Testing a model of stress and health using meta-analytic path analysis.

The goal of this study was to use meta-analytic path analysis to evaluate a theoretical model of stress and health. A meta-analysis technique was adopted to combine and re-analyze 477 studies that investigated stress-related topics between January 1980 and December 2003 in Taiwan. Databases searched included PerioPath-Index to Chinese Periodical Literature, Electronic Theses and Dissertations System, and NSC (National Science Council) Science and Technology Information System. Variables recorded included stress, health, social support, coping strategies, and personality traits. A correlation matrix of these variables was derived from meta-analytic data and then analyzed using structural path analysis to test the fitness of the hypothesized stress-health model to the observed aggregated data. Results showed the revised hypothesized model to be a reasonable, good fit to aggregated data. Based on the theoretical stress-health model developed in this study, subjective stress was found to have a substantively important and direct effect on health, whereas objective stress required the mediating function of subjective stress to exercise an influence on health. Such variables as social support, coping strategies, and personality traits had comparatively weaker influences, either direct or indirect, on the stress-health process. This study provided a holistic view on the relationship between stress and health in the context of stress and proposed a direction for future research and practice.

A meta-analysis of the association between stress and health in Taiwan.

This study adopted the meta-analysis technique to analyze 354 journal articles, theses, and dissertations that had investigated the association between stress and health in Taiwan between January 1980 and December 2003. This study was conducted with the purpose of understanding the association between general stress and general health, the discrepant associations between different stress types and health facets, and the possible moderators between general stress and general health. A computer search for relevant studies was conducted on several databases using the key words "stress" and "life event". For each eligible study, the important study characteristics were recorded, and the effect sizes of the relationship between stress and health were computed. Furthermore, in order to investigate the moderating effects of the study characteristics on the stress-health relationship, the methods of categorical model analysis and correlation analysis were employed. The results of this study revealed that: (1) the correlations between general stress and general health as well as between general stress and various health facets fell between medium and high; (2) there existed different degrees of association between various stress types and health facets; and (3) none of the demographic and methodologic variables could by itself moderate the relationship between general stress and general health as the moderator effects were not sufficient and strong enough. This study presents a multidimensional framework of the issues on the relationship between stress and health, and it provides guiding references for future research. No evidence was found for moderating effects of social support, coping strategies, and personality traits on the stress-health relationship. Such findings may be due to methodologic limitations. This suggests that further investigation is needed.

Relationship between post-stroke depression and lesion location: a meta-analysis.

Our understanding of the relationship between the neuroanatomic loci of brain damage and the incidence of post-stroke depression (PSD) is not complete. Many studies have investigated this relationship and the evidence is conflicting. With the purpose of gaining a consistent, strong, and credible conclusion on the relationship between PSD and the loci of brain damage, a meta-analysis was used in this study to systematically reanalyze the findings of related studies and to investigate the sources of heterogeneity among study results. The key words "stroke or cerebrovascular" and "depression or mood or affective" were entered into the MEDLINE, PsycINFO, and EMBASE databases to search for relevant studies. The references cited in the studies found were also used to locate additional studies. For each eligible study, the important study characteristics were recorded, and the effect sizes of the relationship between PSD and lesion location were computed. Furthermore, we conducted subgroup analyses to explore the heterogeneity among study results. A total of 3,668 patients participating in 52 studies were included in this meta-analysis. There was a weak relationship between PSD and right hemisphere lesion. The major sources of heterogeneous study results included systematic exclusion of patients with language dysfunction and use of different assessors and instruments for diagnosing depression. Future efforts should aim to enhance standards for reporting studies, improve assessment tools for assessing depression of aphasic patients, and adopt appropriate study methodologies for investigating the relationship between PSD and lesion location.

Meta-analysis of counseling and psychotherapy outcome studies in Taiwan.

This study applied the meta-analysis method to investigate the effectiveness of counseling and psychotherapy. It began with a systematic search of the literature through computer search and previous narrative reviews to locate counseling and psychotherapy outcome studies conducted in Taiwan between January 1971 and August 2000. Salient characteristics of each study were recorded systematically. These study characteristics included type of therapy, type of target problem, therapist experience, and type of outcome measure, among others. In total, 257 studies, which yielded 302 effect sizes, were examined, in which clients who received psychotherapy or counseling were compared with controls. Results demonstrated that the overall mean effect of counseling and psychotherapy was positive and significant. Further categorical model testing indicated that most coded study characteristics were significantly related to effect sizes.