass destruction are briefly discussed.

Stressful events among adolescents from public schools in a community in Brazil

Introduction Adolescence can be seen as a fundamental stage of life for the construction of the subject, resulting from childhood experiences and decisive for adulthood. It is common stressors to appear during adolescence, due to the lack of necessary resources to deal with a stressful problem or event. In this way, the evaluation of a stressful situation by the adolescent is important, because from it he will develop coping strategies that will help him to deal with the problem. Stressful life experiences, whether important events or even common annoyances, threaten the adolescent’s well-being, in addition to being linked to mental health and behavior problems, both internalizing ones, such as isolation, somatic complaints and anxiety/depression, as well as externalizing factors such as breaking rules and aggressive behavior. Romantic relationships are related to a major source of stress in the lives of these young people when conflicts, jealousy, aggression and infidelity occur, and have a great impact on the mental health of the individuals involved. Breakups, for example, have been linked to the onset of clinical depression in adolescents.There are three categories of concern for adolescents: (a) related to achievements, such as success in school or opportunity for success in the future; (b) relationships with colleagues or family members; and (c) social problems such as the environment, poverty and unemployment.ObjectivesTo identify and describe stressful life events in adolescents from public schools in a poor community in Brazil.MethodsThe study included 64 adolescents, boys (51.56%) and girls (48.43%), aged between 12 and 16 years old (average 13.76%). The Adolescent Perceived Events Scale (APES) was used, which consists of 90 items that correspond to events that may occur in the adolescent’s daily life.ResultsThe most significant stressors for the adolescents in this study were those dealing with the death of close people, such as a friend (100%), a family member (96.29%) and a relative (94.73%). Also appearing as major stressors were “plans that did not work” (91.89%), use of alcohol or drugs by family members (87.5%), loss of a job by parents (75%), imprisonment of a family member (75%), fights with boyfriend or girlfriend (86.66%), breakup (75%) and concern about their own appearance (76.52%).ConclusionsEvents referring to interpersonal relationships were considered the greatest stressors, with percentages above 80%. The present study contributed to the understanding of adolescents’ perceptions of their life events. In this way, we can understand the relationship between stressors and the coping strategies. Furthermore, it allows the proposition of preventive intervention strategies in the school context.Disclosure of InterestNone Declared

UNDERSTANDING THE EXPERIENCE OF EUSTRESS AMONG OLDER ADULTS WITH CHRONIC CONDITIONS

Abstract In their longitudinal study of stress and health among adults, McGonigal and colleagues (2013; 2016) suggested that how person perceives stress is a key factor affecting their actual physiological health. This is related to the concept of eustress (i.e., positive response to a given stressor) which has received very little attention in the literature. Besides, older adults with chronic conditions deal with symptoms that are difficult to manage and can contribute to chronic stress, which can then affect their health status and quality of life. Thus, helping older adults to shift their perceptions and interpretations of stressors from distress to eustress, rather than trying to avoid stress seems to be a reasonable approach to help them experience healthy aging. The purpose of this study was to explore the experience of eustress among older adults with chronic conditions in the context of leisure. Sixteen participants were recruited from three settings in a Midwestern city: a retirement community, an assisted living center, and a community senior program. Findings showed that participants’ health conditions were one of their greatest stressors, however, they modified their leisure engagement based on their conditions to enable their engagement in valued leisure activities. In the context of leisure, five themes emerged as facilitators that helped older adults to experience eustress: leisure satisfaction, sense of control, high levels of perseverance, positive attitude, and spiritual belief. Direct quotes and further discussion on how the themes are represented in the stress, leisure, and gerontology literature will be presented.

The Recover Study: A Cross-Sectional Examination of the Relationship Between Ontario Parents' Resilience and COVID-19-Related Stressors.

Resilience, or the ability to bounce back despite facing adversities, may influence parents’ abilities to handle the multitude of parent-specific COVID-19-related challenges that have faced them. This cross-sectional study examined (1) the relationship between parents’ resilience and their COVID-19-related family stressors; (2) parents’ perceptions of their greatest stressors throughout the pandemic; and (3) non-school-related challenges and their resultant impact on parents’ and children's resilience. Via an online survey, data was collected from 63 parents (Mage = 37.09; 82.54% female). A significant relationship was found between parents’ resilience and both their COVID-19-related stressors and family stressors. Parents described stressors challenging their resilience, including impacts on their mental health, managing occupational and educational responsibilities, social isolation, and economic setbacks, while also noting the impacts of social isolation, missing extracurricular activities, and lacking routines for their children. Overall, Ontario parents high in resilience are likely better positioned to adapt to pandemic-related stressors.

Maternal Stress Experience in the Neonatal Intensive Care Unit after Preterm Delivery.

Preterm delivery with the admission of a child in the neonatal intensive care unit (NICU) is extremely challenging for parents. Being separated from the baby and seeing her infant feeling pain and being sick together with the complexity of the NICU environment, the mother experiences great anxiety, fear, and stress. The purpose of the study was to assess NICU-related stress and to identify maternal and infant factors associated with increased stress in mothers of preterm infants. The maternal stress level was assessed in 122 mothers of preterm infants using the Parental Stressor Scale: NICU (PSS: NICU) in which items were distributed in three subscales as follows: Sights and Sounds of NICU-subscale 1 (S1), Infant Appearance and Behavior-S2, and Parental Role Alteration-S3. Maternal total PSS: NICU score was 3.46 ± 0.71. Parenteral Role Alteration was the most stressful (4.20 ± 0.79) followed by Infant Appearance and Behavior (3.51 ± 0.91) and Sights and Sounds subscale (2.28 ± 0.95); p (S1-S2) < 0.001, p (S1-S3) < 0.001, and p (S2-S3) < 0.001. Total PSS: NICU and Infant Appearance and Behavior scores correlated positively with maternal age (r = 0.189; p = 0.040 and r = 0.204; p = 0.027, respectively) and duration of NICU treatment (r = 0.188; p = 0.044 and r = 0.190; p = 0.042). More visits in NICU by a mother were associated with a lower PSS: NICU score (p = 0.049) and neonatal seizures and invasive ventilation in infants were associated with higher stress scores (p = 0.007 and p = 0.042). Mothers of preterm infants admitted in the NICU experience significant stress which is correlated with maternal age and NICU treatment duration and is associated with frequency of NICU visits, presence of neonatal seizures, and need for ventilator support. Parental role alteration is the greatest stressor followed by Infant Appearance and Behavior and NICU-surrounding stressor factors which show the need for interventions and counseling focused on mothers' role, their involvement in infant's care, and thus, family-centered care implementation. · Mothers of preterm infants experience significant stress.. · Parental role alteration is the greatest maternal stressor.. · Maternal stress is correlated with age and NICU duration, and is associated with the frequency of NICU visits and infant's health status.

The Cure SMA Clinical Trial Experience Survey: A Study of Trial Participant Perspectives on Clinical Trial Management and Patient-Centric Management Practices.

IntroductionUnderstanding clinical trial experiences can illuminate opportunities to optimize trial design and management, with potential benefits for recruitment and retention. This study sought to better understand clinical trial participant experiences and attitudes within spinal muscular atrophy (SMA), and how the evolving treatment landscape and participant characteristics may predict attitudes.MethodsA survey was developed following a review of published literature and discussions with caregivers of SMA trial participants. This was distributed via email to known trial participants in Cure SMA’s database, announcements in Cure SMA’s newsletter, and emails to SMA clinical trial principal investigators.ResultsSeventy complete surveys reflecting unique clinical trial experiences were included in analysis. Responses revealed positive attitudes about clinical trial management overall. Top motivators for trial participation included clinical benefit, investigational drug access, and the opportunity to help others. Top concerns were safety, whether benefits would justify risks, and concerns about pain accompanying tests. The greatest stressors were fear of pain, adverse event concerns, and challenges managing medical complications of SMA. Top benefits of trial participation were hope for a better future, helping others, and relationships with the study team. In regression analysis, participant gender, age, and race all emerged as significant predictors (p < 0.05) of motivators, concerns, stressors, and benefits, as did respondent type, knowledge about SMA, distance to the trial site, and treatment era. Top recommendations for improving study management all related to receiving more information.ConclusionThis research provides new perspective on patient experiences in SMA clinical trials. It underscores the importance of information and efforts to anticipate and accommodate participant needs. These findings may inform study design and interactions with research participants. They may become especially important in supporting recruitment and retention as more treatment options become available.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40120-022-00360-w.

Do neonatal nurses′ perceptions agree with parents’ self-reported needs and stressors in a surgical neonatal intensive care unit?

To explore neonatal nurses' and parents’ perceptions of parental needs and stressors in a surgical neonatal intensive care unit (NICU) using the Neonatal Family Needs Inventory and Parental Stressor Scale:NICU. Matched data for 99 nurse-parent dyads showed only limited agreement (Gwet's agreement coefficients 0.23 - 0.26). Nurses recognised Assurance as parents' priority need and Parental Role Alteration as parents' greatest stressor. They identified 8 of parents' 10 most important needs and recognised parents' highest stressors. Nurses under-estimated the importance of mothers' (p's < 0.01, large effect sizes [ES]) but not fathers' needs. They under-rated parents' stress at feeling helpless to protect their baby and overrated stress around NICU sights and sounds (medium ES's). Nurses' years of NICU experience showed no significant effects. Greater awareness is needed of the importance and uniqueness of parents’ needs and stressors. Education to enhance attunement would better support individualized family-centred care.

Factors that shape pregnant women\u2019s perceptions regarding the safety of cannabis use during pregnancy

BackgroundCannabis use among pregnant women has increased. We surveyed pregnant women in rural Pennsylvania to examine cannabis use and opinions regarding its safety during pregnancy. We examined associations between challenges of pregnancy (e.g., exhaustion, pain, nausea) and cannabis use.MethodsA cross-sectional survey was administered to a convenience sample of English-speaking pregnant women receiving prenatal care at Geisinger, May–June 2019. Principal component analysis (PCA) was used to construct three scores (overwhelmed/exhausted, happy/optimistic, and health worries) based on 10 questions regarding common experiences during pregnancy (e.g., nausea/vomiting, pain, exhaustion, mood). A score based on four questions regarding cannabis safety during pregnancy was also constructed.ResultsFrom a maximum of 300 surveys distributed, 284 were completed (95%). Most participants were white (87%), married (49%) or living with a partner (38%), and had private health insurance (62%). Most women indicated it was unsafe to use alcohol and tobacco products during pregnancy (> 90%), but that proportion dropped to 82% and 63% regarding recreational cannabis and medical cannabis, respectively. Only women with prior cannabis use (23% of sample) continued to do so during pregnancy: 57% of women reporting daily cannabis use prior to pregnancy continued to use cannabis during pregnancy with 33% reporting daily use. Two thirds of users during pregnancy indicated they were self-medicating for: nausea (90%), anxiety (70%), insomnia (30%), and pain management (30%). Many (56%) of the women who used cannabis during pregnancy believed it is safe. Younger women and women who were overwhelmed/exhausted or less happy/optimistic were more likely to believe cannabis use is safe. Women valued healthcare provider advice more than advice from family and friends. Study strengths include a high response rate. Weaknesses include self-report and that is was a convenience sample; however, the demographics of the sample were similar to past studies.ConclusionWomen with a history of cannabis use, especially daily use, are at risk of continuing during pregnancy and should receive counseling. Younger women and women with greater stressors during pregnancy also are at greater risk. Screening for prior use and for stressors may identify patients that would benefit from enhanced counseling.

Neonatal medical trainee doctors' perceptions and parents' self-reported needs and stressors in a surgical neonatal intensive care unit: An individualised approach.

As more infants survive surgery in the newborn period for major congenital anomalies, the focus has shifted to the quality of care for parents as well as infants. In contemporary neonatal intensive care units (NICUs), doctors are encouraged to practice family-centred care and partner with parents in their infant's care. This study explored doctors' perceptions and parents' self-reported needs and stressors in a surgical NICU. From January 2014 to September 2015, parents of infants admitted for general surgery for a major congenital anomaly who were present in the NICU between 48 and 72 h of admission and doctors caring for their infant at the time of data collection were invited to participate. Matched data were provided using the Neonatal Family Needs Inventory and the Parental Stressor Scale:NICU. Matched data for 12 doctor-parent dyads showed that doctors (neonatal medical trainees) consistently under-rated the importance of parents' needs and identified fewer of mothers' than fathers' most important needs. Doctors also consistently under-rated parents' stressors. They perceived few of fathers', but all of mothers', greatest stressors. Thematic analysis revealed four themes: infant pain management; parental autonomy; empathy; and communicating reassurance and education to parents. The findings suggest incongruences between doctors' perceptions and parents' self-reported needs and stressors. While there is hesitation in making recommendations with this sample size, the findings highlight issues that may inform further research and contribute to a dialogue regarding the role of doctors in family-centred relationship-based models of care in the NICU.

Attitudes and stressors related to the SARS-CoV-2 pandemic among emergency medical services workers in Germany: a cross-sectional study

BackgroundThe aim was to investigate attitudes and stressors related to the SARS-CoV-2 outbreak among emergency medical services (EMS) workers in Germany. We further aimed to detect possible changes within a 5-week period and potential determinants of attitudes and stressors.MethodsWe conducted two cross-sectional studies using an online questionnaire in early April 2020 (i.e., the first peak of the SARS-CoV-2 outbreak in Germany) and five weeks later. The study instrument comprised sociodemographic items, self-devised items on pandemic-related attitudes, stressors and work outcomes, and established instruments assessing depressive symptoms and symptoms of anxiety. Logistic regression was performed to identify possible determinants.ResultsData of 1537 participants was included in the analysis (April: n = 1124, May: n = 413, 83.1% male, median age 32). Most participants agreed that their personal risk of infection was higher compared to the general population (April: 87.0% agreement, May: 78.9%). The greatest stressor was uncertainty about the pandemic’s temporal scope (82.0 and 80.9%, respectively). Most participants (69.9, 79.7%) felt sufficiently prepared for the pandemic and only few felt burdened by their financial situation (18.8, 13.3%). Agreement to all stressors decreased from April to May except related to the childcare situation. Regression analysis identified subgroups to be burdened more frequently such as older employees, those with SARS-CoV-2 cases among their colleagues, and those with lower paramedic training levels.ConclusionsWe identified key SARS-CoV-2-related stressors whose levels generally decreased within a 5-week period. Our results indicate that EMS workers are less affected by existential fears and rather worry about their personal infection risk.

Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment.

Losing a loved one is one of life's greatest stressors. Although most bereaved individuals navigate through a period of intense acute grief that lessens with time, approximately 10% will develop a prolonged grief condition. This review provides an overview of the course of grief and describes risk factors for developing prolonged grief disorder. The evolution of the prolonged grief disorder diagnosis, including the latest criteria sets for ICD-11 and DSM-5, as well as common comorbid conditions and differential diagnosis are discussed. Clinically useful self-report and clinician-rated measures for assessing symptom constructs and overall prolonged grief disorder severity, evidence-based psychotherapies (such as complicated grief treatment), as well as evidence about pharmacologic approaches are presented. Finally, the authors discuss important future directions, including a potential increase in prolonged grief disorder cases due to the COVID-19 pandemic.

A Cross Sectional Study on the Effect of Stress and Academic Stressors Among International Medical Students of a Romanian University

Medical students are exposed to increased stress due to academic, psycho-social and health-related factors. This study aimed to assess the levels of stress and the associations with socio-demographic characteristics and academic performance; the frequency of the major academic stressors; the most stressful factors as stated by the students themselves. A cross-sectional study including 110 international medical students of the 3rd-year was performed in the first two weeks of November 2019. A questionnaire including socio-demographic data, a list with potential academic stressors and an open question regarding the greatest stressors in student’s opinion as well as The Kessler Psychological Distress Scale, was administrated in pen-andpaper format. Mild, moderate and severe levels of stress were found in 36.73%, 22.44 %, and 13.26 % of students, respectively. Increased levels of stress were associated with poor academic performance and did not correlate with age or country of origin. The frequency of moderate and severe stress was 3-times greater in women than in men. The most stressful factors in students’ opinion were the academic stressors (88.77%) followed by psychosocial factors (25.51%) and health-related factors (9.18%). The frequency of examination was perceived as a stressor always present by more than 25% of the students. Most of the students showed elevated levels of stress. Academic factors were the most important stressors in students’ opinion. Further research is needed to identify the proper strategy to rectify academicrelated problems to decrease the levels of stress.

Individual and joint associations of daily sleep and stress with daily well-being in hospital nurses: an ecological momentary assessment and actigraphy study

Sleep and stress are predictors of daily physical and emotional well-being, but few studies assess both simultaneously. This study examined individual and joint associations of daily sleep and stress with daily well-being (DWB) in hospital nurses. Nurses (n = 60) participated in a 14-day ecological momentary assessment and actigraphy study. Multilevel modeling revealed associations of stressor severity and poor sleep health with DWB, independent of and coupled with each other, at within- and between-person levels. Greater stressor severity or poorer sleep health, independent of each other, were associated with more physical symptoms, less positive affect (PA), and more negative affect (NA). Joint associations of stress and sleep with DWB were observed: PA was lowest when higher stressor severity was coupled with poorer sleep health; NA was lowest when lower stressor severity was coupled with better sleep health. Findings suggest the importance of considering both sleep and stress for DWB in hospital nurses.

Exposure to a mimetic or non-mimetic model avian brood parasite egg does not produce differential glucocorticoid responses in an egg-accepter host species

Avian obligate brood parasitism, a reproductive strategy where a parasite lays its egg into the nest of another species, imposes significant fitness costs upon host parents and their offspring. To combat brood parasitism, many host species recognize and reject foreign eggs (rejecters), but others are accepters that raise the parasitic progeny. Some accepter hosts may be unable to grasp or pierce parasitic eggs even if they recognize them as foreign eggs in the clutch, whereas other accepters may not have evolved the cognitive skillsets to recognize dissimilar eggs in the nest. Here we assessed the endocrine responses of an accepter host species to model parasitic eggs to address these two alternatives. We experimentally parasitized nests of a locally common host of the brood-parasitic brown-headed cowbird (Molothrus ater), the prothonotary warbler (Protonotaria citrea; a cowbird-egg accepter), with a mimetic or non-mimetic model cowbird-sized egg. Our goal was to determine whether they perceived the non-mimetic egg as a greater stressor by measuring circulating corticosterone levels. We added eggs to nests during the incubation stage and obtained blood plasma samples from females on the nest 2 h later, using females with unmanipulated clutches as controls. Incubating females showed no differences in baseline plasma corticosterone levels between our different treatments. We conclude that exposure to foreign eggs does not activate the hypothalamic–pituitary–adrenal axis of prothonotary warbler hosts in this experimental paradigm.

The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale.

Objectives:To investigate the most common sources of stress faced by medical students and the degree to which different stressors impact their lives. As a secondary objective, a new instrument, Medical Student Stress Factor Scale (MSSF), was developed based on these stressors.Methods:The MSSF was applied to 431 medical students. The Depression, Anxiety and Stress Scale was administered to investigate the relationship between these stressors and the students’ mental health.Results:The five greatest stressors were the extensive content, lack of time to study, sleep deprivation, excessive self-pressure for good grades, and lack of leisure time. The MSSF showed good psychometric characteristics, resulting in a 28-item scale with five subscales. The Relationships and Health subscales were associated with depressive symptoms; Relationships, Health, and Learning Environment/Academic Performance were associated with anxiety symptoms, while Health, and Learning Environment/Academic Performance were associated with stress symptoms.Conclusions:Our study presents important data about the most important stressors that affect medical students’ lives and cause mental health issues. The factors are generally related to academic performance and the learning environment and should be targeted in future interventions.

The role of psychological variables in improving resilience: Comparison of an online intervention with a face-to-face intervention. A randomised controlled clinical trial in students of health sciences

BackgroundMost studies on improving resilience lack representative samples and pre- and post-intervention assessments. Results regarding the effectiveness of online interventions versus face-to-face interventions are mixed. ObjectivesTo evaluate the effectiveness of online and face-to-face programmes for the improvement of coping strategies to develop resilience to stressful situations, and to assess their relationship with personality traits, mood, and academic stressors. DesignRandomised controlled clinical trial. Three-armed parallel design. Participants245 students of the Nursing and Physical Therapy Degree. MethodsStudents were randomly assigned to the control group (CG), intervention group 1 (IG-1, face-to-face) or intervention group 2 (IG-2, online). They were assessed after the intervention with the following instruments: the Positive and Negative Affect Schedule (PANAS), the Academic Stressors Scale, the Coping Orientation to Problems Experienced (COPE), the Connor-Davidson Resilience Scale, and the NEO-FFI scale. ResultsNegative affect was higher in IG-1 (p = 0.12). The greatest stressors were methodological deficiencies of the teaching staff, academic overload, and beliefs about academic performance. The most widely used coping strategies were “Active Problem-Focused Coping” and “Seeking Social Support”. There were differences between IG-1 and IG-2 only regarding “Focus on and Venting of Emotions” (p = 0.086). On the Resilience scale, “Persistence, Tenacity, and Self-Efficacy” was higher in the CG, and there were differences with IG-1 (p = 0.06). With respect to the traits measured by the NEO-FFI questionnaire, higher levels of emotional instability (neuroticism) were observed in IG-1 than in the CG (p = 0.06). ConclusionsThe results of both interventions are similar, with increased self-awareness of negative personality traits, which is useful for those ignoring their areas for improvement. In addition, these factors are further increased in individuals with high levels of neuroticism and low levels of extraversion. The online intervention was as effective as the face-to-face intervention.

Daily Association Between Sleep and Stressors: Role of Caregiving at Work and Home

Previous research shows that adults with children experience poor sleep. We know that poor sleep is associated with experiencing more frequent and severe stressors (i.e, subjective feelings of believing his/her life is uncontrollable, unpredictable and overloading) the following day. This study examined whether the sleep—stressor relationship is stronger for individuals with children than those without. Participants were 61 oncology nurses (92% female). Participants completed a background survey that assessed sociodemographic and work characteristics. Using 14 days of ecological momentary assessments, participants reported their sleep characteristics daily upon waking. Three times daily, they also reported whether they experienced any stressors and how severe those stressors were. Multilevel modeling was used to assess whether the sleep—stressor relationship was stronger in nurses with children than those without. After controlling for sociodemographic covariates, poorer sleep quality was associated with more severe stressors. This daily association was moderated by the presence of children (B=-16.89, p<.01); the association was apparent for individuals with children (B=-5.74, p<.05), but not for those without. The daily association for sleep quality and stressor frequency also differed by the presence of children (B=-0.22, p<.01), although the slope for individuals without children did not reach the statistical significance. These findings suggest that individuals with children are at risk for experiencing a stronger linkage between poorer sleep and greater stressor severity. Improving sleep health among adults with children is critical for stress management. Future studies should examine whether age of children or number of children further influences the sleep—stressor relationship.

Mechanisms of Cardiometabolic Disparities: Stressor Characteristics Linked to HPA-Axis Dysregulation

Diurnal cortisol slopes are stress-sensitive HPA-axis biomarkers implicated in cardiometabolic health outcomes and disparities. This study used two longitudinal cohort studies (CREATE and TRIAD) with harmonized variables to comprehensively examine what types of exposure to stressors are most salient for cortisol dysregulation in later life, and whether the characteristics of stressor exposure accounts for Black-White disparities in cortisol dysregulation (merged sample N=209, 65% male, mean age 61, 17% Black). Black participants reported greater stressor exposure than Whites along some dimensions (e.g., # recent major stressors, appraised severity of lifetime stressors, all p<.02) but comparable exposure in others (e.g., # of lifetime stressors and life domains). Stressor exposure measures that captured psychological components (i.e., appraised severity, psychological distress) and pervasiveness (i.e., # life domains with major stressors) were more closely related to cortisol dysregulation than more objective measures (e.g., # of recent /lifetime stressors). Everyday discrimination was associated with racial disparities.