Moderate Psychological Stress Research Articles

A Cross-sectional Study to Assess the Effect of COVID-19 Stressors and Knowledge on Infection Control Measure on Nurse’s Performance at a Selected Hospital at Sirsa Haryana

Background: The SARS-CoV-2 virus, which causes the coronavirus disease (COVID-19), was initially discovered in Wuhan, China, in December 2019. A current study purpose was to evaluate how COVID-19 stresses affected nurses’ performance during the epidemic. Methods: A total of 30 nurses were selected through convenient sampling technique; 18 were female nurses and 12 were males. A descriptive cross-sectional research design has been utilized to evaluate the COVID-19 stressors effect on nurses. The data were collected with selfstructured questionnaire to measure the knowledge and infection control measures on COVID-19 and COVID-19 stress scale to measure the varied stress levels among nurses. Results: 70.0% of the studied participants had a satisfactory level of knowledge and infection control measures and 30.0% had good knowledge. 60.0% of the nurses who took part in the study reported moderate psychological stress levels on the COVID-19. Nurses’ adequate degree of knowledge and COVID-19 psychological stressor levels are significantly correlated. Conclusion: The majority of nurses possessed satisfactory knowledge and infection control measures. The majority of them had moderate amounts of COVID-19 psychological stress.

Psychological stress and associated factors in caring for patients with delirium among intensive care unit nurses: A cross-sectional study

BackgroundCaring for patients with delirium is challenging and overwhelming for intensive care unit (ICU) nurses. Investigating the psychological impact of delirium care on ICU nurses is crucial to maintaining their psychological health and improving the quality of care. ObjectiveThe objective of this study was to investigate the psychological stress of ICU nurses in caring for patients with delirium and potential factors. MethodsA total of 355 nurses from three tertiary care hospitals in Hunan Province, China, participated in this cross-sectional survey. Data were collected using the demographic sheet, Impact of Event Scale-Revised, Connor-Davidson Resilience Scale, and Occupational Coping Self-Efficacy Scale for Nurses. Descriptive and multiple linear regression analyses were used to examine the factors associated with psychological stress. ResultsICU nurses suffered moderate psychological stress related to delirium care. The recent time to care for patients with delirium (P < 0.001), familiarity with delirium-related knowledge (P = 0.002), satisfaction with delirium-related support (P = 0.046), psychological resilience (P < 0.001), and occupational coping self-efficacy (P < 0.001) were significant contributors to psychological stress. ConclusionNurse managers and researchers need to focus on the psychological well-being of ICU nurses in caring for patients with delirium, especially those who are currently caring for patients with delirium, and provide tailored support, increase their knowledge of delirium, and also boost psychological resilience and coping skills.

A study to assess the risk factors contributing to psychological stress, anxiety and depression in mothers of Covid-19 positive hospitalized children in a Tertiary care hospital

Parents of the COVID -19 positive hospitalized children are facing different psychological stresses which are affecting child’s care and well-being. To determine the psychological stress, anxiety and depression and to identify the associated influencing factors in mothers of hospitalized COVID-19 infected children In this cross-sectional observational study, 150 mothers of COVID-19 positive hospitalized children in a paediatric tertiary care hospital were randomly selected and studied. Data collection tool was a two part questionnaire; the first part was based on ‘Perceived stress scale-10’ and ‘Hospital anxiety and depression scale’ and the second part included stressors related to COVID-19 pandemic selected based on previous researches. The incidence of these stressors and their significance in causing stress, anxiety and depression was assessed using standard statistical methods.83.4% had moderate psychological stress, 35% had significant anxiety and 38% had significant depression. Worry about hospital bed availability and treatment cost (Odd’s ratio&amp;#62;9) and worry about getting infection (Odd’s ratio&amp;#62;8) as main stressors for stress, concern about family members and worry about getting infection (Odd’s ratio&amp;#62;9 for both) as main factors for anxiety and concern about family members (Odd’s ratio&amp;#62;22) as main factor for depression was found in study population. This pandemic has imposed grave psychological impact on mothers of hospitalized COVID infected children and various influencing social factors have been identified through our study. Holistic approach including socio-economic, administrative and political measures should be taken and adequate psychological support should be provided to address maternal mental health related issues.

Assessment of Psychological Stress Associated with COVID-19 Lockdown in the Urban Adult Population of India

Background: COVID-19, the unprecedented deadly pandemic has turned the world topsy-turvy. It has affected all the people like poor and rich, young and old, educated and uneducated, male and female with detrimental consequences. People who are in quarantine and/or lockdown are likely to develop a wide range of symptoms like psychological stress, irritability, anxiety, depression etc. Hence, this study was undertaken to assess the psychological effects of COVID-19 lockdown among adult population residing in Chennai, India. This study is a cross sectional descriptive study carried out in Chennai, India. A structured questionnaire was developed containing 25 questions related to the emotional disturbance, depression, self-concept, physical problems, cognitive changes and role performance and 7 questions related to the demographics. An online survey was conducted using a structured questionnaire using a non-probability snowball sampling technique. A total of 579 responses were received. The findings of the present study revealed that, among 579 respondents, more than half of the respondents 320(56.3%)were under severe psychological stress, 192(33.2%) respondents that is one third of the people had moderate psychological stress and remaining were having mild psychological stress. The study also revealed that there was a statistically significant association of psychological problems associated with demographic variables. Our Study revealed that people living in Chennai had severe psychological problem due to theCOVID-19 lockdown. This highlights the importance and immediate need for the development special intervention programmes for the people with psychological problems due to the COVID-19 lockdown.

Dental Psychological Stress or Phobia among Orthodontic Patients of Mardan

Objective: To assess the psychological stress or phobia due to dental procedure among patients. Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Orthodontic, Bacha Khan College of Dentistry/Medical Teaching Institute, Mardan from 1st January 2020 to 31st August 2021. Methodology: One hundred and twenty patients coming for orthodontal treatment with age between 12-31 years were enrolled. The demographic and psychological stress information was recorded. Results: There were more females (65%) than males (35%). The mean age was 15.5±3.2 years. About 82.5% patients reported high level of psychological stress or phobias towards dental treatments while 19.1% were those who had moderate psychological stress or phobias. Majority of the patient’s fear of pain was between 12-17 years. Patients having highest anxiety also belonged to the same group Conclusion: Dental phobias and fears are widespread among patients seeking dental treatments. Orthodontists should recognize the dental phobias and fears so they efficiently interconnect with the patients. Key words: Orthodontic treatment, Pain, Dental phobia

Promoting social distancing and preventing panic buying during the epidemic of COVID-19: the contributions of people's psychological and behavioural factors.

ObjectivesCOVID-19 disease has progressed to the level of a global pandemic. This study aimed to investigate people’s psychological and behavioural responses to the COVID-19 epidemic and explore the predictors for social distancing and panic buying.MethodsA 17-item questionnaire was developed and distributed randomly to people using social media. Descriptive statistics and one-way ANOVA were used to assess people’s psychological and behavioural responses. Hierarchical regression was conducted to investigate the predictive effects of psychological and behavioural variables on reports of social distancing and panic buying respectively.ResultsRespondents reported a low degree of risk perception and risk beliefs with regard to being outside, and had moderate psychological stress and positive safeguarding behaviours for being outside. Respondents reported high concern regarding COVID-19 and tended to keep social distancing during the epidemic. They would panic-purchase food and supplies. In addition, psychological stress emerged as a very strong predictor for reporting COVID-19 concerns and panic buying. Furthermore, reported concerns about COVID-19 information sharing had a significant predictive influence on panic buying of food. Safeguarding behaviours for being outside had a significant predictive effect on respondents reported social distancing of cancelling outings. Reported concerns about COVID-19 were stronger predictors for reported social distancing.ConclusionIt is important to relieve people’s psychological stress and manage information sharing to control panic buying. In addition, we should promote adoption of safeguarding behaviours for being outside and emphasise the concerns with regard to COVID-19 to encourage people keep social distancing. Measures should be implemented according to the characteristics of the population.

Perceived psychological stress and associated factors in the early stages of the coronavirus disease 2019 (COVID-19) epidemic: Evidence from the general Chinese population.

IntroductionCoronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by novel coronavirus 2019. Many individuals suffered psychological symptoms in the early stage when the epidemic was uncertain. We explored the perceived psychological stress and associated factors in the early stage of COVID-19 epidemic.MethodThe Perceived Stress Scale, Simplified Coping Style Questionnaire, Social Support Rating Scale and a general information questionnaire were integrated in an on-line survey conducted from February 1, 2020 until February 4, 2020. Multiple linear regression analysis was performed to explore whether coping style, social support or other factors contributed to psychological stress.ResultsA total of 1638 participants were included, of whom 44.3% showed moderate psychological stress. Individuals who were younger, female, unmarried, spent more time on the disease, felt more concern about it, reported lower social support (Subjective Social support; Objective social support; Utilization social support), or showed a negative coping style were more likely to suffer higher psychological stress in the early stages of the COVID-19 epidemic.ConclusionPsychological interventions may be targeted to individuals with the risk characteristics identified in this study. It may be helpful to promote social support and positive coping style in the early stage of infectious disease epidemics. This initial evidence from the general Chinese population may be relevant to interventions in other countries for dealing with the COVID-19 and other epidemics.

Psychological Stress among Parents of Hearing Impaired versus Intellectually Disabled Pakistani Children

Background: Parents of special children face physical, psychological and social impact of their child’s disability, including hopelessness and depression. This study is important as it will help professionals plan and provide effective coping strategies so parents could have a positive perception and behavior for disabilities (like hearing impaired and intellectual disability) in their children. The objective of this study was to analyze level of psychological stress among parents of children with hearing impaired (HI) versus intellectual disability (ID) and relationship between disability and psychological stress.Material and Methods: This cross-sectional study comprised of parents (n = 200) of 100 HI and 100 ID children, of both genders, aged 1 to 16 years. These were recruited by non-probability convenience sampling after taking consent from special education centers of Punjab (Pakistan), over a period of six months from May 2017 to October 2017. After collecting demographic details, quantitative assessment of parental stress was done using Parental Stress Scale (PSS). Statistical analysis was carried out using SPSS v21.Results: The sample population (n=200) consisted of 32.5% male and 67.5% female respondents, with a mean age of 41.23 ± 6.7 years. The mean of total parental psychological stress score was 61.85 ± 17.1 with significant association between disabilities (HI and ID) and psychological stress (p&lt;0.01). In HI group, moderate psychological stress was seen (n=53, 26.5%), while in ID group, profound level of psychological stress was noted in majority (n=70, 35%) of participants.Conclusions: Parents of both HI and ID children showed psychological stress, however, parents of ID children suffered higher level of stress.

Daily perceived stress and time to pregnancy: A prospective cohort study of women trying to conceive

BackgroundPrior studies among women with impaired fecundity have consistently demonstrated a positive association between daily perceived stress and the ability to conceive. However, the effects of daily stress on time to pregnancy (TTP) among women with proven fertility is not known. Materials and MethodsOne hundred and forty-three women ages 18–35, in a relationship of proven fertility, who desired to conceive were included in the analysis. Daily diaries recording perceived stress (scale 0–10) were completed for up to 7 menstrual cycles or until pregnancy. Cox proportional hazards regression models were used to estimate the association between time-varying perceived stress tertiles (high [>4.1–7.2], moderate [>2.7–4.1], and low [0.1–2.7]) and adjusted fecundability odds ratio (aFOR), 95% confidence intervals (CI), after taking into account age, parity, education, time-varying caffeine and alcohol intake, fertility awareness tracking, and cycle intent to conceive. ResultsAmong the 111 participants who completed daily diaries, 90 (81.1%) conceived. Women reporting high or moderate stress, versus low stress, had no difference in probability of achieving pregnancy (aFOR: 1.11 [95% CI: 0.58, 2.14]; and aFOR: 1.37 [0.71, 2.67]), respectively. Additional adjustment for intercourse frequency during narrow fertile window, or narrowing exposure focus to pre-ovulatory or pre-implantation stress did not appreciably alter the estimates. ConclusionDaily perceived stress was not adversely associated with TTP among women with proven fertility. While a growing body of evidence supports adverse effects of more severe stressful life events on female reproductive function, moderate psychological stress, commonly referred to as eustress, among relatively healthy women with proven fertility does not appear to adversely impact TTP.

Physiological and Psychological Stress in Patients Living With a Left Ventricular Assist Device.

Patients with a left ventricular assist device (LVAD) commonly experience psychological distress post-implantation, but physiological stress and differences by implant strategy remain unstudied. This study describes indicators of physiological (salivary cortisol, C-reactive protein, sleep quality) and psychological (perceived stress, depression, and fatigue) stress by implant strategy and examines relationships between stress and outcomes (quality of life [QOL] and functional status). Prospective, cross-sectional data were collected from patients ≥3 months post-LVAD implantation (n = 44), and descriptive statistics and logistic regression were used. The study sample was average age 57.7 ± 13 years, mostly male (73%), married (70.5%), and racially diverse. Median LVAD support was 18.2 months. Most had normal cortisol awakening response and fair sleep quality, with moderate psychological stress. There were no differences in stress by implant strategy. Normal cortisol awakening response was correlated with low depressive symptoms. Sleep quality and psychological stress were associated with QOL, whereas cortisol and C-reactive protein levels were associated with functional status. This is the first report of salivary biomarkers and stress in LVAD outpatients. Future research should examine physiological and psychological stress and consider potential clinical implications for stress measurement for tailored approaches to stress management in this population.

Evaluation of an app-based stress protocol

Abstract Stress is a major influence on the quality of life in our fast-moving society. This paper describes a standardized and contemporary protocol that is capable of inducing moderate psychological stress in a laboratory setting. Furthermore, it evaluates its effects on physiological biomarkers. The protocol called “THM-Stresstest” mainly consists of a rest period (30 min), an app-based stress test under the surveillance of an audience (4 min) and a regeneration period (32 min). We investigated 12 subjects to evaluate the developed protocol. We could show significant changes in heart rate variability, electromyography, electro dermal activity and salivary cortisol and α-amylase. From this data we conclude that the THM-Stresstest can serve as a psychobiological tool for provoking responses in the cardiovascular-, the endocrine and exocrine system as well as the sympathetic part of the central nervous system.

Psychological Stress-related Angina Pectoris among Adult Patients in Kirkuk City (Comparative study)

Objective: The purpose of this study was to assess the psychological stress-related angina pectoris among adult patients (male and female) and find out relationship between patients' stress and some socio-demographic characteristics such as age, marital status, level of education, occupation, socioeconomic status and BMI. Methodology: A comparative (descriptive) study was carried out at two hospitals (Kirkuk general and Azadi teaching) in CCU and medical ward in Kirkuk city for a period of the 1st of May 2014 and up to the 1st of January, 2015. A non-probability (Convenience) sample of (50 male) and (50 female) definitely diagnosed angina pectoris patient. To achieve the objectives of the study a constructed questionnaire conducted for the purpose of the study, which consisted of three parts: the demographic characteristics; medical data and assessment of stress which includes (24) items. The data were collected through the use of the interview. They were analyzed through the application of descriptive statistical analysis (Frequency, Percentage%) and inferential statistical (T-Test and ANOVA) data analysis. Results: The majority of the study sample were male aged (50-59) years while, the female aged (40-49) years old. 90% of the male and (62%) of the female were married. The majority (20%) of the male was graduated of primary school, while (42%) of female were graduated of the institute. Both male (36%) and female (46%) had (1-3) child. Most of the study sample was employed, had moderate socioeconomic status and mostly of urban residency. Regarding to the medical data, finding of the study indicated that (38%) of them were no history of chronic disease. 58% of the male and (82%) of the female were no smoking, Majority (42%) of the male and (38%) of females was overweight Conclusions: the study was detected as a gender difference between male and female with psychological stress. In the study sample were found a significant relationship between psychological stress between male and female and ages. As the study concluded that most of the study sample were to have moderate psychological stress. Also founds a significant relationship only in female patients with angina and level of education, occupation, BMI and psychological stress. Recommendations: Routine screening patients who attending to the hospital and primary health care center , for psychosocial vulnerability, current feelings and state of stress, with the use of reliable and valid measures.

Interactions between psychological stress and drinking status in relation to diet among middle-aged men and women: a large-scale cross-sectional study in Japan.

The aim of this study was to investigate the interaction between psychological stress (PS) and drinking status in relation to diet among middle-aged Japanese men and women in a large-scale cross-sectional study. The study population included 5,587 middle-aged Japanese men and 2,718 middle-aged Japanese women who underwent annual health checkups. The subjects were divided into 2 groups (non-drinkers and drinkers) and classified as having low, moderate, or high self-reported PS levels. Energy-adjusted food and nutrient consumption was assessed with a validated food frequency questionnaire. Using a general linear model, food and nutrient consumption was estimated for each self-reported PS level in the 2 groups (non-drinkers and drinkers) and the interactions between self-reported PS levels and drinking status were calculated. In men, pork and beef; squid, octopus, shrimp, and clams; eggs; mushrooms; Japanese-style sweets; ice cream; bread; Chinese noodles; coffee; and soda as foods and protein, animal protein, fat, animal fat, carbohydrate, monounsaturated fatty acid, polyunsaturated fatty acid (PUFA), n-3 PUFA, n-6 PUFA, cholesterol, vitamin D, vitamin B2, vitamin B6, vitamin B12, niacin, pantothenic acid, magnesium, phosphorus, and zinc as nutrients significantly interacted with self-reported PS levels and drinking status (p for interaction <0.05 for all). No specific interactions were found in women. These findings suggest interactions between PS levels and drinking status with consumption of some foods and nutrients, especially macronutrient intake, in men but not in women.

The effect of moderate acute psychological stress on working memory-related neural activity is modulated by a genetic variation in catecholaminergic function in humans

Acute stress has an important impact on higher-order cognitive functions supported by the prefrontal cortex (PFC) such as working memory (WM). In rodents, such effects are mediated by stress-induced alterations in catecholaminergic signaling, but human data in support of this notion is lacking. A common variation in the gene encoding Catechol-O-methyltransferase (COMT) is known to affect basal catecholaminergic availability and PFC functions. Here, we investigated whether this genetic variation (Val158Met) modulates effects of stress on WM-related neural activity in humans. In a counterbalanced crossover design, 41 healthy young men underwent functional magnetic resonance imaging (fMRI) while performing a numerical N-back WM task embedded in a stressful or neutral context. Moderate psychological stress was induced by a well-controlled procedure involving viewing strongly aversive (versus emotionally neutral) movie material in combination with a self-referencing instruction. Acute stress resulted in genotype-dependent effects on WM performance and WM-related activation in the dorsolateral PFC, with a relatively negative impact of stress in COMT Met-homozygotes as opposed to a relatively positive effect in Val-carriers. A parallel interaction was found for WM-related deactivation in the anterior medial temporal lobe (MTL). Our findings suggest that individuals with higher baseline catecholaminergic availability (COMT Met-homozygotes) appear to reach a supraoptimal state under moderate levels of stress. In contrast, individuals with lower baselines (Val-carriers) may reach an optimal state. Thus, our data show that effects of acute stress on higher-order cognitive functions vary depending on catecholaminergic availability at baseline, and thereby corroborate animal models of catecholaminergic signaling that propose a non-linear relationship between catecholaminergic activity and prefrontal functions.

Effect of psychological stress on glucose control in patients with Type 2 diabetes

To investigate the effect of acute psychological stress on glucose concentrations in patients with Type 2 diabetes, in the fasting state as well as in the postprandial state. Thirty patients (12 female) with Type 2 diabetes were included. Mean ± SD age was 60 ± 12 years, BMI 28.8 ± 4.2 kg/m(2), diabetes duration 8.9 ± 6.7 years and HbA(1c) 51 ± 9 mmol/mol (6.8 ± 0.8%). Using a non-randomized approach, all participants were exposed to moderate psychological stress by means of the Trier Social Stress Test: 10 participants in the fasting state and 20 participants 75 min after intake of a standard meal. Blood pressure, heart rate and salivary cortisol were monitored on the control day and the stress-test day. Glucose concentrations were assessed using a continuous glucose monitoring system. On the stress-test day, blood pressure rose from 117/73 ± 13/12 to 155/92 ± 22/14 mmHg, heart rate from 77 ± 11 to 91 ± 25 b min(-1) and salivary cortisol concentrations from 8.5 ± 3.7 to 26.4 ± 12.1 nmol/l (P < 0.001); these measurements remained unchanged on the control day. On the stress-test day, when the Trier Social Stress Test was applied 75 min after the intake of a standard meal, the glucose concentrations were significantly higher compared with the control day (mean difference 1.5 mmol/l, 95% CI 0.5-2.4, P = 0.003). In the fasting state, glucose concentrations slightly decreased during the control day but remained stable on the stress-test day (mean difference compared with the control day 0.7 mmol/l, 95% CI -0.7 to 2.0, P = 0.31). When stress is experienced in the postprandial period, acute psychological stress significantly increases glucose concentrations in patients with Type 2 diabetes.

Primary care visits to occupational health physicians and nurses in Finland

In Finland, 91% of employer-arranged occupational health services (OHS) include primary care for employees. Occupational health (OH) physicians and OH nurses carry the main responsibility for primary care in OHS. This study analyses work- and health-related factors associated with primary care visits to OH physicians and OH nurses. This population-based cross-sectional survey encompassed 1636 randomly selected working employees aged 25-64 covered by OHS which included primary care. The associations between factors and visits during the previous 6 months were tested by Poisson regression analysis. The proportion of employees who visited OH physicians or OH nurses was 57%. Men visited OH nurses more often than women, but the number of visits to OH physicians was similar. Long-standing illnesses impairing work ability, work-related symptoms, and type of OHS provision were associated with visits to both OH physicians and nurses. Moderate psychological stress was associated with visits to OH physicians. Among men, the requirement of obtaining a sick-leave certificate on the first day of absence was associated with visits. Less possibilities to influence one's work was associated with visits to OH nurses, and among women also to OH physicians. Poor support from supervisors and co-workers had non-significant or inverse associations. The wide use of OHS and both the type and similarities between factors associated with visits may signify that both OH physicians and OH nurses are likely to encounter work-related health problems through primary care in OHS.

Enhanced resting-state connectivity of amygdala in the immediate aftermath of acute psychological stress

Recent neuroimaging studies investigating responses to stressful stimuli may importantly further our understanding of psychological trauma etiology. However, theory posits that sustained activation of these stress circuits after the stressful event may play an equally important role in the development of stress-related psychopathology. Importantly, such post-stress network changes remain poorly characterized. The amygdala with its connections is crucially positioned in the central stress circuitry that mediates the initial stress response. Hence, we investigated post-stress amygdala-centered connectivity patterns in order to characterize the aftermath of acute, experimentally-induced stress in healthy humans. We recorded resting-state functional MRI in 26 female participants following a period of moderate psychological stress induced by means of aversive (vs. emotionally neutral) movie watching with a self-referencing instruction. Next, we implemented a seedregion analysis calculating the voxel-wise correlation with the anatomically extracted time-series of the amygdala. Various stress measures confirmed successful stress induction. Moreover, we demonstrated enhanced functional coupling of the amygdala with dorsal anterior cingulate cortex, anterior insula, and a dorso-rostral pontine region, which appears to overlap with the anatomical location of the locus coeruleus (LC), when contrasting the stress with the control group. Thus, we show that the aftermath of acute stress is qualified by prolonged activation in an amygdala-connectivity network. This pattern of co-activation may indicate an extended state of hypervigilance that promotes sustained salience and mnemonic processing after stress. Characterization of the post-stress brain state may provide initial insight into the early phases of psychological trauma formation.

Neural mechanisms underlying changes in stress-sensitivity across the menstrual cycle

Hormonal fluctuations across the menstrual cycle are thought to play a central role in premenstrual mood symptoms. In agreement, fluctuations in gonadal hormone levels affect brain processes in regions involved in emotion regulation. Recent findings, however, implicate psychological stress as a potential mediating factor and thus, we investigated whether effects of moderate psychological stress on relevant brain regions interact with menstrual cycle phase. Twenty-eight healthy women were tested in a crossover design with menstrual cycle phase (late luteal versus late follicular) and stress (stress induction versus control) as within-subject factors. After stress induction (or control), we probed neural responses to facial expressions using fMRI. During the late luteal phase, negative affect was highest and the stress-induced increase in heart rate was mildly augmented. fMRI data of the control condition replicate previous findings of elevated amygdala and medial prefrontal cortex responses when comparing the late luteal with the late follicular phase. Importantly, stress induction had opposite effects in the two cycle phases, with unexpected lower response magnitudes in the late luteal phase. Moreover, the larger the increase in allopregnanolone concentration across the menstrual cycle was, the smaller the amygdala and medial prefrontal cortex responses were after stress induction in the late luteal phase. Our findings show that moderate psychological stress influences menstrual cycle effects on activity in the emotion regulation circuitry. These results provide potential insights into how fluctuations in allopregnanolone that naturally occur during the menstrual cycle may change stress vulnerability.

Acute Psychological Stress Reduces Working Memory-Related Activity in the Dorsolateral Prefrontal Cortex

Acute psychological stress impairs higher-order cognitive function such as working memory (WM). Similar impairments are seen in various psychiatric disorders that are associated with higher susceptibility to stress and with prefrontal cortical dysfunctions, suggesting that acute stress may play a potential role in such dysfunctions. However, it remains unknown whether acute stress has immediate effects on WM-related prefrontal activity. Using functional magnetic resonance imaging (fMRI), we investigated neural activity of 27 healthy female participants during a blocked WM task (numerical N-back) while moderate psychological stress was induced by viewing strongly aversive (vs. neutral) movie material together with a self-referencing instruction. To assess stress manipulation, autonomic and endocrine, as well as subjective, measurements were acquired throughout the experiment. Successfully induced acute stress resulted in significantly reduced WM-related activity in the dorsolateral prefrontal cortex (DLPFC), and was accompanied by less deactivation in brain regions that are jointly referred to as the default mode network. This study demonstrates that experimentally induced acute stress in healthy volunteers results in a reduction of WM-related DLPFC activity and reallocation of neural resources away from executive function networks. These effects may be explained by supraoptimal levels of catecholamines potentially in conjunction with elevated levels of cortisol. A similar mechanism involving acute stress as a mediating factor may play an important role in higher-order cognitive deficits and hypofrontality observed in various psychiatric disorders.

The 'Trier Social Stress Test'--a tool for investigating psychobiological stress responses in a laboratory setting.

This paper describes a protocol for induction of moderate psychological stress in a laboratory setting and evaluates its effects on physiological responses. The 'Trier Social Stress Test' (TSST) mainly consists of an anticipation period (10 min) and a test period (10 min) in which the subjects have to deliver a free speech and perform mental arithmetic in front of an audience. In six independent studies this protocol has been found to induce considerable changes in the concentration of ACTH, cortisol (serum and saliva), GH, prolactin as well as significant increases in heart rate. As for salivary cortisol levels, the TSST reliably led to 2- to 4-fold elevations above baseline with similar peak cortisol concentrations. Studies are summarized in which TSST-induced cortisol increases elucidated some of the multiple variables contributing to the interindividual variation in adrenocortical stress responses. The results suggest that gender, genetics and nicotine consumption can influence the individual's stress responsiveness to psychological stress while personality traits showed no correlation with cortisol responses to TSST stimulation. From these data we conclude that the TSST can serve as a tool for psychobiological research.