BackgroundEscalating workplace stress has made employee well-being a global concern, necessitating the identification of factors and underlying mechanisms that impair psychological health. Against this backdrop, examining burnout as a potential workplace stressor and its implications for employee well-being is both timely and crucial.PurposeBuilding upon the Stress Appraisal Theory, this study endeavoured to assess the impact of burnout on employee well-being at work in terms of their work engagement and job satisfaction. The relationship between these variables has been elucidated through the lens of a moderated mediation framework of psychological capital (PsyCap) and psychological distress. Specifically, the contribution of psychological distress in mediating the relationship between burnout and employee workplace well-being was ascertained. Further, the function of PsyCap in alleviating the influence of burnout on the workplace well-being of employees was examined.MethodsThis study proposed a moderated mediation model exploring the underlying and intervening mechanisms of the association between burnout and employee workplace well-being, with reference to psychological distress and PsyCap. The model was tested among 439 human service professionals using a two-step approach to structural equation modelling.ResultsThe findings revealed that burnout results in poor workplace well-being of employees in terms of work disengagement and job dissatisfaction through an indirect relationship via psychological distress. Further, it was found that PsyCap has moderated this indirect relationship such that employees with high PsyCap suffer less from the repercussions of burnout and subsequent psychological distress.ConclusionThe study highlights the role of personal factors in a comprehensible model of burnout and well-being. Insights about such factors and their latent processes are indispensable for designing effective mental health interventions at work.

Women with primary infertility experience elevated psychological distress, yet the interplay between individual symptoms and psychosocial factors remains unclear. This study aimed to identify central and bridge symptoms within a network of depression, anxiety, and psychosocial factors in Chinese women with primary infertility. A total of 1,062 women with primary infertility were recruited from four reproductive medicine centers in China between February and December 2025. Depression (PHQ-9), anxiety (GAD-7), perceived stress (PSS-10), fertility-specific stress (COMPI-FPSS-SF), infertility stigma (ISS), social support (MSPSS), and resilience (CD-RISC-10) were assessed. Network analysis using regularized partial correlation networks was conducted to estimate network structure, centrality, bridge centrality, and predictability. Of the participants, 9.6% met clinical thresholds for depression and 5.3% for anxiety. Difficulty relaxing exhibited the highest centrality among symptoms. Public stigma showed the strongest centrality among psychosocial factors, with a robust connection to family stigma (edge weight = 0.538). Perceived stress emerged as the primary bridge linking psychosocial factors to symptoms (bridge expected influence = 0.297), followed by fertility-specific stress (bridge expected influence = 0.143). Guilt was the key bridge symptom (bridge expected influence = 0.086). Resilience showed the strongest negative association with perceived stress (edge weight = - 0.275). Network stability was excellent (CS-coefficient = 0.75). Difficulty relaxing, perceived stress, and guilt emerged as potentially important nodes that warrant further investigation as candidate intervention targets for psychological distress in women with primary infertility. Interventions targeting relaxation training, stress appraisal, and self-compassion, alongside resilience enhancement, warrant further investigation. Not applicable.

Background: Cardiovascular diseases pose a challenge for patients, partners, and medical staff. This study aimed to explore how patient activation relates to partner reactions (pessimistic illness perception, overprotection, hostility, support for patient activation, dyadic stress appraisal, and common dyadic coping), as well as relationships with the healthcare team (clarity of information, satisfaction with medical staff, partner-doctor relationship quality). Methods A dyadic design was used, with partners from 86 couples filling a self-report questionnaire at cardiac rehabilitation admission. Findings Results from path analysis showed that patient activation was higher when the partner’s illness perception was less pessimistic, when the partner was less overprotective, and the couple was more able to cope together. Also, patient activation was higher the better the patient’s relationship with the medical staff and the less the partner reported to have a good relationship with the patient’s doctor. No associations were found between patient activation and partner’s hostility, partner support to patient activation, and dyadic stress appraisal. Finally, no associations were found between patient activation and clarity of information received at intake. Discussion Research and interventions should take advantage of dyadic and team-based approaches to better understand relational drivers of patient activation and effectively leverage their different roles.

The Leiden Stroop-like Stress Task: A Tool to Reveal Physiological Dynamics Using Graded Stress Induction.

ABSTRACT Grounded in the stressor-emotion model, this study reports an empirical examination of the relationships between exploitative leadership on employees’ cognition and work behavior, incorporating the mediating role of organizational frustration and the moderating effect of stressor appraisals. Since ambiguity surrounds these processes, this perspective offers clarity on the negative chain reactions triggered by supervisors’ exploitative leadership of employees. Data were collected from 298 full-time front-line employees and their direct supervisors. The findings reveal: (1) exploitative leadership positively affects employees’ organizational frustration; (2) organizational frustration mediates the relationship between exploitative leadership and both contextual performance and silence behavior; (3) hindrance stressors amplify the positive relationship between exploitative leadership and organizational frustration; and (4) challenge stressors mitigate the positive relationship between exploitative leadership and organizational frustration. These findings extend the understanding of exploitative leadership by distinguishing employees’ active and passive behavioral responses and revealing organizational frustration as an important mediating process. By including stressor appraisals as a boundary condition, we clarify when exploitative leadership worsens or attenuates frustration and associating employee behaviors

Risky driving behavior (RDB) while ambulances are engaged in medical emergency services comprises a critical occupational risk as well as a public-safety threat, but the mechanisms underlying such behaviors influenced by perceived stress among emergency medical services (EMS) personnel remain poorly articulated. Based on transactional stress appraisal theory and conservation of resources theory, this study investigated the mediating role of cognitive failures and emotional exhaustion between perceived stress and risky driving. A cross-sectional survey was carried out among 400 frontline emergency medical services personnel, including ambulance drivers, emergency medical technicians, and paramedics with recent experience in driving ambulances on duty in Saudi Arabia. Partial least squares structural equation modeling was used to analyze data. Perceived stress directly did not significantly affect risky driving. But perceived stress positively affected cognitive failures and emotional exhaustion. Cognitive failures and emotional exhaustion, in consequence, had strong positive effects on risky driving. Mediation analysis also indicated specific indirect effects of perceived stress on risky driving through cognitive failures and emotional exhaustion, with both counting as full mediations. The control variables listed were not significant. Perceived stress affects risky driving behavior among emergency medical services personnel not directly but through both cognitive and affective pathways that are parallel to each other. Stress may also promote risky driving in particular through attention lapses, action and memory failures, stressful task conditions leading to emotional depletion, etc. These findings are an expansion of the understanding of driving safety in emergency medical services and emphasize that to enhance safe driving during ambulance operations, it is vital to address not just stress itself but also the cognitive and emotional fallout from stress.

Hopelessness Appraisals of Stressors and Suicidal Ideation: The Moderating Role of Girls' Expressed Vulnerability to a Close Friend Following Stressor Exposure.

ABSTRACT In mainstream classrooms, students are frequently confronted with achievement expectations. Some students might struggle in meeting these expectations for different reasons. A mismatch between expectations and expected outcomes might be appraised as school-related stress. The appraisal of stressors varies between individuals and groups. Students with low academic achievement and behaviour difficulties in schools are possibly at risk of experiencing increased levels of stress. Nevertheless, only a few and inconsistent study results are available on differences between the experiences of stress of these subgroups of students. As inclusive education aims to support students’ mental health, it is important to examine the school-related stress perception of students with (comorbid) learning and behavioural difficulties. Therefore, longitudinal self-reports of N = 619 students were analysed using linear mixed-effects models. The results highlight an increase in the stress levels over the course of 1 year as well as significant differences between subgroups with and students without these difficulties. Significant proportions of variance are explained by class affiliation. These findings indicate the need to support students’ perception that they can adequately cope with the demands of school. This is particularly the case for students with low academic achievement and behaviour difficulties.

A large body of literature details the deleterious effects of everyday discrimination on health, focusing on stress processes after discrimination occurs. In contrast, less work has investigated what occurs prior to encountering discrimination when a person expects it. Using a 10-day daily diary design, the current study examined predictors and outcomes of anticipated discrimination. Participants included 341 U.S. adults aged 19–74 years (29% racial minorities, 68% women). Multiple regression examined predictors of anticipated and reported discrimination. Further, two-level multilevel models evaluated anticipated discrimination predicting discrimination occurrence, appraisals, affect, and physical symptoms. Results showed that discrimination was anticipated on 21% of days; racial minorities and people with more prior exposure to discrimination anticipated more daily discrimination than White participants and those with lower prior exposure. People who anticipated discrimination more often than others reported more daily discrimination and perceived discrimination as more stressful but also perceived greater control over the events. They additionally had relatively larger upticks in physical symptoms on days when discrimination occurred—but no differences in discrimination-related affect—compared to people who anticipated discrimination less frequently. Within-persons, anticipating discrimination on a given day (versus not) was associated with greater likelihood of reporting discrimination occurred later that day and greater perceived stress severity, but no differences in perceived control, affect, or physical symptoms. In sum, anticipated discrimination was fairly common in daily life, and individual differences in anticipated discrimination were linked to more perceived daily discrimination, higher perceived stress severity, and more discrimination-related physical symptoms.

Neuromyelitis Optica Spectrum Disorder (NMOSD), a rare antoimmune condition, is characterized by a high relapse rate, necessitating long-term maintenance therapy even during clinically stable periods. This prolonged treatment regimen imposes a significant financial burden on patients, which may be greater than that associated with many other chronic diseases. However, data on the impact of financial toxicity (FT) specifically in NMOSD populations remain limited. This study aims to identify factors influencing FT in NMOSD patients using the ABC-X model as a conceptual framework. A mixed-methods study was conducted in two phases. In the quantitative phase, 210 NMOSD patients were evaluated using four validated scales: (1) Comprehensive Score for FT based on the Patient-Reported Outcomes Measurement Information System (COST-PROM), (2) Fear of Progression Questionnaire-Short form (FoP-Q-SF), (3) Social Support Rating Scale (SSRS), and (4) general self-efficacy scale (GSES). Multivariate linear regression analysis was performed to identify the predictors of FT. In the qualitative phase, 15 NMOSD patients were recruited via purposive sampling and interviewed using a semi-structured format. Interview data were analyzed according to Colaizzi's seven-step phenomenological method. Quantitative findings indicated that fear of disease progression and lower self-efficacy were significantly associated with higher levels of FT (p < 0.05). Qualitative analysis revealed four thematic categories characterizing the FT experience: (1) direct economic burden stemming from core illness-related stressors, (2) insufficient or suboptimal utilization of available resources, (3) biased appraisal of stressors and maladaptive coping strategies, and (4) emergence of a multidimensional familial crisis state. The convergent results from both methodological approaches reinforced the study conclusions while enriching the overall understanding of FT in the population. This study demonstrates substantial FT among NMOSD patients, influenced by clinical, psychological, and social factors. These findings highlight the importance of integrating FT assessment into routine clinical care. In the Chinese healthcare context, challenges including delayed diagnosis, restricted access to medication, and high costs contribute significantly to this burden. Policy-level interventions should focus on improving disease awareness, expanding treatment accessibility, and reducing financial strain on affected individuals and families.

Decomposing the Association Between Neighborhood Homicide Rates and Stress-Related Health Outcomes Among Black Men in Chicago.

Based on the conservation of resources theory, this study examines the relationship between algorithmic stigma and work engagement among platform workers. Hindrance stressor appraisal is proposed as a mediating variable, while job autonomy and fairness perception are introduced as moderating factors. The data were collected from a two-wave survey of 297 platform workers. The results indicated that algorithmic stigma is negatively related to work engagement, and that hindrance stressor appraisal partially mediates the relationship between algorithmic stigma and work engagement. Furthermore, job autonomy and fairness perception moderate the positive link between algorithmic stigma and hindrance stressor appraisal, and also moderate the mediating role of hindrance stressor appraisal in the relationship between algorithmic stigma and work engagement. This study not only extends occupational stigma research into the realm of algorithmic management by proposing and validating the concept of "algorithmic stigma" with technological embeddedness, but also uncovers the stress transmission mechanism through which algorithmic stigma influences work engagement from a dynamic perspective of resource gains and losses. The findings offer practical guidance for platform enterprises to mitigate the adverse effects of algorithmic stigma and enhance workers' work engagement and sustainable career development by optimizing algorithm design, increasing job autonomy, and improving procedural and distributive fairness.

ABSTRACT This study investigates AI use for assignment completion in distance education by focusing on two cognitive predictors, cognitive load and cognitive distortion, and by testing perceived study stress as a moderator of these relationships. We used Structural Equation Modeling–Partial Least Squares (SEM-PLS) to analyze survey data from undergraduate to doctoral students. In total, 308 students from multiple Indonesian provinces completed the questionnaire via Google Forms. The results indicate positive associations between cognitive load, cognitive distortion, and AI-usage intensity, whereas perceived study stress does not strengthen those effects in the moderation tests reported. The study contributes by linking cognitive conditions and technology-use behavior in a single model and by specifying how stress appraisal was expected to shape reliance on AI in distance-learning tasks. The final section provides recommendations derived from the observed patterns in the data.

The COVID-19 pandemic severely disrupted healthcare systems, placing immense physical, emotional, and organizational strain onfront linenursing staff, including registered nurses and nursing assistants. These professionals faced heightened stress due to increased virus exposure, global personal protective equipment (PPE) shortages, and rapidly changing protocols. This study sought to explore the experiences of registered nurses and nursing assistants working in inpatient care during the COVID-19 pandemic, focusing on workplace stressors and available or recommended resources to mitigate these challenges. Despite extensive documentation of elevated stress and burnout among nurses during COVID-19, little is known about how registered nurses and nursing assistants appraised specific workplace stressors and evaluated the adequacy of available organizational resources during the pandemic. Using a qualitative descriptive design, semi-structured interviews were conducted with 14 registered nurses and six nursing assistants from COVID-19 and non COVIDunits at a large academic medical center. Guided by Lazarus and Folkman's Stress and Coping Model, the analysis identified a range of personal, interpersonal, organizational, and societal stressors. Personal stressors included long work hours, loss of loved ones to COVID-19, and feelings of isolation. Interpersonal stressors involved exposure risk, emotional strain from coworkers' stress, and shifts in bedside roles. Organizational stressors encompassed staffing shortages, changes in protocols, and being called off shifts. Societal stressors included inconsistent public health messaging and concerns about protecting vulnerable family members. Participants emphasized the importance of authentic leadership and nursing-centered delivery of resources in addressing these stressors. Six key resource categories emerged: emotional support, staffing, safety, compensation, communication, and stress management. Findings highlight the critical role of nurse managers, effective communication, and staffing policies in mitigating workplace challenges. While rooted in a U.S. context, these insights may inform strategies to support nursing staff globally in future crises, reinforcing the need for tailored, sustainable approaches tofront linecaregiver well-being.

This study examines how university students respond psychologically to an increasingly uncertain employment environment by exploring the relationships among loneliness, job search stress, anticipated organizational belonging, and perceived social support during the transition from university to work. Anticipated organizational belonging is understood here as expectations of inclusion in a future organization rather than feelings of attachment to an existing group. Drawing on belongingness theory and stress appraisal perspectives, survey data from 390 final year students in China were analyzed using structural equation modeling. The results show that loneliness was positively related to job search stress, and job-search stress accounted for part of the association between loneliness and anticipated organizational belonging. This pattern suggests that experiences of social disconnection may coincide with heightened sensitivity to employment uncertainty and a stronger orientation toward future organizational attachment. Job search stress was also positively associated with anticipated organizational belonging, indicating that under competitive and uncertain entry conditions, stress may be accompanied by greater attention to organizational stability and institutional placement. Perceived social support was positively related to anticipated organizational belonging and weakly negatively related to job-search stress, but it did not moderate the relationship between stress and belonging. Overall, the findings do not support a simple deficit interpretation in which loneliness and stress necessarily weaken belonging. Instead, anticipated belonging during the school-to-work transition appears to function as a forward looking evaluation that can increase alongside both stress and loneliness. Because the data are cross-sectional and self-reported, the results should be interpreted as associations rather than causal effects.

Prelicensure nursing students face significant stress and retention challenges. Understanding how students perceive their resources versus demands, academic resilience, grit, and stress may improve their persistence and success in nursing programs. Explore the prevalence of and relationships among academic resilience, grit, perceived stress, and threat appraisal in first-semester students. This study utilized a cross-sectional, observational research design in a sample of 68 nursing students enrolled in three large undergraduate universities in the southwestern United States. Average perceived stress stores were higher than the normed average. There was a significant correlation between academic resilience and both stress ( p < .001) and grit ( p < .001). After controlling for resilience and grit, higher stress significantly increased the likelihood of a threat state. Strategies to reduce stress and boost academic resilience may enhance nursing students' performance by using the academic threat appraisal scale to identify and support struggling students.

ABSTRACT The rapid digitalisation of higher education has intensified academic work demands, particularly in resource-constrained contexts of the Global South, raising critical questions about how faculty sustain teaching effectiveness under growing occupational pressures. Drawing on the conservation of resources (COR) theory and stress appraisal theory, this study investigates how stressors (job insecurity and work-family conflict) shape faculty perceived online teaching effectiveness, with faculty identity disruption as a mediator and leadership support as a moderator across gender and institution types (private and public universities). Using survey data from 426 full-time faculty members engaged in online teaching in Bangladeshi universities, we tested our hypotheses. Results reveal that work-family conflict significantly reduces teaching effectiveness, particularly for female faculty. Contrary to core COR assumptions, job insecurity showed a positive association with teaching effectiveness among public university faculty. Leadership support was insufficient to fully buffer the negative impact of job insecurity on faculty identity disruption. By integrating stress, identity, and institutional context, this study advances research on digital academic work and faculty well-being in higher education, offering new insights into how academics in Global South contexts sustain teaching effectiveness while navigating competing demands in rapidly transforming university environments.

IntroductionHereditary angioedema due to C1-inhibitor deficiency (HAE-C1INH) features clinical heterogeneity and stress-triggered attacks. Behavioral tolerance to acute stress may reveal vulnerability profiles beyond standard clinical descriptors. This study aimed to characterize stress response patterns and compare groups based on behavioral tolerance.MethodsHAE-C1INH patients underwent the Socially Evaluated Cold Pressor Test (SECPT) and were stratified as Completers or Non-completers (early withdrawal). Stress appraisal, cardiovascular parameters (heart rate, HR; systolic/diastolic arterial pressure, SAP/DAP), and plasma cytokines (IL-1β, TNF-α, IL-6) were assessed. Disease control and quality of life were measured via Angioedema Control Test (AECT) and Angioedema Quality of life (AE-QoL) questionnaires.ResultsTwenty patients were enrolled (15 Completers and 5 Non-completers). Non-completers showed poorer disease control (10.6 ± 5.5 vs 14.5 ± 2.2; p ≤ 0.05) and worse AE-QoL, particularly in the Functioning (8.6 ± 4.3 vs 4.7 ± 1.7; p ≤ 0.05) and Fatigue/Mood (13.6 ± 7.1 vs 10.5 ± 3.5; p ≤ 0.05) domains. They reported higher stress (91 ± 8.9 vs 50.5 ± 33.7; p ≤ 0.05), pain (87.8 ± 12.8 vs 50.1 ± 31.3; p ≤ 0.05) and unpleasantness (83 ± 19.9 vs 49.5 ± 30.5; p ≤ 0.05) during the SECPT. Non-completers displayed an attenuated SAP response relative to Completers (128.3 ± 18.0 vs 148.9 ± 18.3 mmHg; p ≤ 0.05). Inflammatory profiles also diverged: Non-completers showed higher IL-6 levels at 40 minutes after SECPT (3.5 ± 1.1 vs 2.2 ± 0.7 pg/ml; p ≤ 0.05) and opposite TNF-α trajectories compared with Completers (0.9 ± 1.0 vs -0.5 ± 0.9 pg/ml; p ≤ 0.05).ConclusionEarly withdrawal during SECPT identifies a vulnerable HAE-C1INH subgroup with distinct psychological, cardiovascular, and inflammatory patterns.

Psychological stress arises when perceived situational demands exceed an individual's available coping resources. Beyond individual differences and broader contextual factors, an individual's emotional connection to a group (i.e., social identity) may shape stress appraisals and physiological reactivity. Across two laboratory experiments with 180 college students, we examined whether making social identity salient influences acute stress responses under different competitive frames, comparing intragroup versus intergroup competition. In Experiment 1, participants in the social-identity condition showed numerically lower cardiovascular reactivity than those in the personal-identity condition, but between-condition differences were not statistically significant. In Experiment 2, the Identity × Competition interaction was statistically significant for heart-rate (HR) reactivity, indicating that the effect of identity salience differed across competition frames; however, this interaction did not generalize to systolic/diastolic blood pressure (SBP/DBP) or subjective stress. We also observed higher HR reactivity in intragroup than intergroup competition in this protocol, which we interpret cautiously given the limited consistency across outcomes. Overall, the findings suggest that any identity-related modulation of acute stress responding may be context-dependent and modality-specific, underscoring the importance of competitive framing when evaluating the stress-related consequences of social identity.

Academic stress, cognitive appraisal, academic self-efficacy, and academic anxiety among Chinese college students: A moderated mediation model.