Stress-related Health Problems Research Articles

Long-term mental health and resilience of the first responders in Japanese ground self-defense forces engaging body recovery after the great east Japan earthquake

Handling human remains is extremely difficult and stressful task, and it can contribute to the development of stress-related mental health problems. To prevent disaster from the development of mental disorders in first responders, it will be important to elucidate factors sustaining psychological well-being following the events requiring handling of human remains. Japanese Ground Self-Defense Forces (JGSDF) first responders (n = 146), involved in human remains recovery after the Great East Japan Earthquake (GEJE) participated. We examined the psychological resilience (S-H Resilience Test), depressive symptoms (SDS), and psychological distress (GHQ-28) 6 years after GEJE, in three groups; Group A: no contact no view of human remains, B: view only of human remains, and C: direct handling of human remains. S-H Resilience test evaluated the 3 subclasses of resilience; Social Support, Self Efficacy, Sociality. One-way ANOVA revealed the significant difference in resilience scores between Group B and C without any differences in depressive symptoms or psychological distress among the 3 groups. Multiple regression analyses revealed that depressive symptoms and resilience were associated with psychological distress in all participants. Path analyses showed that whereas one subtype of resilience indirectly reduced psychological distress through lower depressive symptoms in Group A (Social Support) and Group B (Sociality), both subtypes of resilience indirectly reduced psychological distress by lowering depressive symptoms in Group C. These findings suggest that exposure to higher stressful situation may decrease the psychological resilience based on the S-H Resilience test, and two subtypes of resilience may be necessary to sustain the psychological well-being.

Psychologists’ involvement in and experiences of treating patients with stress-related exhaustion in primary care

BackgroundPrimary health care is the setting for most patients with stress-related mental health problems. Good care processes are important for patients with stress-related mental health problems and the complex needs of these patients has become a challenge for primary care settings which is traditionally designed to manage acute episodes of one illness. The care process of these patients is thus interesting to investigate. The aim of this study was to explore psychologists´ involvement and experiences regarding the organisation of the care process and treatment of patients seeking care for stress-related exhaustion.MethodFifteen psychologists (14 women and 1 man, age range 27–72 years)c from fifteen different primary health care centres in the western part of Sweden, located in both rural and urban areas were included. Qualitative content analysis of individual semi-structured interviews was conducted.ResultsThe analysis resulted in eight subcategories within the two main categories studied illuminating psychologists’ involvement and experiences regarding the organisation of the care process and challenges regarding treatment of patients seeking care for stress-related exhaustion.ConclusionThe care process of patients with stress-related exhaustion is perceived to be ineffective and not congruent with the needs of the patients. A lack of holistic overview of the care process, a lack of collaboration and poor utilization of the health care professionals’ competence leads to an unstructured process forcing the patients to be the carriers and coordinators of their own care.

Medical Nature-Based Rehabilitation Program for Individuals with Exhaustion Syndrome: Changes in Quality of Life, Exhaustion Symptoms and Overall Health.

Stress-related health problems have increased sharply over the last two decades and have become a serious issue at all levels of society. In the Jönköping Region in southern Sweden, a nature-based rehabilitation (NBR) program for adults with Exhaustion Syndrome has been developed and then implemented into the Swedish National Healthcare System. The main aim of this study was to investigate the effectiveness of this NBR-program. This was achieved by examining patients' quality of life, exhaustion symptoms and overall health using self-assessment instruments, comparing the results before participation to immediately after, three months after and six months after. With a sample size of 67 participants, the results show a statistically significant improvement for all points. From a public health perspective, and with background knowledge of the nature of the patient group under treatment, the studied program would appear to be effective and economic, having a satisfied patient group as well as a favourable comparison with the outcomes of other research programs. Although the results are promising, as this is a naturalistic field study, there is no control group, and further research is encouraged. We suggest randomised controlled studies, longitudinal studies and investigation of mediators.

A qualitative exploration of how lifetime stressor exposure influences sport performers’ health, well-being, and performance

ABSTRACT Background and objectives Recent research has shown that lifetime stressor exposure can negatively impact sport performers. However, this work has predominantly relied on quantitative methods, which has provided limited information regarding how stressors occurring over the life course affect health, well-being, and performance. This study aimed to explore how relatively high levels of lifetime (non-sport and sport-specific) stressor exposure influenced sport performers’ health, well-being, and performance. Methods and Design To identify participants who had experienced high lifetime (non-sport and sport-specific) stressors, we used criterion-based purposeful sampling from a prior study. Subsequently, semi-structured interviews, complemented by timelining, were conducted with 22 sport performers (17 female; Mage  = 25.89, SD = 10.20). Results We used reflexive thematic analysis to develop three overarching themes that illustrate how high lifetime (non-sport and sport-specific) stressor exposure influences sport performers’ health, well-being, and performance. These were: psychological (e.g., maladaptive coping strategies), social (e.g., difficulties in building relationships), and behavioral (e.g., risky behaviors) factors. Conclusions These findings can help practitioners identify sport performers at risk of developing stress-related health, well-being, and performance problems, and may aid the development of effective interventions.

Improvement of serum cortisol levels in obese female college students after moderate-intensity acute exercise

Obesity is a condition that can cause metabolic stress by activating the HPA axis, which impacts increasing stress levels characterized by increased cortisol secretion. The present research aims to investigate the impact of moderate-intensity acute exercise on decreasing cortisol levels among obese female students. A true-experimental method with a pretest-posttest control group design was utilized to conduct the study. A total of 20 female students between the ages of 20 and 23, with a BMI ranging from 25-28 kg/m2, voluntarily participated in the research. The participants were divided into two groups: control (n=10) and exercise (n=10) - the latter group being exposed to moderate-intensity acute exercise once as an intervention, with 40-minute sessions and an intensity level of 60-70% HRmax using the Treadmill Life Fitness equipment. The serum cortisol levels were measured through the ELISA 30 minutes pre-exercise and 6 hours post-exercise. The collected data were analyzed using an independent sample t-test with a 5% significance level. The study's findings will help compare the mean serum cortisol levels between the control and exercise groups.  Based on the results of the study, it was found it can be concluded that moderate-intensity acute exercise carried out for 40 minutes/exercise session was effective in reducing serum cortisol levels in obese female students. We recommend exercise to overcome stress-related metabolic health problems in individuals with obesity.

An Automatic Stress Analysis and Emotion Detection Framework for Humans Based on Several Brain Signals

In common parlance, stress is the feeling people get when they have a lot on their plates and are having trouble keeping up with everything. Although some degree of stress might be useful in the short term, chronic stress has serious negative effects on health, including increased risk of cardiovascular problems such heart disease, high blood pressure, and stroke. Depression, anxiety, and personality disorders are also possible outcomes. Hence, stress detection is helpful for managing stress-related health problems. Perceptual, behavioural, and physiological reactions all provide useful indicators of stress levels. Based on feature extraction and classification methods, numerous researchers have presented a wide variety of methods. Some of these methods are difficult to implement and produce unreliable outcomes when applied to the study of human stress.Patient denial, insensitivity, subjective biases, and inaccuracy are only some of the issues that arise from relying solely on doctor-patient interaction and scale analysis when diagnosing Stress. To better predict clinical results, a computerised, objective system is needed for Stress diagnosis and treatment. In an effort to better detect Stress, this research modifies EEG data and use machine learning algorithms. Ten participants' EEGs were recorded using a Narosky system while they were exposed to various emotional face cues. Psychologists relied on the EEG signal as a diagnostic tool for Stress. Both machine learning and deep learning were used to analyse the features. Using PCA, ICA, and EMD for BCI applications yields significant results. With SVM, a programmer can reap many benefits: PCA has great generalisation properties, and it can detect tension and pressure from EEG signals. The effect of overtraining is particularly vulnerable to the curse-of-dimensionality when the signals are negative. By analysing EEG waves, we were able to detect Stress with these benefits. The experimental study provides a somewhat comprehensive summary of the various methods, all of which rely on frequency domain analysis of 14 EEG data.

From trauma to resilience: The effect of stress on the labor market outcome of refugees

Millions of refugees struggle to survive in foreign countries. They have a high prevalence of stress-related mental health problems which lead to a growing concern about their labor market outcome. This study develops a stress and coping model of refugees that includes two stressors. The stress triggered by traumatic events may be eased gradually over time by coping, while the one triggered by workplace discrimination persists throughout their working life. Since coping takes time, refugees must carefully manage their time among coping, leisure, and working. We find that refugees choose to ease more stress but earn less in the early stage of their working life. After refugees reduce stress gradually over time, they transform their working life from barely surviving to striving. We also find that emotional outbursts release stress and increase income in the short term but not necessarily in the long term. Refugees prefer avoiding intentional outbursts that would do more harm than good.

Longitudinal study of Alzheimer's disease biomarkers, allostatic load, and cognition among memory clinic patients

BackgroundAllostatic load (AL) is defined as the cumulative dysregulation of neuroendocrine, immunological, metabolic, and cardiovascular systems that increases the susceptibility to stress-related health problems. Several dementia and Alzheimer's disease (AD) risk factors have been identified, yet little is known about the role of AL and its associations with AD biomarkers (e.g., beta-amyloid (Aβ) or tau) and cognitive function among memory clinic patients. Hence, this study aims to assess the association between AL and AD biomarkers, cognitive performance, and cognitive decline after 3-years of follow-up. MethodsData from 188 memory clinic patients were derived from the Cortisol and Stress in AD (Co-STAR) study in Sweden. Participants underwent baseline assessments including blood tests for AL measures (including cortisol, thyroid stimulating hormone, cobalamin, homocysteine, leukocytes, glycated hemoglobin, albumin, high-density and low-density lipoprotein cholesterol, triglycerides, and creatinine), cerebrospinal fluid (CSF) sampling for AD biomarkers and neuropsychological tests including five cognitive domains. Linear regressions were conducted, adjusting for age, sex, and education. ResultsHigher AL was associated with lower CSF Aβ1-42 levels (β = −0.175, p = 0.025), reflecting higher brain levels of Aβ1-42. Stratified analyses suggested a significant association among women but not men, although the AL-sex interaction was not statistically significant. AL was not significantly associated with T-tau level (β = −0.030, p = 0.682) and P-tau level (β = 0.091, p = 0.980). There were no significant associations between AL and cognition or cognitive decline after 3 years. ConclusionThis study showed that higher AL was associated with increased brain amyloid accumulation. This suggests that AL may play a role in AD/dementia pathophysiology. Potential sex-related differences should be assessed in further larger studies.

A remotely sensed weight gain model for sheep in the semi-arid Karoo shrublands of South Africa

The monitoring of animal weight gain is expensive as it often involves the rounding up of animals over large areas and long distances. Such monitoring is an arduous process that causes stress related health problems and weight loss in animals. The aim of this study was to evaluate the use of remotely sensed vegetation indices for modelling sheep weight gain in semi-arid rangelands. The temporal and spatial patterns of grazing were investigated using Sentinel-2 imagery, collar data obtained from a global position system (GPS), and data of sheep weight related to grazing hotspots. Historical animal weight data were compared statistically with nine commonly used spectral indices extracted from Sentinel-2 imagery to determine how vegetation conditions relate to sheep weight gain. Sheep appeared to adapt their grazing behaviour according to time of the year, with the average distance walked per sheep per day in line with previous studies. In contrast to distance walked, sheep at lower stocking densities used less grazing area than at higher densities. The normalised difference vegetation index (NDVI) proved to best model liveweight changes. By combining remote sensing (RS) and GPS data, our understanding of sheep grazing patterns and sheep weight gain was improved. This can lead to the optimisation of production potential through precision farming. The finding has applications for studies conducted on non-reproductive sheep in semi-arid Karoo rangeland systems of South Africa. Because the model is both cost-effective and replicable, it offers a long-term monitoring template for livestock studies elsewhere.

Transcriptome and DNA Methylation Responses in the Liver of Yellowfin Seabream Under Starvation Stress.

Fish suffer from starvation due to environmental risks such as extreme weather in the wild and due to insufficient feedings in farms. Nutrient problems from short-term or long-term starvation conditions can result in stress-related health problems for fish. Yellowfin seabream (Acanthopagrus latus) is an important marine economic fish in China. Understanding the molecular responses to starvation stress is vital for propagation and culturing yellowfin seabream. In this study, the transcriptome and genome-wide DNA methylation levels in the livers of yellowfin seabream under 14-days starvation stress were analyzed. One hundred sixty differentially expressed genes (DEGs) by RNA-Seq analysis and 737 differentially methylated-related genes by whole genome bisulfite sequencing analysis were identified. GO and KEGG pathway enrichment analysis found that energy metabolism-related pathways such as glucose metabolism and lipid metabolism were in response to starvation. Using bisulfite sequencing PCR, we confirmed the presence of CpG methylation differences within the regulatory region of a DEG ppargc1a in response to 14-days starvation stress. This study revealed the molecular responses of livers in response to starvation stress at the transcriptomic and whole genome DNA methylation levels in yellowfin seabream.

FROM STRESSED CAREGIVERS TO HEALTHY CAREGIVING: THE IMPLICATIONS OF BALANCED PERSPECTIVES AND UPDATED FINDINGS

Abstract Research on family caregiving continues to evolve and stress process models are now frequently balanced by perspectives of benefits emanating from prosocial behaviors including caregiving and volunteering. Initial findings that caregivers have elevated inflammation levels and shorter life expectancies than non-caregivers have been contradicted by numerous more recent findings from larger, population-based, epidemiological studies. In many ways, the caregiving literature shows a bias pattern that is sometimes found in other areas, where initial studies with relatively small samples and alarming results are widely cited, whereas subsequent studies with larger samples and contradicting results are given much less attention. A minority of caregivers are highly stressed, but most caregivers are resilient and face other challenges besides stress-related health problems. Caregivers are the backbone of long-term care, and interventions and policy initiatives to support caregivers are vital, but should be based on replicable findings of verifiable challenges to vulnerable caregiving subgroups.

Organizational Justice and Health: Reviewing Two Decades of Studies

Organizational justice refers to employees’ perceptions of the fairness of decision-making rules and policies in the workplace. Lack of justice is suggested to be a significant psychosocial risk factor that affects employees’ attitudes and health. The aim of this narrative review was to compile the evidence available about the effects of organizational justice on health. To this end, a literature search was carried out using the Web of Science, PubMed, and PsycINFO databases. The final sample consisted of 103 articles that studied the effects of justice on mental health (40 results), job stress (26), sickness absence (15), physical health (14), absenteeism/presenteeism (3), safety at work (3), and health of third parties (2). The results show that perceptions of workplace justice predict employees’ mental health, stress-related health problems, and lower levels of sickness absence were relatively compelling. Future studies should focus on less-researched outcomes and on how these associations are modified by other variables for a better understanding of how justice affects health, with a view to being able to carry out preventive measures more efficiently.

Self-Compassion and Mental Health in Sexual and Gender Minority People: A Systematic Review and Meta-Analysis.

Purpose: Literature shows that sexual and gender minority (SGM) individuals are at higher risk of developing minority stress-related mental health problems. Recently, it has been suggested that promoting self-compassion through affirmative mental health care for SGM people can be beneficial. However, no systematic analysis has been published exploring the relationship between self-compassion and mental health indicators in SGM individuals. We aim to fill this gap by synthesizing and meta-analyzing studies that focus on the relationship between self-compassion and mental health in SGM people. Methods: After registering in PROSPERO (CRD42021254774), PubMed, PsycINFO, CENTRAL, and Web of Knowledge were systematically searched to identify studies assessing the association between self-compassion and mental health and/or minority stress indicators in SGM individuals. All screening steps and data extraction were performed independently by the two researchers. The quality of each study was assessed with the National Heart, Lung and Blood Institute tool, and meta-analysis was performed on R software. Results: Twenty-one studies were included in the meta-analysis, corresponding to a total of 6573 nonheterosexual and/or noncisgender participants. All meta-analytic models were significant: higher levels of self-compassion were associated with less depression, anxiety, psychological distress, suicidal ideation, internalized homophobia/transphobia, and stigma, and with more well-being, outness, and social support. Conclusion: This meta-analysis suggests that self-compassion is significantly associated with mental health indicators in SGM people, and this relationship is especially strong with internalized homophobia/transphobia in older SGM adults, and with suicidal ideation in younger SGM individuals. Results suggest that affirmative mental health care may benefit from promoting self-compassion.

Job demands, job resources, and health outcomes among nursing professionals in private and public healthcare sectors in Sweden – a prospective study

BackgroundNursing professionals exhibit high prevalence of stress-related health problems. Job demands and job resources are parallel drivers of health and well-being among employees. Better job resources associate with better job satisfaction, job motivation and engagement even when job demands are high. To date, there is limited research which explores the association between job demands, job resources and health outcomes among nursing professionals in the Swedish context. The aim of this study was therefore to investigate Swedish nursing professionals’ job demands and job resources in relation to health outcomes, with comparisons between the private and public healthcare sectors. The specific research questions were as follows: (1) Are there differences between private and public healthcare regarding job demands, job resources, and health outcomes? and (2) Are there prospective associations between job demands and job resources in relation to health outcomes?MethodsData were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2016 and 2018, including 520 nurses and 544 assistant nurses working in the private and public healthcare sectors from 2016 (baseline). Data were analyzed using binary logistic regression.ResultsNursing professionals reported higher threats, lower bullying, lower control, lower social support, and lower cohesion in the public healthcare units compared to the private healthcare units. The prospective analyses showed that job resources in terms of social support and rewards were associated with higher self-rated health and lower burnout. Cohesion was associated with higher self-rated health. Job demands in terms of psychological demands and job efforts were associated with lower self-rated health, higher burnout, and higher sickness absence, while emotional demands were associated with higher burnout.ConclusionsNursing professionals’ job resources are deficient in public healthcare units. Job resources are associated with positive health outcomes, whereas job demands are associated with negative health outcomes, among nursing professionals. Strengthening job resources among nursing professionals in the private and public healthcare sectors can promote and sustain their work-related health.

Occupational balance in parents of pre-school children: Potential differences between mothers and fathers

Background Parents of young children are a vulnerable group with an increased risk of stress-related health problems compared to adults without children. Low occupational balance has been identified as a risk factor for stress-related disorders. Aim The study aimed to describe occupational balance in parents of pre-school children and to explore potential differences between mothers and fathers. Method Data were collected by a web-based survey based on the Occupational Balance Questionnaire (OBQ11). A total of 302 working parents (200 mothers and 102 fathers) with at least one child under seven years of age were included in the study. Findings Mothers reported lower occupational balance than fathers with a median value of 10 for mothers and 12 for fathers (p = 0.029). Mothers rated significantly lower than fathers in three items; ‘Balance between work, home, family, leisure, rest and sleep’, ‘Having sufficient time for doing obligatory occupations’ and ‘Balance between doing things for others and for oneself’. Conclusion The results indicate that caring for pre-school children may negatively impact both parents, impacting mothers’ occupational balance to a greater degree. Significance Occupational therapists’ knowledge could be utilised to increase awareness of the importance of occupational balance within health services and improve mothers’ occupational balance.

The Impact of Perceived Social Support on the University 'Educators' Flourishing and the Moderating Effect of Challenge Appraisal

This study provides insights into what makes teachers flourish in public sector universities of Sindh, Pakistan. Flourishing represents a balanced life where a person is happy with their status and is functioning effectively. The well-being of teachers has reportedly been lower than the general population (Education Support Partnership, 2019). Depressive symptoms were reported by 49% of 1189 academic staff members at 12 universities in Sindh, according to research on stress-related mental health problems in the Pakistani Scenario. Yet, research on evaluating teachers' mental health is lacking, notably among Pakistani university professors (Akram, 2019). Therefore, this study sheds light on the impact of perceived social support on educators' flourishing. Also, it discusses the boundary condition of challenge appraisals in this relationship. Statistical analysis was performed on data collected from 229 educators in Sindh, Pakistan's public sector universities. The result found a positive and statistically significant link between educators' perceptions of supervisors and co-worker support with educators' flourishing. However, challenge appraisal was found insignificant between exogenous and endogenous latent components. Overall, the study's findings suggest that perceived social support might help educators flourish at Sindh's public higher education institutions. The results' implications are discussed.

Cortisol changes in healthy children and adolescents during the COVID-19 pandemic

The Coronavirus Disease 2019 (COVID-19) pandemic has caused massive disruptions to daily life in the United States, closing schools and businesses and increasing physical and social isolation, leading to deteriorations in mental health and well-being in people of all ages. Many studies have linked chronic stress with long-term changes in cortisol secretion, which has been implicated in many stress-related physical and mental health problems that commonly emerge in adolescence. However, the physiological consequences of the pandemic in youth remain understudied. Using hair cortisol concentrations (HCC), we quantified average longitudinal changes in cortisol secretion across a four-month period capturing before, during, and after the transition to pandemic-lockdown conditions in a sample of healthy youth (n = 49). Longitudinal changes in HCC were analyzed using linear mixed-effects models. Perceived levels of pandemic-related stress were measured and compared to the physiological changes in HCC. In children and adolescents, cortisol levels significantly increased across the course of the pandemic. These youth reported a multitude of stressors during this time, although changes in HCC were not associated with self-reported levels of COVID-19-related distress. We provide evidence that youth are experiencing significant physiological changes in cortisol activity across the COVID-19 pandemic, yet these biological responses are not associated with perceived stress levels. Youth may be especially vulnerable to the deleterious impacts of chronic cortisol exposure due to their current status in the sensitive periods for development, and the incongruency between biological and psychological stress responses may further complicate these developmental problems.

QASIS: a QoC aware stress identification system using machine learning approach

Stress is a serious health problem that affects a large part of humanity. Early stress detection helps preventing stress-related health problems. The Internet of Things (IoT) plays an important role in healthcare monitoring. In this paper, we present an automatic stress detection system (QASIS), to increases the effectiveness and efficiency of healthcare system providing services. QASIS benefits of emerging wearable physiological sensors, specifically, electromyograph (EMG), electrocardiogram (ECG), and nasal/oral airow, to monitors physical, cognitive and emotional stress. Our system uses an Extra Trees Classifier to achieve expected results in the areas like car driving. We also illustrate how the reliability of the contextual information represented by QoC metrics, can enhance the accuracy of the stress detection system. We conducted a stress detection experiment with twenty-six subjects. We confirmed that the proposed system could effectively detect stress, based on the measured breathing rate and the electrical activity of the heart and the muscles.

Climate change and demand of emergency care in Japan.

Both the frequency and severity of heat stress-related health problems have been increasing globally, probably due to global warming. The Intergovernmental Panel on Climate Change published a landmark climate report, the 6th Assessment Report, which shocked the world. It emphasized that anthropogenic activities, such as the combustion of fossil fuels, oil, gas, and coal, were responsible for climate change. The combination of population aging, and increased temperatures has meant that the number of people requiring emergency transport for heatstroke has been increasing in Japan from 2008 to 2020. The increase in ambient temperatures and the number of patients requiring emergency transport were strongly correlated (Spearman correlation coefficient: r=0.669 and P=0.008). Like many human activities, medical care is resource intensive and contributes significantly to climate change through the consumption of energy and water, as well as the emission of greenhouse gases. As healthcare professionals, we need to be cognizant of how our eco-friendly activities both on and off the job can contribute to saving both the patients and us.

"Who I Am Now, Is More Me." An Interview Study of Patients' Reflections 10 Years After Exhaustion Disorder.

Aim: To achieve a deeper understanding of the patient’s perception regarding individual aspects related to the development of exhaustion, hindering and supporting factors in the recovery process, and potential remaining consequences, 7–12 years after receiving an exhaustion disorder diagnosis.Participants and Methods: Twenty patients previously diagnosed with and treated for exhaustion disorder were interviewed 7–12 years after onset of the disease. The semi-structured interviews were transcribed verbatim and analyzed with inductive content analysis.Results: Three main themes with patterns of shared meaning resulted from the analysis: “it’s about who I am,” “becoming a more authentic me,” and “the struggle never ends.” The interviewees described rehabilitation from exhaustion disorder as the start of an important personal development toward a truer and more authentic self-image. They perceived this as an ongoing long-lasting process where learned behavior and thought patterns related to overcommitment and overcompliance needed to be re-evaluated. The results also convey long-term consequences such as cognitive difficulties and reduces energy, uncertainty about one’s own health, and the need to prioritize among one’s relationships.Conclusion: Patients with exhaustion disorder are still struggling with dysfunctional strategies and functional impairments such as cognitive problems which limit their lives, 10 years after receiving their exhaustion disorder diagnosis. While informants describe some positive consequences of ED, the results also emphasize the importance of acknowledging that the patients are embedded in systems of relationships, in working life as well as in family life. This needs to be considered, together with other aspects, when working toward prevention of stress-related mental health problems.