Higher Levels Of Perceived Stress Research Articles

Post-traumatic stress disorder and associated factors among high school students who experienced war in Woldia town.

The experience of war in recent time is very common around the world, and the impact is profound on the mental health of the victims, especially among the young population. The most implicated mental health problem is post-traumatic stress disorder, which comes after an exposure to trauma as a severe and long-term result of the traumatic event. Studies in developed countries revealed this finding, but there is insufficient information in developing countries, where much of war and conflict exist and young population live including Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of post-traumatic stress disorder among high school students who experienced war. We assessed the prevalence and factors associated with post-traumatic stress disorder among high school students who experienced war. A multi-centered school base cross-sectional study was conducted from May 23 to June 08, 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression was used to identify the independent factors associated with post-traumatic stress disorder. A total of 338 of the 410 students participated in this study (94.5% response rate). The prevalence of post-traumatic stress disorder was 39.2%. In the multivariable analysis, poor social support (AOR = 3.40, 95% CI: 1.45, 7.95), depression (AOR = 3.24, 95% CI: 1.69,6.21), high level of perceived stress (AOR = 2.98, 95% CI: 1.61, 5.50), being in war fighting situation (AOR = 2.85, 95% CI: 1.40, 5.78), and witnessing the murder of family members or friends (AOR = 3.05, 95% CI: 1.47, 6.32) were factors significantly associated with post-traumatic stress disorder at a p-value <0.05. In this study, around two in five of high school students had post-traumatic stress disorder. Independent factors of PTSD were depression, high stress levels, poor social support, witnessing the murder of family members/friends, and being in war fighting situation. We recommend that the Ministry of Education and the Ministry of Health collaborate to integrate mental health services into schools. This focuses on the early detection of students at risk of PTSD, such as those with depression, high perceived stress levels, and exposure to murder or war, and provides necessary social support to prevent PTSD.

A study of the relationship and mediating effects of perceived stress and post-traumatic growth in patients undergoing postoperative chemotherapy for breast cancer

ObjectiveThe traumatic experience of cancer, in addition to its negative impact on breast cancer patients, can also bring about positive change, i.e., post-traumatic growth (PTG). PTG can help boost patients’ confidence in their fight against the disease and improve their adherence to treatment, thereby facilitating their recovery. The study aimed to investigate the effect of perceived stress on the PTG of patients undergoing postoperative chemotherapy for breast cancer and to examine the roles of rumination and self-efficacy between two. MethodsThe data was collected using a cross-sectional design. From December 2021 to October 2022, a total of 306 breast cancer patients who had undergone chemotherapy following surgery and met the inclusion and exclusion criteria were selected from three tertiary-level A hospitals in Henan Province, China. We conducted descriptive analysis, Pearson correlation analysis, and a regression analysis using PROCESS Macro Model 80 to explore the relationships among perceived stress, rumination, self-efficacy, and PTG. ResultsPerceived stress of patients undergoing postoperative chemotherapy for breast cancer had a negative predictive effect on PTG (r = −0.340, P < 0.01); Rumination and self-efficacy played a partial mediating effect between perceived stress and PTG, accounting for 45.25% of the total effect. ConclusionsClinical nursing staff could promote PTG by strengthening psychological assessment and timely psychological intervention for patients with high perceived stress levels, encourage patients to adopt a positive way of thinking about illness and improve their self-efficacy level, so as to improve their PTG level.

Gene-environment interaction between gaming addiction and perceived stress in late adolescents and young adults: A twin study.

The association between perceived stress (PS) and gaming addiction (GA) is well documented. However, the mechanism for explaining this association remains unclear. Using a genetically informative design, this study aims to distinguish between the diathesis-stress and bio-ecological models of gene by environment interaction (G x E) to explain the underlying mechanism of the relationship. In total, 1,468 twins (mean age = 22.6 ± 2.8 years) completed an online survey including the GA and PS scales. Twin correlations for GA and PS were computed and univariate model-fitting analysis was conducted to determine genetic and environmental influences on GA and PS. The bivariate G x E model-fitting analysis was performed to determine the best G x E interaction model. Additive genetic, shared environmental, and non-shared environmental effects were 0.70 (95%CI = 0.61, 0.77), 0.00, and 0.30 (95%CI = 0.26, 0.33), and 0.38 (95%CI = 0.24, 0.55), 0.35 (95% CI= 0.18, 0.51), and 0.22 (95%CI = 0.20, 0.26) for GA and PS, respectively. Bivariate G x E model-fitting analysis supported the diathesis-stress model, where genetic influences on GA were greater in higher levels of PS, whereas environmental influences on GA were small and constant across levels of PS. The evidence for the diathesis-stress model for GA is consistent with the etiological process of many forms of psychopathology. The findings should be incorporated in clinical settings to improve the treatment of GA, and used in developments of intervention and prevention methods for GA.

Overweight and Obesity Is Associated with Higher Risk of Perceived Stress and Poor Sleep Quality in Young Adults.

Background and Objectives: Overweight and obesity are growing public health challenges, particularly concerning young adults. University life presents a unique set of stressors that may influence weight management alongside sleep quality. In this cross-sectional study, we aimed to investigate the association between overweight or obesity, stress, and sleep quality in a large sample of Greek university students. Materials and Methods: The study recruited 2116 active students from across various Greek universities. Participants completed questionnaires on sociodemographics, academic performance, and physical activity levels using the International Physical Activity Questionnaire (IPAQ). Stress and sleep quality were assessed using the Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI), respectively. Body weight and height were directly measured to calculate Body Mass Index (BMI). Results: Our analysis of 2116 Greek university students revealed significant associations between various factors and overweight/obesity. Compared to their rural counterparts, young adults in urban areas had an 88% higher prevalence of overweight/obesity (p = 0.0056). Regular smokers were twice as likely to be overweight or obese (p = 0.0012). Notably, those with low physical activity levels displayed a more than two-fold increased risk (p = 0.0008) compared to those with moderate or high activity levels. Similarly, students with moderate or high perceived stress levels had a more than two-fold prevalence of overweight/obesity compared to those with low stress (p = 0.0005). Inadequate sleep quality was also associated with an 86% higher risk of overweight/obesity (p = 0.0007). Interestingly, good academic performance showed a 57% greater prevalence of overweight/obesity compared to very good/excellent performance (p = 0.0103). Conclusions: Our findings reveal that perceived stress and poor sleep quality are significant risk factors for overweight and obesity in this young adult population.

Population under Stress: The Coping Mechanisms of Lebanese Adults in Times of Intermingling Crises and Their Relationship with Stress.

The Lebanese population has faced numerous stressors due to multiple crises in the past four years. This study aims to measure the perceived stress of the Lebanese population, identify the coping mechanisms being used, and determine whether they are associated with their stress levels. A cross-sectional study of 205 individuals randomly selected from Beirut was conducted. Frequency distribution, descriptive analysis, and multivariable cumulative logit models were used to determine the associations between coping mechanisms and perceived stress. Our results indicated that 95.4% of our population had moderate to high perceived stress levels. Problem-focused coping was the most adopted mechanism and was associated with a statistically significant lower stress level, whereas avoidant coping was associated with a statistically significant higher stress level. Our study can pave the way for raising awareness on the importance of managing stress with adaptive coping mechanisms.

Perceived Stress, Depression, Anxiety, and Stress Among Frontline Healthcare Workers Working in COVID-19 Level 2 Hospital

Perceived Stress, Depression, Anxiety, and Stress Among Frontline Healthcare Workers Working in COVID-19 Level 2 Hospital

Smartphone use and its association with body image distortion and weight loss behaviours among adolescents in Saudi Arabia.

Concerns about the harmful effects of smartphone use on teenage development have been raised as the use of cell phones among adolescents has risen. This study aimed to examine the associations of smartphone usage patterns with Body Image Distortion (BID) and weight loss behaviors among adolescent smartphone users in Saudi Arabia. This population-based, cross-sectional study was conducted from July to October 2022. We assessed the mean daily length of smartphone use and classified it into quartiles using data from a self-reported survey and data on weekday and weekend use. Self-reported body weight and height were collected via an online survey. Out of the 11384 adolescents, the majority was females (65.7%) and was secondary school students (68.9%). The prolonged smartphone use (301 min/d) was found in 36.4% of adolescents, 181-300 min/d in 27.6% of respondents, 121-180 min/d in 22.4% of respondents, while the modest smartphone use (1-120 min/d) was found only in 13.6% of participants. The duration of smartphone use was significantly associated with BID (P= 0.000); students with middle perceived stress levels (51.4%) and no depressive symptoms (68.9%) used smartphones 121-180 min/d sparingly. However, prolonged smartphone use was significantly associated with the presence of depressive symptoms (42.6%) and high perceived stress levels (21.5%). Weight loss behaviors were significantly associated with smartphone use duration. Modest smartphone use was significantly found in students with normal weight (P= 0.00, 71.9%); however, aerobic physical activity weight loss strategy (P= 0.00, 30.9%) was correlated with prolonged smartphone use. Adequate parental advice is required to assist teenagers in developing healthy smartphone usage practices. Digital platform companies may increase their social responsibility for the information generated and delivered on their networks, boosting its beneficial effect.

Sleep quality in relation to perceived psychological stress in patients with type 2 diabetes and in age- and sex-matched control individuals.

To assess sleep quality in relation to perceived stress in patients with type 2 diabetes (T2DM) and age- and sex-matched controls. Perceived stress level and sleep quality assessed in 154 patients with T2DM (58 men, 96 women, age 58.3 ± 11.9years), 154 matched controls (58 men, 96 women, age 56.8 ± 12.2years) using Perceived Stress Scale and Pittsburgh Sleep Quality Index. Patients with T2DM had worse subjective sleep quality (p < 0.001), sleep latency (p = 0.047) than controls. Patients with high stress level had worse subjective sleep quality (p = 0.027), higher use of sleeping medication (p = 0.023), daytime dysfunction (p < 0.001) than those with low stress level. No significant differences in sleep quality between controls with high and low perceived stress level. Perceived stress level in patients with T2DM correlated with subjective sleep quality (r = 0.260, p = 0.002), sleep duration (r = 0.228, p = 0.005), use of sleep medication (r = 0.245, p = 0.004), daytime dysfunction (r = 0.326, p < 0.001), in age- and sex-matched controls-to daytime dysfunction (r = 0.191, p = 0.037). Sleep quality (subjective sleep quality, sleep latency) is worse in patients with type 2 diabetes than in age- and sex-matched controls. Patients with high perceived stress level have worse subjective sleep quality, higher use of sleeping medication, daytime dysfunction than patients with low perceived stress level; no significant differences in sleep quality between controls with high and low stress level. Perceived stress level in patients with type 2 diabetes is related to subjective sleep quality, sleep duration, use of sleep medication, daytime dysfunction, in age- and sex-matched controls-to daytime dysfunction.

Homelessness and psychosocial resources: the role of stress and psychological capital

Objective: Homelessness is widely recognised as a social problem which has major health consequences for those who experience the condition. The aims of the study were to a) to develop a brief homelessness stress scale based on previous evidence, b) determine whether the experience of being homeless is a source of psychological distress, c) determine whether stress is associated with negative health behaviour and psychological disturbance and d) investigate psychosocial variables that may mediate the experience of stress. Method: A total of 189 individuals (132 males and 57 females) experiencing homelessness, based in one of two UK cities completed face-to face surveys with validated measures focusing on psychological capital, social support, health behaviours, stress, and psychological wellbeing. Results: Participants recorded significantly lower levels of psychological capital and social support and significantly higher levels of psychological distress compared to normative scores. Analysis suggests that low SES, and mental health issues are associated with lower perceived social support, lower psychological capital scores and higher perceived stress levels. Discussion: Findings suggest the potentially utility of psychological capital as a measure of psychological resources contributing to the resilience of vulnerable homeless individuals. What is known: Homelessness is a social problem which affects a wide range of individuals across ethnicity, sex, and age. Homeless individuals are vulnerable to physical and mental health problems. Homeless people are deprived of economic, social, psychological, and political power. What this paper adds: Housing is a public health issue and needs to be addressed as such. Psychological Capital can mediate the impact of homelessness on physical and mental health. Most homeless individuals are fundamentally resilient but need to be empowered.

How are you coping? Stress, coping, burnout, and aggression in forensic mental healthcare workers.

Perceived stress at work has been linked to several adverse outcomes in workers, including increased risk of burnout and aggression (e.g., anger and irritability). However, much remains unknown about factors that might mitigate the negative influences of perceived stress on workers' well-being. This study focusses on coping as a possible protective factor against perceived stress and its consequences in forensic mental healthcare workers. We aimed to identify which higher-order coping factors were present in this worker sample and to investigate whether these coping factors modify the associations between perceived stress and burnout or aggression. For this observational survey study, 116 forensic mental healthcare workers completed questionnaires assessing changes in work situation since the start of COVID-19, perceived stress, coping, burnout symptoms, and aggression. Results from principal component analysis indicated that four higher-order coping factors could be distinguished: social support and emotional coping, positive cognitive restructuring, problem-focused coping, and passive coping. Higher perceived stress levels were associated with higher levels of both burnout and aggression in workers. Problem-focused coping was associated with less burnout symptoms in workers. Furthermore, positive cognitive restructuring was associated with less aggression in workers. In conclusion, problem-focused coping and positive cognitive restructuring may protect workers against burnout symptoms and aggression and these results may inform future studies on preventive interventions aimed at promoting worker's well-being.

The Relationship Between Perceived Stress and Coping Styles in Women Following Breast Cancer Surgery: A Cross-sectional Descriptive Study

Purpose: The present study aimed to examine therelationship between perceived stress levels andcoping styles of women with breast cancer.Materials and Methods: This descriptive and crosssectional study was carried out with 132 women whounderwent breast cancer surgery at a training andresearch hospital in Turkey between March andOctober 2021. Data were collected face-to-facemethod before the discharge from the hospital via thePersonal Information Form, the Perceived StressScale, and the Brief Cope Inventory. Data wereanalyzed with descriptive statistics, independentsample t-test, One-Way ANOVA and Pearsoncorrelation analysis.Results: It was found that women who hadsecondary or above education, were housewives, had comorbidities, had undergone a total radicalmastectomy, and were supported by their childrenduring the disease had higher perceived stress levels(p&lt;0.05). Women without social security had lowercoping styles (p&lt;0.05). On the other hand, there wasa significant negative relationship between women'sperceived stress levels and their coping styles(p&lt;0.05).Conclusions: The results emphasize the importanceof evaluating the perceived stress levels and copingstyles of women undergoing breast cancer surgeryby the multidisciplinary healthcare team andproviding counseling on this issue.

Perceived Stress and Coping Strategies among B.Sc. Nursing Students in Mizoram during COVID-19 Pandemic

ABSTRACT Background: During the COVID-19 pandemic, the education system was among the worst hit. The online education system was introduced, and students have to stay home surrounded by uncertainty of their future, leading to various levels of stress and the need to somehow cope with it. Materials and Methods: An online cross-sectional descriptive study involving 417 B.Sc. Nursing students were conducted between March 2, 2022 and March 8, 2022 to assess the perceived stress and coping mechanisms among Mizoram’s B.Sc. nursing students during the COVID-19 pandemic and to ascertain the association between stress and coping with specific demographic variables. To assess the level of stress and coping strategies, respectively, Pandemic-Related Perceived Stress Scale of Covid-19 (PSS-10-C) and Modified Brief-Coping orientation to problems experienced Scale were used. Results: The majority of the participants 89% were female, whereas 10.1% were male. Most of the participants 89.2% resided in a hostel. A high level of stress is seen among 2.15% of the participants. The majority 83.7% have moderate stress levels and a low level of stress is seen among 14.15% of the participants. Perceived stress is higher among the females significantly at 0.02 and also among those who reside in the hostel at 0.02 level. Among the participants with high perceived stress levels, avoidance coping is most adopted by a mean value of 25.00 (5.61). Conclusions: The findings suggest that there is a need for appropriate intervention for assisting the B.Sc. nursing students in stress management to adopt healthy coping strategies.

Poor Glycaemic Control and It’s Risk Factors Among Diabetes Patients in An Urban Area of Western India

Introduction: Diabetes is a major public health problem worldwide including India. Poor glycaemic control is a major risk factor for the development of diabetes-related complications. Hence, monitoring and achieving good glycaemic control is critical to reducing the risk of complications and improving outcomes in people with diabetes. This study conducted to determine the prevalence of poor glycaemic control and to identify the factors associated with poor glycaemic control. Methodology: This cross-sectional descriptive study conducted in an urban area among those patients having diabetes since more than five years. All participants were interviewed and tested for HbA1c. Cases with good glycaemic control (HbA1c &lt;7%) were compared with those with poor glycaemic control (HbA1c ≥7%). Multivariate analysis was conducted to find out independent determinants. Results: Out of 632 cases, poor glycaemic control was found in 81.3% cases. Multivariate logistic regression indicated that living without a spouse (p 0.036), Female gender (p 0.032), MBI &gt;23(kg/m2) (p &lt;0.001), poor medication adherence (p 0.022), and high perceived stress level (p 0.011) were independent predictors of poor glycaemic control. More than 10 years duration of diabetes was found to be associated with good glycaemic control (p 0.016) Conclusion: There are a high proportion of patients with poor glycaemic control. Higher BMI, poor drug adherence and higher stress level are independently associated with poor glycaemic control.

A comparative study on eating habits and mental health of Korean middle school students according to their bedtime across regions: using data from the 2020-2022 Korea Youth Risk Behavior Survey.

The objective of this study was to compare dietary habits and mental health among middle school students in urban and rural areas based on bedtime, and to provide evidence supporting appropriate bedtime for Korean middle school students in relation to their healthy dietary habits and mental well-being. The study population consisted of 25,681 second-year middle school students who participated in the Korea Youth Risk Behavior Survey in 2020-2022. Participants were asked about their bedtime and wake-up time during the past 7 days and were classified into five categories. The study compared the general characteristics, academic factors, dietary habits, and mental health of urban and rural students based on their bedtime. Bedtime was found to be later in the following order: urban female students, rural female students, urban male students, and rural male students. As bedtime got later, the rates of smoking and alcohol consumption increased. Students who went to bed before 11 p.m. had lower academic performance, while rural male students who went to bed after 2 a.m. had lower academic performance. Later bedtime was associated with increased smartphone usage, skipping breakfast, consuming fast food, and drinking carbonated beverages. Later bedtime was also associated with higher perceived stress levels, particularly among students who went to bed after 2 a.m., higher rates of suicidal ideation, experiencing sadness and despair, as well as the prevalence of clinically significant anxiety disorders. These results suggest that middle school students who go to bed too late have higher rates of smoking and alcohol drinking, as well as unhealthy eating habits, stress, suicidal ideation, sadness, and anxiety. Therefore, it is necessary to provide educational and social institutional support to promote adequate sleep for the health of adolescents.

Association of polygenic scores for depression and neuroticism with perceived stress in daily life during a long-lasting stress period.

Genetic factors contribute significantly to interindividual differences in the susceptibility to stress-related disorders. As stress can also be conceptualized as environmental exposure, controlled gene-environment interaction (GxE) studies with an in-depth phenotyping may help to unravel mechanisms underlying the interplay between genetic factors and stress. In a prospective-longitudinal quasi-experimental study, we investigated whether polygenic scores (PGS) for depression (DEP-PGS) and neuroticism (NEU-PGS), respectively, were associated with responses to chronic stress in daily life. We examined law students (n = 432) over 13 months. Participants in the stress group experienced a long-lasting stress phase, namely the preparation for the first state examination for law students. The control group consisted of law students without particular stress exposure. In the present manuscript, we analyzed perceived stress levels assessed at high frequency and in an ecologically valid manner by ambulatory assessments as well as depression symptoms and two parameters of the cortisol awakening response. The latter was only assessed in a subsample (n = 196). No associations between the DEP-PGS and stress-related variables were found. However, for the NEU-PGS we found a significant GxE effect. Only in individuals experiencing academic stress a higher PGS for neuroticism predicted stronger increases of perceived stress levels until the exam. At baseline, a higher NEU-PGS was associated with higher perceived stress levels in both groups. Despite the small sample size, we provide preliminary evidence that the genetic disposition for neuroticism is associated with stress level increases in daily life during a long-lasting stress period.

B - 64 Association of Perceived Stress during the COVID-19 Pandemic on Cognitive Performance in HIV+ Adults.

Stress may impact cognitive ability, and perceived stress may be a modifiable risk factor for cognitive impairment. This study investigates the potential impact of perceived stress levels on cognitive test performance in a NYC cohort of people living with HIV (PLWH), assessed during the COVID-19 pandemic. 124 racially-diverse PLWH participating in a longitudinal cohort completed comprehensive face-to-face neurocognitive test batteries between August 2020 and February 2023 (Mage = 61.22). Self-reported stress was assessed using the Perceived Stress Scale-14, and a median split (value of 18) was used to divide the sample into high and low stress groups. One-way ANOVAs were used to evaluate differences in cognitive performance based on stress grouping. Significant differences between high and low stress groups were found in: Trail Making Test-A (TMT-A), F(1,104) = 3.962,p = 0.049; Trail Making Test-B (TMT-B), F(1,80) = 7.106,p = 0.009; Paced Auditory Serial Addition Test (PASAT), F(1,80) = 7.096,p = 0.009; and Symbol Search (SS), F(1,102) = 5.280,p = 0.024. Participants in the high stress group had lower performance on TMT-A (M = 48.78, SD = 13.47), TMT-B(M = 49.56, SD = 13.92), PASAT (M = 43.07, SD = 12.57), and SS (M = 44.85, SD = 11.76) compared to the low stress group (M = 53.71, SD = 11.87; M = 57, SD = 10.72; M = 50.20, SD = 11.62; M = 49.78, SD = 9.85; respectively). Individuals reporting higher levels of stress during the COVID pandemic had reduced performance on tasks assessing information processing speed, executive functioning, and attention. This suggests that higher perceived stress levels and ambient stressors (such as the pandemic) may influence cognitive functioning.

Correlation Between Perceived Stress and BMI Among Obstructive Sleep Apnea Individuals

Objective: To investigate the potential association between higher perceived stress levels and elevated Body Mass Index (BMI) in patients with obstructive sleep apnea (OSA). Methodology: This prospective study was conducted at the Pulmonology Department of Dow University Hospital, Dow University of Health Sciences, from July to October 2020. The study included adults aged 18 and above, of both genders, diagnosed with OSA through clinical evaluation and sleep studies. BMI was calculated using the formula BMI = kg/m², and the Perceived Stress Scale (PSS) was utilized to assess participants' perceived stress levels. The PSS questionnaire, comprising 10 items, was completed by participants, with each item rated on a 5-point Likert scale (ranging from 0 to 4). Higher scores indicated higher perceived stress. Relevant clinical data were recorded, and the Pearson correlation coefficient was calculated to determine the direction of the relationship. Results: The study included 160 OSA cases, with an average age of approximately 50.29 years. The majority of participants were male (59.4%), while females constituted 40.6% of the sample. BMI categories revealed that 13.8% were overweight, 85.0% were obese, and only two individuals had a normal BMI. Concerning stress levels, 41.3% experienced low stress, 45.6% reported moderate stress, and 13.1% reported high perceived stress. Importantly, the study found an insignificant association between BMI and perceived stress (p-value &lt; 0.278). Conclusion: The study identified a predominant occurrence of obesity among OSA patients. A positive correlation between elevated BMI and perceived stress was observed. The limited number of similar studies and the acknowledged limitations of the current study underscore the necessity for further research and interventions to explore the impact of BMI on stress in OSA.

Latent class symptom profiles of colorectal cancer survivors with cancer-related cognitive impairment.

Colorectal cancer (CRC) survivors experience cancer-related cognitive impairment and co-occurring symptoms after cancer treatments. There has been little data to inform the risk factors of complex symptom phenotypes in CRC survivors. To determine if subgroups of CRC survivors after cancer treatments could be identified based on the cognitive impairment and common co-occurring symptoms (depression, anxiety, sleep disturbance, fatigue, and pain); and to explore risk factors (sociodemographic and clinical characteristics, perceived stress, and social support) of these subgroups. Latent class profile analysis (LCPA) was used to identify subgroups based on self-reported symptoms in 64 CRC survivors. Cognitive impairment was measured by assessing subjective cognitive function using the Patient-Reported Outcome Measurement Information System (PROMIS) measure. The Kruskal-Wallis test and regression analyses were performed. Three distinct latent classes were identified (Class 1: All Low '28.1%'; Class 2: High Psychological Symptoms (depression/anxiety) '25%'; Class 3: High Somatic Symptoms (fatigue, sleep disturbance, and pain) with High Cognitive Impairment'46.9%'). The pain was the most distinguishable symptom across the latent classes. The high symptom burden group was associated with less time since cancer diagnosis, higher perceived stress levels, and poor emotional social support. Our study adds to the information on interindividual variability in symptom experience of CRC survivors with cognitive impairment. Findings suggest a need for increased attention to screening for co-occurring symptoms (e.g., high pain) and future interventions focused on stress management and social support.

Factors associated with postpartum depressive symptoms among women who conceived with infertility treatment

Infertility treatment experiences may accumulate and influence postpartum psychological well-being among women with infertility. However, the association between infertility treatment experiences and postpartum depressive symptoms remained unclear. This cross-sectional survey aimed to describe depressive symptom scores of 180 women, who conceived while undergoing infertility treatment, at 2–6 months after childbirth, and to explore factors, including infertility history and treatment experiences, associated with postpartum depressive symptoms. Data were collected via telephone interviews and patient record reviews. Postpartum depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. The prevalence of postpartum depressive symptoms was 34.4 %. Higher perceived stress levels after childbirth than before undergoing infertility treatment, a duration of infertility diagnosis longer than three years, maternal age >35 years, pregnancy conceived through in vitro fertilization (IVF), and experiencing all three lines of infertility treatment, namely ovarian stimulation, intrauterine insemination, and IVF, were associated with a higher risk of postpartum depressive symptoms. Breastfeeding, social support, and baby sex in line with stated preference were negatively associated with postpartum depressive symptoms. There were no significant interactions between the variables. The women's infertility history and treatment experiences were found to have influenced their postpartum depressive symptoms, especially among women who had a long duration of infertility, conceived through IVF, and had received all lines of infertility treatment.

Adding fuel to the fire: The impact of stress on decision-making in dilemmas among emergency service personnel

IntroductionCertain professions are particularly exposed to stress and must make decisions with far-reaching consequences. Recent research indicates that stress alters subsequent decision-making. The two current studies examine the predictive effect of perceived stress and leadership responsibility on moral decision-making among emergency service personnel. ObjectiveWe hypothesized that under high levels of perceived stress, fewer utilitarian and fewer altruistic decisions are made. Utilitarian decisions involve saving the lives of more people while sacrificing a smaller number of people. Altruistic decisions lead to outcomes that benefit others rather than oneself. Furthermore, we hypothesized that leaders under high levels of perceived stress make more utilitarian and altruistic decisions than non-leaders. MethodTwo different samples (N1=368; N2=562) were exposed to two different types of moral dilemmas (Sample 1: sacrificial dilemmas, Sample 2: everyday dilemmas). Stress levels were assessed using the Perceived Stress Scale. The hypotheses were tested with hierarchical regression analysis. ResultsAs hypothesized, in sacrificial dilemmas, high perceived stress levels predicted a decrease in utilitarian decisions. Moreover, highly stressed leaders made more utilitarian decisions compared to non-leaders. In everyday dilemmas, high-perceived stress levels predicted fewer altruistic decisions. No moderating effect of leadership responsibility was observed. ConclusionOur results indicate that perceived stress predicts moral decision-making among emergency service personnel.