Self-reported Stress Levels Research Articles

Narrative review: The role of nature, plants, and art in post‑operative outcomes

BACKGROUND Recovery from surgery is a stressful experience for patients, both physically and psychologically. Previous research has shown that in- creased stress has effects on post-operative outcomes. Non-pharmacological therapies, such as experiencing nature, may be potential avenues to further improve patient care. METHODS PubMed and Google Scholar were searched for the terms “nature,” “plants,” “surgery,” “post-operative outcomes,” and “pain.” RESULTS There were very limited numbers of studies looking into the effect of plants, nature, and art on post-operative outcomes. Those that did exist were relatively low quality in design. Nevertheless, exposure to plants was associated with a slightly reduced systolic blood pressure and reduced self-reported stress levels and pain intensity. Similarly, a retrospective study found that patients in rooms with views of nature consumed less analgesia on days three to five post-operatively, and had a slightly shorter hospital stay. Views of artwork were associated with increased mobilization distance on day one post-operatively, but this association disappeared from day two onwards. Some evidence exists that nature and images of nature can improve pain tolerance in university students, but this may not generalize well to the clinical population. CONCLUSION There is limited evidence to support the thesis that the view of plants, nature, or art can improve post-operative outcomes. The papers identified in this review were of low quality with limited statistical power. However, enabling access to nature and art could be an avenue for non-pharmacological improvement of patient outcomes, and high-quality studies are warranted.

Psychosocial Effects of COVID-19 pandemic on Yemeni healthcare workers: A Web-based, Cross-sectional Survey

ABSTRACT Yemeni healthcare workers (HCWs) experience high levels of psychosocial stress. The current study provides a psychosocial assessment of Yemeni HCWs during the COVID19 pandemic and the factors that influence this. Between 6 November 2020, and 3 April 2021, 1220 HCWs inside Yemen self-reported levels of stress, anxiety, insomnia, depression and quality of life using a web-based, cross-sectional survey. According to the findings, 73.0%, 57.3%, 49.8%, 53.2%, and 85.2% of all HCWs reported moderate or severe stress, insomnia, anxiety, depression, and a lower quality of life, respectively. Significant positive correlations were found between stress and anxiety, insomnia, and depression scores, as well as anxiety and insomnia and depression, and insomnia and depression (p < 0.001). There was also a significant inverse relationship between wellbeing scores and stress, anxiety, insomnia, and depression scores (p < 0.001). A high percentage of respondents (85.8%) were 40 years old or younger and 72.7% had fewer than 10 years’ experience, suggesting that experienced medics leave Yemen for safer and more secure jobs elsewhere. Psychosocial support to assist in building resilience to the prevailing conditions may need to be embedded in medical school training and continuing professional development to help support HCWs within Yemen and prevent even more from leaving the country.

Assessing Stress Levels, Predictors and Management Strategies of Inmates at Ankaful Prison Complex in the Central Region, Ghana.

Stress among prison inmates is a neglected psychological health issue, but this phenomenon seems worse in Ghana's prisons. This study examined the stress levels, predictors and management strategies utilized among inmates at Ankaful Prison Complex. This survey sampled 1160 inmates using the census approach at the Ankaful Prison Complex with a self-developed questionnaire for the data collection. Frequency counts, one-way ANOVA, and multiple regression analysis were applied to the data. The findings indicate that more than half of the inmates were moderately or highly stressed. Specifically, inmates at the Maximum Security Prison were the most stressed, followed by Annex Prison, Communicable Disease Prison, and the least, Main Camp Prison inmates. Inmate engagement in exercises, sporting activities, visit and chat with colleagues, and family connectedness outside the prison were stress-management strategies. Inmates' self-reported stress levels were influenced by the prison of custody and state of depression. The moderate to high stress levels identified among inmates of Ankaful Prison Complex are influenced by person-environment factors. Management of the Ankaful Prison Complex is encouraged to initiate health screening services for inmates on common mental health challenges such as stress and to promote functional stress reduction interventions to improve prisoners' mental health and overall well-being.

Changes in Working Women’s Self-Reported Subjective Wellbeing and Quality of Interpersonal Relationships During COVID-19: A Quantitative Comparison of Essential and Non-essential Workers in Singapore

Abstract The COVID-19 pandemic has affected working women’s well-being in different ways due to contrasting national responses. This article focuses on the specific context of Singapore, which implemented differentiated rules for workers: essential workers continued to report to workplaces, while non-essential workers were required to work from home. This policy had far-reaching implications for working women, who are more likely than husbands to juggle paid work and household duties. The article uses longitudinal data collected in 2018 and during the pandemic in 2020, specifically during Singapore’s lockdown period, to measure changes in 287 working women’s self-reported levels of stress, fatigue, and quality of interpersonal relationships by essential worker status. While all workers were affected by the pandemic, female essential workers were more likely than their non-essential peers to report declines in stress levels from 2018 to 2020, and less likely to report changes in spousal relationships, both positive and negative. Findings suggest that the differences were driven by exposure to quarantine conditions faced by non-essential workers. Our results highlight the importance of policies supporting frontline workers and more gender-equitable labour market policies to support married women juggling the twin demands of employment and household responsibilities.

Stress and Oral Health-Related Quality of Life Among a Sample of College-Educated Black Men.

This study assessed if higher levels of self-reported stress were associated with self-reported oral health-related quality of life (OHRQoL) among a sample of college-educated Black men. Using a community-based participatory approach, a questionnaire was developed and distributed using two validated instruments, the Holmes-Rahe Stress Inventory and the Oral Health Impact Profile-14. Eighty men completed the questionnaire, with 58.8% reporting Holmes-Rahe scores above 150 (mean=209, SD=175.2). The highest OHIP-14 mean ratings on a scale of 0 to 3 were for feeling self-conscious (mean=.67), painful aching (mean=.55), feeling embarrassed (mean=.49), and eating discomfort (mean=0.48). Among participants with Holmes-Rahe Stress Inventory scores above 150, mean OHRQoL levels were significantly higher for domains of painful aching (p=.007), eating discomfort (p=.038), feeling self-conscious (.006), and experiencing tense feelings (.049). Higher stress levels may be associated with college-educated Black men's experiences of oral health-related physical pain and psychological discomfort.

Leveraging Campus Landscapes for Public Health: A Pilot Study to Understand the Psychological Effects of Urban Sheep Grazing on College Campuses.

Since the 1980s, college students in the U.S. have self-reported a decline in their physical and emotional health. With these conditions compounded by the COVID-19 pandemic and its physical distancing restrictions, higher education institutions have an increased responsibility to establish strategic interventions and health-promoting programs for their students. Research collaborations between public health professionals and environmental designers have highlighted the benefits of environmental factors, such as wildlife, street trees, and public parks, on mental health. This pilot project aims to build upon the transdisciplinary dialogue between ecology, design, and public health by examining the social benefits of grazing lawnscape management, which is the practice of using herbivorous livestock to manage turfgrass areas. Through the design of an accessible central campus grazing space for a flock of 25 sheep and use of online questionnaires, a smartphone-based single-item survey, and open-ended feedback given via social media, the UC Davis Sheepmower Project addresses three primary questions: (1) Are there differences in self-reported stress levels and well-being between people who did not watch grazing sheep (no sheepmower group) compared with those who did watch grazing sheep (sheepmower group)? (2) Does holding sheep grazing events create opportunities for education about well-being and engagement with the campus community? (3) Can this type of urban grazing installation ultimately contribute to the overall identity of a college campus? Web-based questionnaire results indicate there is no significant difference in self-reported stress levels between the two groups; however, the moment-in-time smartphone-based single item question suggests that the presence of sheep provides temporary, noticeable relief and enhanced mood for those who observe the animals. Reflections posted on social media suggested that participants found the sheep grazing events fostered feelings of community and placemaking within the campus identity. However, the questionnaire sample indicated the grazing events did not have a significant effect on participants' sense of place or overall campus identity. This transdisciplinary effort breaks down traditionally siloed approaches to human and environmental health and is an example of a whole-systems approach to developing innovative solutions and encouraging applied collective action.

Stress in performance-related pay: the effect of payment contracts and social-evaluative threat

There is some evidence that performance-related pay (PRP) leads to higher levels of stress as it incentivizes employees to work harder for longer. However, PRP in the workplace also typically involves performance monitoring, which may introduce an additional source of stress via social-evaluative threat (SET). The current study examined the effect of PRP on stress while varying the level of performance monitoring/SET. Using an incentivized mixed design experiment, 206 participants completed a simulated work task after being randomly allocated to either a PRP contract (£0.20 per correct response, n = 110) or minimum-performance fixed payment contract (£5 for ≥10 correct responses; £0 for <10, n = 96) condition. All participants completed the task during a high SET (explicit performance monitoring) and low SET (no monitoring) condition. Subjective and objective stress were measured through self-report and salivary cortisol. High SET led to higher levels of self-reported stress but not cortisol, whereas there was no effect of the payment condition on either self-reported stress or cortisol. A statistically significant interaction revealed that high SET-fixed payment participants were significantly more stressed than those in the high SET-PRP group. Estimating the regressions separately for high- and low-performing individuals found that the effect was driven by low-performing individuals. These results suggest that fixed payment contracts that have a minimum performance threshold and which include performance monitoring and SET can be more stressful than traditional piece-rate PRP contracts. The current study suggests that incorporating performance monitoring and SET into payment contracts may affect the well-being of employees.

Pythagorean Self-Awareness Intervention Promoted Healthy Dietary Patterns, Controlled Body Mass Index, and Reduced Self-Reported Stress Levels of Primary School Children: Α One-Arm Pilot Study.

Stress is common in childhood and an important factor that affects behavior later in adulthood. The aim of this study was to assess the effects of the Pythagorean Self-Awareness Intervention (PSAI), a holistic "cognitive reconstruction" technique to assess primary school children's stress levels, adherence to the Mediterranean diet, and body mass index. Secondary outcome measures included relations with peers, sleep, and hair cortisol concentrations. This one-arm pilot study took place in a primary school, from February to June 2019. Participants were 32 pupils attending the second grade of primary school who received the 8-week PSAI to adopt healthy behaviors and lifestyle. Self-report measures were applied for the evaluation of various variables at the beginning and the end of the eight-week intervention. There were statistically significant reductions in stress levels (p=0.00), nightmares' frequency (p=0.00), body mass index (p=0.03), and bully scale (p=0.00), and improvement in Mediterranean diet quality (p=0.00). Hair cortisol concentrations increased (p=0.02). The social scale significantly increased. Bedtime remained the same after the intervention. This pilot trial showed that the PSAI promoted healthy dietary patterns, controlled children's body mass index, and reduced their self-reported stress levels. Further research on the implementation of this holistic program on children is suggested, in well-powered randomized controlled trials.

CROSS-NATIONAL COMPARISONS OF STRESS AND WELL-BEING IN THE INTERNATIONAL FAMILY OF HEALTH AND RETIREMENT STUDIES

Abstract Strong evidence demonstrates the long-term influence of stress and well-being on psychological, social, and physical health outcomes across the lifespan. Because of this, stress and well-being measures have been added to nearly all of the International Family of Health and Retirement Studies. However, this newly available data has not been compared cross-nationally or within-country to unpack how culture influences these important predictors of healthy aging. Using the Gateway to Global Aging Data, which provides harmonized data from the Health and Retirement Study and its sibling nationally representative studies, levels of self-reported stress (e.g. job stress, discrimination, loneliness) and well-being (e.g. quality of life, life satisfaction) are compared across 30 countries. Data come from the following studies: HRS, ELSA, SHARE, TILDA, CHARLS, KLoSA, MHAS, and JSTAR. We used data from the latest study wave for which the relevant survey was implemented. Average age of participants across studies is 67 and 55% are women. Initial analyses show stressor specific findings such as participants in Korea reported greater work stress than participants in Japan, England, the United States, and across Europe, and the United States reported higher loneliness than China and England, but not higher than Ireland. Reporting cross-national and within-country variation in these measures will be generative in pointing to new research directions for understanding how culture influences health and aging trajectories.

The effect of online social evaluation on mood and cognition in young people

Adolescence is characterised by increased peer interactions and heightened sensitivity to evaluation by peers. Increasingly, social interactions and evaluation happen in online contexts. Yet, little is known about the impact of online social interactions and evaluation on adolescent emotional and cognitive functioning. The present study examined the impact of online social evaluative threat on young people’s mood and learning and whether this varied as a function of known offline social risk and protective factors. 255 participants completed a perceptual learning task under online social evaluative threat and a perceptually-matched control condition. Participants were aged 11–30 years, to allow for the exploration of age differences in the impact of online social evaluative threat from adolescence to early adulthood. Participants reported a greater increase in negative mood (self-reported levels of stress, anxiety, and anhedonia), following social evaluative threat compared to the control condition. Heightened social rejection sensitivity (measured using the Online and Offline Social Sensitivity Scale) and lower perceived social support (measured using the Schuster Social Support Scale) were associated with elevated negative mood across the study. Social evaluative threat adversely impacted overall accuracy on the perceptual matching task, but not learning. These findings provide preliminary evidence that online social evaluative threat impacts adolescent mood and cognitive functioning.

Assessing students' mental health in two American dental hygiene programs.

Dental hygiene students adapt to new environments while learning technical skills and providing clinical care during their education. Understanding how stress affects students in their professional healthcare program warrants exploration. This study assessed stress among dental hygiene students in two educational settings in the Southeastern United States. First and second-year dental hygiene students (N= 136) from a community college setting (n= 67) and a university setting (n= 69) were invited to complete an anonymous online survey on mental health in fall 2019. Validated surveys on depression, anxiety, social support, and burnout were included. Data analysis included chi-squared and Mantel-Haenszel statistics, depending on the scale of measurement, with the level of significance set at 0.05 for all analyses. Participants included 54 dental hygiene students from a community college (Response rate=80.6%) and 69 dental hygiene students from a university (RR=100%). There was a statistically significant difference in the proportion of students reporting moderately severe or severe anxiety (p = 0.007), with 56% (n= 30) of the community college respondents and 36% (n= 24) of the university reporting these anxiety levels. Students attending a community college were also more likely to express feelings of worry (n= 34) compared to students in a university setting (p =0.005). There was no statistically significant difference in depression (p= 0.07) or suicidal thoughts (p= 0.41). Dental hygiene students enrolled in these two programs reported high levels of self-reported stress, mental and emotional concerns that may increase suicidal tendencies.

Safety Concerns for Laboratory Professionals in Rural Practice Settings During Covid-19

Abstract Introduction/Objective The COVID-19 pandemic exacerbated the health risks of laboratory professionals. This study aimed to understand the impact increased workload and decreased staffing levels have, specifically in rural areas where clinical laboratory testing is performed, and to document how these changes affect the wellbeing of laboratory professionals. Methods/Case Report The study integrated responses from a cross-sectional study of laboratory professionals which employed an anonymous electronic survey deployed between November of 2021 and February of 2022. Specific items asked if participants had worked in clinical laboratories since the public health emergency started, if they were concerned regarding Covid-19 transmission, adequate staffing, and support at their workplace. A subsequent qualitative study including focus groups and an interview questionnaire targeted laboratory professionals working in rural laboratories in four states of the Mid-west to further understand any immediate health impacts on wellbeing for these professionals. Results (if a Case Study enter NA) Among 438 participants in the survey that indicated they worked in the laboratory since March of 2020, 20% said they worked in non-metro US counties (RUCC 4-9). Among the non-metro laboratory professionals, 70% indicated that staffing levels in their laboratories were inadequate, with over 50% of them expressing concern about contracting Covid-19 at their workplace, and 53% saying they had been told to work despite a possible or confirmed exposure to the virus. The analysis of thirteen focus groups (N=59) and qualitative written interviews (n=15) found that workplace changes impacted the health of laboratory professionals in rural areas. These included lack of availability of laboratory equipment and increased work hours, which increased self-reported levels of stress. Recommendations for improvement included flexibility in scheduling of hours and proper compensation for overtime work. Conclusion Working in rural clinical laboratories during the Covid-19 pandemic exposed laboratory professionals to stress that was exacerbated by a work environment operating in scarcity.

Personalized audio montage: Impact of a receptive music therapy method-variation on youth experiencing homelessness

ABSTRACT Introduction This quantitative research investigates the impact of a receptive music therapy method-variation, Personalized Audio Montage (called Montage Audio Personnalisé [MAP] in French), on self-reported levels of stress, anxiety, physical tension, fatigue, and mood of youth experiencing homelessness. Method A single-group pretest-posttest design was used to determine the impact of MAP. Participants completed the co-researcher music therapist-developed Visual Analogue Scales (VAS) for five independent variables (i.e. self-reported levels of stress, anxiety, fatigue, physical tension, and mood), before and after participating in individual MAP sessions. Multivariate ANOVAs for repeated measures were used considering time (pretest-posttest), and MAP sessions as within-subjects factors. Results Nine youth (n = 9) participated in one to three MAP sessions. There were 20 pre-tests and post-tests for each independent variable except for anxiety, for which 19 pre-tests and post-tests were completed. Results of quantitative data analysis show a statistically significant decrease in scores for self-reported levels of stress, anxiety and physical tension at post-session as compared to pre-session. No significant effect was observed for fatigue. Finally, mood scores significantly improved from prettest to posttest. Discussion Findings suggest that MAP holds potential to be a valuable part of music therapists’ intervention strategies to support the emotional and physical well-being of youth experiencing homelessness. Limitations and future research recommendations are presented with regard to the small sample size and complexity of conducting research with youth experiencing homelessness.

The association between adolescent mental health and oral health behavior: The Luxembourg Health Behavior in School-Aged Children study

Oral health remains a global health problem. Mental health has been linked to oral health behavior. However, studies among adolescents in high-income countries are limited. This study aimed to investigate the association between adolescent mental health and well-being with regular toothbrushing. We used data from the 2018 Luxembourg Health Behavior in School-Aged Children study (n = 7,561; n = 3,896 [51.5%] girls; mean [standard deviation] age = 14.9 [2.1] years). Multiple logistic regression analyses were performed to assess the associations of self-reported stress levels, life-satisfaction, somatic health complaints, and psychological health complaints with regular toothbrushing (≥2 daily). Analyses were adjusted for gender, age, family affluence, family structure, migration background, daily sugar consumption, smoking behavior, and general health. 70.5% of the adolescents regularly brushed their teeth. Adolescents who reported higher levels of stress (odds ratio [OR], 95% confidence interval [CI]; 0.97 [0.95;0.99] per one-point increase), low life-satisfaction (OR = 0.92 [0.89;0.95] per one-point increase), and psychological health complaints (OR = 0.95 [0.91;0.99] per complaint) were less likely to regularly brush their teeth. No association was found between somatic health complaints and regular toothbrushing (OR = 1.00 [0.94;1.06] per complaint). Adolescents with poor mental health and well-being are less likely to regularly brush their teeth and may have an increased risk for oral diseases. Interventions focused on lifestyle modification in adolescents with mental health problems should include regular toothbrushing to prevent dental caries and other oral diseases.

Perceived Barriers in Delivering Optimal Healthcare Services in a Dedicated COVID-19 Hospital: Perspectives of Health-Service Providers.

Background The coronavirus disease 2019 (COVID-19) pandemic challenged the healthcare infrastructure, with health-service providers (HSPs) offering unconditional and unprejudiced service to admitted patients. During the first wave, due to the novelty of the disease and the lack of clarity regarding its transmission in the initial phases of the evolution of the disease, the predominant fear was of contracting the disease while caring for patients. With the prevailing uncertainty in knowledge and management, this study was planned to identify the barriers to delivering optimal healthcare to COVID-19 patients. Methodology A cross-sectional study was conducted among HSPs working in the first phase of a dedicated 500-bed government COVID-19 hospital at Kalinga Institute of Medical Sciences using an online questionnaire with the following five aspects: workplace guidelines and support, protective equipment, access to information regarding updates on the epidemic, overall self-reported stress and workplace stress about self-infection with COVID-19 and family being infected, and demographics. All HSPs aged 18 years or above, who were working either on a full- or a part-time basis, were able to understand the English language, and who were working in the COVID-19 hospital and gave digital informed consent (via Google Forms) were included in the study. All data were collected, coded, tabulated, and analyzed using Google Forms in an Excel format and Epi Info software version 7.2.5.0. Results Of the 144 respondents contacted, 132 completed the survey, with a participation rate of 91.67%. About 52.27% of respondents were aged 21-30 years, 68.18% were females, and 56.06% were nurses. Challenges faced were "working in a new context" (40.91%), "the uncertainty and fear of being infected and infecting others"(31.06%), and "exhausted by the workload and protective gear" (18.94%). Moreover, 64.12% were aware of a workplace policy. Only 0.75% felt that their workload needed to be reduced; 2.27% felt the need for a penalty policy for hiding travel history, lack of quarantine compliance, avoiding the accumulation of face masks, and price inflation of face masks. The overall self-reported stress level was significantly associated with a lack of awareness of workplace policies and the fear of getting infected. Furthermore, 93.94% reported that they had an adequate supply of personal protective equipment. As high as 81.06% of the HSPswere "worried about being infected from COVID-19 during work," and 94.69% were "worried about their family being infected from COVID-19 due to their working in COVID-19 hospitals." Conclusions HSPs' perception of barriers in providing healthcare gave an insight into the problems being faced and helped improve the quality of services. The study highlighted the need of increasing awareness regarding the existing workplace policies among HSPs to promote preparedness during crisis management.

An ecological momentary music intervention for the reduction of acute stress in daily life: A mixed methods feasibility study.

Background: Despite the growing potential of mobile-based technologies, innovative interventions targeting the reduction of acute stress in daily life remain under-researched. Music listening is an easy-to-administer activity that is associated with lower levels of biological and self-reported stress. However, the application of music as an intervention in moments of acute stress in daily life remains to be examined. We developed a just-in-time intervention delivering music in moments of stressful experiences in daily life and tested its feasibility using a mixed methods approach.Methods: In this uncontrolled pilot study, the ecological momentary music intervention (EMMI) was tested by 10 chronically stressed women aged 23.5 ± 3.3 years. Over 18 consecutive days, whenever participants reported stressful experiences, they were encouraged to listen to a self-compiled playlist. Subjective stress levels and saliva samples were assessed at three time points per stress report (T0, upon reporting a stressful situation; T1, directly after music listening/15 min after T0 in case of no music listening; T2, 15 min after T1). We analyzed app-based log data, in-the-moment responses, questionnaire data, and semi-structured interview data.Results: On average, participants’ compliance with the study protocol lay at 70%. Overall, 65 stressful experiences were reported, 51 of which were followed by music listening, for an average duration of 12:53 min. Complete data (i.e., self-reports and saliva samples at all three time points) were provided for 46 stressful experiences. Participants reported immediate relaxation and distraction through music listening. The interviews revealed that the intervention was easy to use and that music listening in moments of perceived stress was viewed as a new and pleasant activity. Several aspects of the protocol (e.g., number of items and prompts) were identified, which should be improved in future studies.Conclusion: Since repeated stressful experiences in daily life can pose a threat to physical and mental integrity, interventions that are easily applicable and deliver support when needed most are necessary. Following minor adaptations, the EMMI can be considered as a feasible approach to target psychobiological stress responses in daily life, which is worthy of investigation in future larger-scale trials.

The impact of the COVID-19 epidemic on students' mental health: A cross-sectional study.

The COVID-19 pandemic is currently one of the biggest public health threats for people's mental health. A particularly endangered group were students, who became highly affected by measures of social distance due to their active lifestyle. Therefore, the aim of this paper is to assess the level of self-reported stress, anxiety and depression of the student population in Serbia, in relation to demographic characteristics, living and studying conditions, students' activities during the epidemic, potential coronavirus infection and general, mental and physical health. We conducted a cross-sectional study of 580 undergraduate medical students from the University of Belgrade during the 2020/2021 school year. Mental health data were collected using the Depression Anxiety Stress Scales (DASS-21). Both bivariate and multivariate logistic regression analysis were used to examine the association between independent variables with the dependent variable mental health. Women made up the majority of the sample with 80.3%. A total of 64.5%, 66.8% and 66.7% of students between the ages of 21 and 30 had severe depressive symptoms, severe degree of anxiety, and a severe degree of stress, respectively. Women almost twice as often (OR = 1.89) assessed their anxiety as severe and almost two and a half times more (OR = 2.39) perceived stress as severe compared to men. Students who lived with their families during studies two and a half times (OR = 2.57) more often assessed their stress as severe, compared to students who lived alone. Fifth- and sixth-year students were less likely to rate depression and anxiety as serious than the first-year students. Medical students reported their health as severely impaired in terms of depression, anxiety and stress reactions. The results indicate the need to launch a mental health program in the form of counseling and emotional support to students affected by the pandemic.

Can’t Shake the Prison Guard Blues: Examining the Effects of Work Stress, Job Satisfaction, Boundary Violations, and the Mistreatment of Inmates on the Depressive Symptomatology of Correctional Officers

Many correctional officers who work in close proximity with inmates are at a heightened risk of experiencing feelings of psychological distress. We analyzed 501 surveys collected from correctional officers within the Texas Department of Criminal Justice to identify characteristics of officers who are likely to exhibit signs of depression. Our findings reveal that female officers, as well as officers who work in higher custody levels, are more likely than other officers to report higher levels of depressive symptomatology. We also found that officers who experienced high levels of self-reported job-related stress were more likely to suffer from depression. Officers with attitudes favorable to the mistreatment of inmates also reported higher levels of depression. Officers who perceived their coworkers were engaging in boundary violations were no more or less likely to exhibit signs of depression. Given these findings, we conclude that organizational and supervisory support, coupled with positive incentives and employee assistance programs, may help mitigate the risks of depression for correctional officers, thereby making these salient staff more efficient and effective in the prison workplace.

Does childhood trauma impact daily psychobiological stress in somatic symptom disorder? An ambulatory assessment study.

ObjectivesSomatic symptom disorder is characterized by excessive thoughts, feelings, and behaviors dedicated to bodily symptoms, which are often medically unexplained. Although 13% of the population are affected by this disorder, its aetiopathogenesis is not fully understood. Research in medically unexplained conditions (e.g., fibromyalgia) points to increased psychosocial stress and alterations in stress-responsive bodily systems as a potential contributing factor. This pattern has often been hypothesized to originate from early life stress, such as childhood trauma. The aim of this study was to examine, for the first time, whether individuals with somatic symptom disorder exhibit elevated levels of self-reported daily stress and alterations in the autonomic nervous system and hypothalamic-pituitary-adrenal axis, both in comparison to healthy controls and individuals with depressive disorders, and whether reports of childhood trauma influence these alterations.MethodsA total of N = 78 individuals were recruited into this study. Of these, n = 27 had a somatic symptom disorder, n = 23 were healthy controls, and n = 28 had a depressive disorder. All individuals underwent a 14-day measurement period at home, with five assessments of self-reported stress, salivary alpha-amylase, and cortisol per day. Childhood trauma was assessed by the Childhood Trauma Questionnaire.ResultsIndividuals with somatic symptom disorder exhibited higher daily stress levels (p = 0.063) as well as a less pronounced alpha-amylase awakening response (p = 0.050), compared to healthy controls (statistical trends). Moreover, they were characterized by significantly attenuated diurnal cortisol concentrations (p < 0.001). A nearly identical pattern was observed in individuals with depression. In individuals with somatic symptom disorder and depressive disorders, childhood trauma was, by trend, associated with a more pronounced alpha-amylase awakening response (b = −0.27, p = 0.077).ConclusionsThis study provides preliminary evidence for elevated daily stress and blunted sympathetic and hypothalamic-pituitary-adrenal axis activity in individuals with somatic symptom disorder and depressive disorders. Further studies will help to uncover the conditions under which these dysregulations develop into medically unexplained vs. depressive symptoms.

Perceptions, Coping Strategies, and Mental Health of Residents during COVID-19.

Since the inception of the coronavirus disease 2019 (COVID-19) pandemic, the United States has been the leader in cases and deaths. Healthcare workers treating these severely ill patients are at risk of many deleterious consequences. Residents, in particular, may be affected by physical as well as psychological consequences. Because data are sparse on perceptions, coping strategies, and the mental health of residents during COVID-19, we explored these issues in survey data from a community-based academic program in the southeastern United States. In May 2020, when US deaths from COVID-19 reached 100,000, we administered multiple-choice online anonymous surveys to assess resident perceptions, coping strategies, and self-reported levels of depression, anxiety, and stress. We used the COPE inventory to assess coping strategies and the Depression, Anxiety, and Stress Scale-21 questionnaire. A total of 59 (41.3%) of 143 eligible residents completed the survey, 52 (88.1%) of whom believed that they were likely or very likely to become infected with COVID-19. If infected, 17 (28.8%) believed that their illness would be serious or very serious. The top three strategies to cope with COVID-19 included acceptance, self-distraction, and use of emotional support. With respect to depression, anxiety, and stress, all of the mean scores were in the normal range. During COVID-19, residents in a southern community-based program with an academic affiliation reported effective coping strategies, predominantly acceptance, self-distraction, and use of emotional support. They reported concerns about becoming infected and, if they did, that their illness would likely be serious. Finally, they have not experienced depression, anxiety, or reported stress. The findings may be restricted in generalizability to a southern community-based program with an academic affiliation.