Effects of a culturally adapted counselling service for low-income ethnic minorities experiencing mental distress: a pragmatic randomised clinical trial.

BACKGROUND: Culturally competent early mental health interventions for ethnic minorities (EMs) with no formal diagnoses are needed. OBJECTIVES: To determine whether 8-12 weeks culturally adapted counselling (CAC) is better than waiting (waitlist (WL) group) to reduce depressive and anxiety symptoms and stress levels among EMs with elevated mental distress. METHODS: Hong Kong EMs with mild and above-mild mental distress were randomly assigned to CAC or WL in this pragmatic, randomised, WL-controlled trial. The CAC group received the intervention after randomisation and the WL group received the intervention after 8-12 weeks (T1). The prespecified primary outcomes were depressive and anxiety symptoms and stress levels measured by the Depression, Anxiety and Stress subscales of the Depression, Anxiety and Stress Scale (DASS-D, DASS-A and DASS-S, respectively) at postintervention (T1, 8-12 weeks). FINDINGS: A total of 120 participants were randomly assigned to either CAC (n=60) or WL (n=60), of whom 110 provided primary outcome data. At T1, CAC led to significantly lower depressive and anxiety symptom severity and stress levels compared with waiting, with unstandardised regression coefficients of -8.91 DASS-D points (95% CI -12.57 to -5.25; d=-0.90),-6.33 DASS-A points (95% CI -9.81 to -2.86; d=-0.68) and -8.60 DASS-S points (95% CI -12.14 to -5.06; d=-0.90). CONCLUSIONS: CAC clinically outperformed WL for mild and above-mild levels of mental distress in EMs. CLINICAL IMPLICATIONS: Making CAC routinely available for EMs in community settings can reduce healthcare burden. TRIAL REGISTRATION NUMBER: NCT04811170.

Estilos de vida relacionados con la salud en estudiantes de Enfermería / Lifestyles health related in Nursing students

Introducción: los cambios de conductas saludables a las no saludables ponen en riesgo la salud, los universitarios son una población muy vulnerable para adoptar estilos de vida que puedan favorecer su calidad de vida. El consumo de alcohol y tabaco como conducta es un tema importante en esta etapa de formación profesional. Objetivo: determinar las conductas de estilo de vida relacionados con la salud como el consumo de cigarrillos, alcohol y drogas, hábitos alimentarios, forma física, control del estrés y seguridad que realizan los estudiantes de la Licenciatura en Enfermería de la Universidad Juárez Autónoma de Tabasco, México. Metodología: estudio de tipo cuantitativo, descriptivo, transversal en una muestra de 666 estudiantes de la Licenciatura en Enfermería seleccionados por muestreo no probabilístico. Resultados: predominó el género femenino con 83%, el 62.8% presenta un buen estilo de vida, seguido del 30.3% que tiene un excelente estilo de vida; el 79.1% corresponde a los estudiantes que no fuman y el 37.8% de los estudiantes tiene una buena alimentación. Los estudiantes calificaron su forma física como regular en el 41% de los casos, seguida de mala con el 34.5%. En cuanto a la práctica de control del estrés calificaron como buena con un 50.8% y excelente con 26.1%. Conclusión: los estudiantes de Enfermería tienen un nivel de estilo de vida bueno relacionado con la salud, los más practicados corresponden a las dimensiones de consumo de alcohol, hábitos alimentarios, control de estrés y seguridad. Es importante considerar la dimensión relacionada con la forma física (práctica de ejercicio físico), ya que se practica ocasionalmente, lo que demuestra que los estudiantes llevan un estilo de vida sedentario.

Introduction: Changes from healthy to unhealthy behaviors put health at risk, so university students are a very vulnerable population to adopt lifestyles that can favor their quality of life. The consumption of alcohol and tobacco as conduct is an important issue at this stage of professional training. Objective: To determine the lifestyle behaviors related to health such as the consumption of cigarettes, alcohol and drugs, eating habits, physical fitness, stress control and safety carried out by the students of the Bachelor of Nursing at the Universidad Juárez Autónoma de Tabasco, in Mexico. Methodology: Quantitative, descriptive, cross-sectional study in a sample of 666 Nursing undergraduate students selected by non-probabilistic sampling. Results: The female gender predominated with 83%, 62.8% have a good lifestyle, followed by 30.3% who have an excellent lifestyle; 79.1% corresponds to students who do not smoke and 37.8% of students have a good diet. The students rated their physical fitness as fair in 41% of the cases, followed by poor with 34.5%. Regarding the practice of stress control, they qualified as good with 50.8% and excellent with 26.1%. Conclusion: Nursing students have a good level of lifestyle related to health, the most practiced correspond to the dimensions of alcohol consumption, eating habits, stress control and safety. It is important to consider the dimension related to physical fitness (practice of physical exercise), since it is only practiced occasionally, which shows that students lead a sedentary lifestyle.

Nível de estresse e humor em estudantes de Educação Físicano último ano de graduação / Nivel de estrés y de humor en estudiantes en estudiantes de Educación Física en el último año de graduación / Stress and mood level in Physical Education studentsin thelast year of graduation

RESUMO: Introdução: As dificuldades e a pressão do último ano da graduação podem afetar negativamente a saúde mental de estudantes universitários. Objetivo: Verificar o nível de estresse e humor em estudantes de Educação Física no último ano de graduação. Métodos: A amostra foi composta por 38 estudantes (idade: 25,51 ± 4,24 anos), concluintes do curso de Educação Física. Para análise do nível de estresse e humor foram utilizados os questionários da Escala de Percepção de Estresse PSS14 e a Escala de humor de Brunel, respectivamente. Resultados: O teste inferencial não paramétrico de Friedman verificou que há diferença significativa (p<0,001) entre os níveis de estresse: Nunca (4,94%), Quase nunca (15,02), Às vezes (23,87), Pouco frequente (23,46) e Muito frequente (32,72) e entre as respostas ao questionário de humor (p=0,026) com: Nada (38,27), Pouco (17,65), Moderadamente (16,23), Bastante (14,36) e extremamente (13,49). Conclusão: Diante dos resultados da investigação, concluímos que os participantes do estudo se apresentaram em condições de estresse, entretanto não expuseram perda de humor.

RESUMEN: Introducción: Las dificultades y la presión del último año de graduación pueden afectar negativamente la salud mental de los estudiantes universitarios. Objetivo: Verificar el nivel de estrés y estado de humor en los estudiantes de Educación Física en su último año de graduación. Métodos: La muestra consistió en 38 estudiantes (25,51 ± 4,24 años), graduados del curso de Educación Física. Para el análisis del nivel de estrés y estado de ánimo, se utilizaron los cuestionarios de la Escala de percepción del estrés PSS14 y la escala del estado de ánimo de Brunel, respectivamente. Resultados: La prueba inferencial no paramétrica de Friedman encontró que existe una diferencia significativa (p<0,001) entre los niveles de estrés Nunca (4,94%), Casi nunca (15,02), A veces (23,87), Poco común (23,46) y Muy frecuente (32,72) y entre las respuestas al cuestionario de estado de ánimo (p = 0,026) con Ninguno (38,27), Poco (17,65), Moderado (16,23), Bastante (14, 36) y extremadamente (13,49). Conclusión: en vista de los resultados de la investigación, concluimos que los participantes del estudio estaban en condiciones de estrés, sin embargo, no mostraron pérdida de humor.

ABSTRACT: Introduction: The difficulties and pressure of the last year of graduation can negatively affect the mental health of university students. Objective: To verify the level of stress and mood in Physical Education students in the last year of graduation. Methods: The sample consisted of 38 students (age: 25,51 ± 4,24 years), graduating from the Physical Education course. Stress Perception Scale questionnaires PSS14 and Brunel's mood scale, respectively, were used to analyze the level of stress and mood. Results: Friedman's non-parametric inferential test found that there is a significant difference (p<0,001) between stress levels: Never (4,94%), Almost Never (15,02), Sometimes (23,87), Uncommon (23,46) and Very frequent (32,72) and among the responses to the mood questionnaire (p=0,026) with: Nothing (38,27), Little (17,65), Moderately (16,23), Quite (14,36) and Extremely (13,49). Conclusion: In view of the results of the investigation, we concluded that the study participants were in conditions of stress, however they did not exhibit loss of mood.

Detection of six novel de novo mutations in individuals with low resilience to psychological stress.

Genetic bases of psychological stress resilience have been studied previously, but mechanisms and genetic variants which are involved in stress resilience are still unclear. The present study aimed to evaluate the associations between variants in dopaminergic pathway genes with stress resilience. Subjects of the present study were divided into four groups. Group A included persons with normal reactions to major life events stressors; group B included persons with an acute stress reaction to major life events stressor; group C included persons with normal reactions to Crises/catastrophes stressors, and group D included persons with an acute stress reaction to Crises/catastrophes stressors. DNA was extracted from the subject's blood, and the entire length of 14 genes DRD1, DRD2, DRD3, DRD4, DRD5, COMT, DBH, TH, MAOA, DDC, DAT, 5-HTT, BDNF, and GDNF were sequenced by automated sequencers ABI 3700. Results showed 24 point mutations in 12 genes, including 16 SNPs and six novel mutations, which were significantly correlated to low-stress resilience. Most of the SNPs were known as risk alleles in psychiatric disorders. Several associations were found between genetic variants and psychological characteristics. Findings suggest dopaminergic as an important pathway in stress and stress resilience also indicated shared genetic bases between low-stress resilience and several psychiatric disorders.

Validation of a new method for saliva cortisol testing to assess stress in first responders.

BACKGROUND: Acute or chronic stress can lead to physical and mental disorders. Measuring cortisol can objectify the degree of stress. Cortisol is traditionally measured in serum, but recently the relevant fraction of free cortisol can be reliably measured in saliva, using the very sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method. The use of saliva is non-invasive and allows easy serial testing around stressful events. The main objective of this study is to investigate whether serial saliva cortisol determinations using the LC-MS/MS method can be used to assess the stress response that first responders may experience during moments of acute professional deployment in their daily work. METHODS: Healthy first responders (police officers, firefighters, rapid response team, ambulance personnel, first aid and emergency medical personnel) were recruited to participate in a Euregional high-reliability simulation training ('Be Aware'-scenario training, 19 April 2018). At three time points, simultaneous venous blood samples and saliva samples were obtained. These time points were 1 hour before, immediately after and 10 hours after the simulation training. The correlation between changes in saliva cortisol measured by LC-MS/MS and serum cortisol at all three time points was determined. Results were compared with spectators not directly participating in the simulation. RESULTS: 70 subjects participated in the simulation. There was a strong correlation between the changes in saliva and blood cortisol at the three time points. A significant increase in blood and saliva cortisol was shown 1 hour after the experienced stress moments. The levels had almost completely returned to baseline in all healthy volunteers 10 hours later. Cortisol in spectators was unaffected. CONCLUSION: Serial saliva cortisol measurements using LC-MS/MS is a reliable and fast non-invasive functional stress assay, which can be easily collected in daily practice and used for investigation and monitoring of stress response in front line responders.

Measuring psychological and physiological stress in emergency clinicians.

BACKGROUND: Evidence regarding stress, team structure and decision-making has been used to inform efficacious team composition and deployment. There have been limited attempts to establish the relationship between psychological stress with physiological data within professional environments. The current study explored measures of psychological and physiological stress in Australian emergency practitioners. METHODS: Thirty-seven staff in an Australian emergency department completed an online survey assessing freedom to make decisions, social support, and psychological job demands. Seven participants provided saliva samples three times daily for seven days (valid n=141 samples). Cortisol levels of the samples were analysed using competitive enzyme immunoassay kits, and α-amylase using kinetic enzyme assay kits. RESULTS: Years of emergency experience was positively associated with freedom to make decisions, and social support was negatively correlated with psychological demand. No consistent pattern was observed between cortisol level and reported psychological demand, decision freedom or social support. Physical activity was not reflected in elevated α-amylase. Diurnal variation of cortisol and α-amylase was not affected by shiftwork. CONCLUSIONS: The data supports the case for using multiple assessments to measure stress. While the psychological data is consistent with previous findings, there are possible disparities between psychological reports and physical indicators of stress.

Hospital Environmental Effects on Sleep in Adults With Traumatic Brain Injury in Rehabilitation.

PURPOSE: The aim of this study was to describe sleep patterns of adults with traumatic brain injury and examine effects of environmental stressors (patient care activities and light) on patterns of sleep. DESIGN: A descriptive, correlational, explanatory design was used for this study. METHODS: Sixty-three subjects with traumatic brain injury (>18 years) on an acute traumatic brain injury rehabilitation unit wore an Actiwatch for 48 hours to collect light and sleep data. Patient care activity data were collected between 11 p.m. and 7 a.m. FINDINGS: Patient care activities and light occurred between 11 p.m. and 7 a.m. Nighttime sleep duration and sleep efficiency were explained by patient care activities, whereas light explained wake time after sleep onset. CONCLUSION: Patient care activities and light serve as environmental stressors that affect sleep. CLINICAL RELEVANCE: Results necessitate examining the need and timing of nursing care activities and light during nighttime. Findings provide a basis for policy changes that optimize sleep.

Public Sector Workers' Mental Health in Argentina: Comparative Psychometrics of the Perceived Stress Scale.

OBJECTIVES: Given that Argentinian public-sector workers are highly exposed to stressful conditions, and that the psychometric properties of the widely used Perceived Stress Scale (PSS) should be evaluated in different settings, this work aimed to compare the psychometric properties of the Latin American Spanish PSS-10 and PSS-4 and to identify the optimal scale for stress assessment. METHODS: A sample of 535 participants was randomly divided into 2 groups to evaluate dimensionality by exploratory and confirmatory factor analyses. The reliability of both scales was also evaluated. Convergent validity was estimated using the Executive Complaints Questionnaire, the average variance extracted, and the composite reliability. Discriminant validity was based on the correlation with the Utrecht Work Engagement Scale and the phi-square correlation between the components. RESULTS: The factor analyses supported bidimensionality of the PSS-10 (stress and coping), which showed a better fit than the PSS-4. Moreover, the reliability of the PSS-10 was higher, whereas the PSS-4 did not achieve adequate values of internal consistency. The PSS-10 was also correlated significantly with all validation scales, and presented proper internal convergent and divergent validity. CONCLUSIONS: The PSS-10 is a reliable and structurally valid instrument to measure perceived stress and coping in a Latin American Spanish-speaking population with high work demands, and the findings of this study expand our knowledge on the geographical and sociocultural applicability of the PSS.

Prevalence and factors associated with depression, anxiety, and stress symptoms among older adults: A cross-sectional population-based study.

Despite population aging and the increase in mental health problems, studies on the mental health of older people in developing countries are lacking. This population-based cross-sectional study estimated the prevalence and associated factors for depression, anxiety and stress symptoms among older adults in Nepal. Community-dwelling older adults (N = 794) were interviewed using a questionnaire which consisted of the 21-item Depression Anxiety Stress Scales; and a wide range of sociodemographic, health-related, and lifestyle characteristics; functional ability, social support, participation in social activities, and adverse life events. The prevalence of symptoms was 15.4% for depression, 18.1% for anxiety, and 12.1% for stress. Risk factors for symptoms included female gender, working in agriculture, lower household wealth, perceived poor health, smoking, chronic conditions, migration of adult children, and exposure to adverse life events. Receiving an allowance, physical exercise, functional ability, social support, and participation in social activities were found to have protective effects. The findings indicate the need for community-based interventions, including appropriate diagnosis and treatment of mental health conditions, and mental health promotion programs targeting the risk and protective factors.

Correlations among life stress, smoking behavior, and depressive symptoms in adolescents: A descriptive study with a mediating model.

The major objective of this study was to investigate how smoking behavior mediates the relationship between life stress and depressive symptoms in adolescents. A descriptive correlational study was conducted from February to June 2017 at a vocational high school in northern Taiwan, and 226 students were recruited through convenience sampling. Results indicated that smoking behavior played a pivotal role by partially mediating the relationship between life stress and depressive symptoms in adolescents. Life stress in adolescents significantly increased the risk of experiencing depressive symptoms, and adolescents who smoked were also at a greater risk. Assessments between the objective and self-reported smoking behavior were significantly correlated. Therefore, integrated methods for assessing life stress, smoking behavior, and depressive symptoms in adolescents are needed for teachers and clinical professionals. Implementing appropriate policies for discouraging tobacco use for adolescents experiencing life stress in order to decrease depressive symptoms in school settings is paramount.

Psychological Effects and Associated Factors of COVID-19 in a Mexican Sample.

OBJECTIVES: The coronavirus disease 2019 (COVID 19) is a new viral zoonosis of global concern that could cause psychological sequelae. We examined the levels of psychological distress, anxiety, depression, and stress during the COVID-19 outbreak in a Mexican sample. METHODS: An online survey was applied that collected information on demographic and financial status data, physical status, contact history, knowledge, concerns, and precautionary measures concerning COVID-19. Impact of Event Scale-Revised and Depression, Anxiety, and Stress Scale were included. RESULTS: A total of 50.3% of respondents rated psychological distress as moderate-severe; 15.7% reported moderate-severe depressive symptoms; 22.6% reported moderate-severe anxiety symptoms; and 19.8% reported moderate-severe stress levels. Female gender, older age, divorced status, lack of confidence related to security of the test, lower satisfaction of health information concerning COVID-19, history of direct or indirect contact with a COVID-19 confirmed case, live with just 1 other person, and spent >9 h/d at home were associated with greater psychological distress and/or higher levels of stress, anxiety, and depression. By contrast, precautionary measures, such as hand hygiene and wearing masks, were associated with lower levels of psychological distress, depression, anxiety, and stress. CONCLUSIONS: COVID-19 outbreak results in considerable psychological effects among the Mexican sample.

The Effects of Casual Videogames on Anxiety, Depression, Stress, and Low Mood: A Systematic Review.

Background: Despite the variety of available treatments for mental health symptoms, many individuals do not engage with treatment and among those who do, dropout rates are often high. Therefore, providing alternative opportunities to access treatment is imperative. Research interest in the therapeutic effects of digital mental health initiatives and serious games has grown in recent years, but the potential of simple, easy-to-use casual videogames (CVGs) that can be played in short bursts of time has seldom been considered. Objective: The objective of the present study is to provide a systematic review of the literature examining the effects of CVGs on treating anxiety, depression, stress, and low mood. Method: A systematic search was conducted, using the terms (casual gam* or casual videogam* or mini gam* or minigam* or mini-gam* or gamif*) and (mental health or anx* or depress* or stress or mood) and (study or trial or treatment or prescribed or prevention) as "Title," "Abstracts," "Keywords," or "Topic" words across all years. A Google search was also completed to check for articles that may have been missed. Results: N = 13 studies met inclusion criteria (no studies were added via the Google search). These studies reported findings for nine different CVGs, with six studies aimed at reducing anxiety, two examining effects for depression, and four investigating the effects of CVGs on treating stress or low mood. Promising effects were identified. Conclusion: CVGs may have promise for treating anxiety, depression, stress, and low mood.

Exploring the validity of allostatic load in pregnant women.

BACKGROUND: The theory of allostatic load has gained momentum in perinatal research to understand the biological pathways of the impact of maternal chronic stress on adverse perinatal outcomes. However, due to physiological changes of pregnancy, including large variations across gestation, the extent to which allostatic load measured in pregnancy is valid has not been queried in depth. OBJECTIVES: This study aimed to assess the gestational patterns of selected individual allostatic load indicators and to explore whether a pregnancy allostatic load index score had face validity in relation to chronic sociodemographic stress. DESIGN: This is a secondary analysis using data from the 1999-2006 National Health and Nutrition Examination Survey. METHODS: A total of 1056 pregnant women were included for analyses. Using ten physiological indicators commonly included in an index of allostatic load, we described individual indicator and index score patterns across gestation and assessed differences in allostatic load index scores between women with and without sociodemographic stress. FINDINGS: The average allostatic load index score at any gestational month was not statistically significantly different from the average allostatic load index score in the non-pregnant sample. We also found the allostatic load index score remained steady across gestational month, despite very different gestational patterns of individual allostatic load indicators, as long as gestation-specific risk quartiles were used to calculate the allostatic load index score. Face validity was affirmed via higher allostatic load index scores in women with sociodemographic stress compared to those without such stress. CONCLUSION: Our study suggests that measuring allostatic load in pregnancy is valid for reflecting women's true physiological functions and chronic stress, but gestational age should be considered when scoring the allostatic load index for women at different gestational age. IMPLICATIONS FOR PRACTICE: As a valid measure of chronic stress, a pregnancy allostatic load index may contribute to research on health inequities and perinatal outcomes.

Trajectories of antenatal maternal psychological stress and their association with gestational age and neonatal anthropometry: A prospective cohort study of multi-ethnic Asian women in an urban setting.

PURPOSE: To determine common temporal change patterns (i.e., trajectories) of perceived antenatal psychological stress throughout the pregnancy, and to examine associations between these identified trajectories and neonatal birth outcomes. METHODS: 926 participants from a prospective cohort study of multi-ethnic Asian women from an urban setting with uncomplicated singleton pregnancies completed the Perceived Stress Scale in their first, second, and third trimesters, and just prior to parturition. Gestational age, neonatal weight, length, and head circumference were recorded at birth. Longitudinal trajectories of antenatal psychological stress were characterized with group-based trajectory modelling; associations between trajectories and neonatal outcomes were assessed with analyses of covariance and covariate-adjusted linear regressions. RESULTS: Three distinct non-fluctuating trajectories of antenatal psychological stress were identified, with 43 % of women experiencing significant levels of stress throughout the pregnancy. Women in this persistently-higher stress trajectory delivered neonates who were 57.5 g lighter and with head circumferences of 20 mm less than their counterparts in the other trajectories. Each one-point increase on the Perceived Stress Scale was associated with a decrease of 5.64 g in birthweight and a decrease of 0.4 mm in head circumference. CONCLUSIONS: This study delineated three meaningful trajectories of antenatal psychological stress. The persistently-higher antenatal psychological stress trajectory, experienced by two in five women, was associated with lower birthweight and possibly smaller head circumference. While further research is needed to better appreciate the clinical relevance of these findings, it highlights the importance of psychosocial support even for healthy pregnant women with uncomplicated pregnancies in Asian settings.

Nurses Consuming Energy Drinks Report Poorer Sleep and Higher Stress.

The energy drink consumption habits of nurses working in clinical settings is unknown. Utilizing a descriptive-comparison design, researchers examined the caffeine and energy drink habits of clinical nurses and relationships or differences that existed with their sleep quantity, sleep quality, and perceived stress levels. Data were analyzed using descriptive and inferential statistics. Significant relationships existed between energy drink consumption and sleep quality, sleep quantity, and perceived stress levels. Nurses who consumed energy drinks had poorer sleep quality and fewer sleep hours compared with caffeine-only consumers and noncaffeine consumers. Nurses who consumed energy drinks also had increased levels of perceived stress than noncaffeine consumers. Educating nurses regarding energy drink ingredients and relationships that exist between energy drink consumption, sleep, and perceived stress could be beneficial. Future studies are needed to examine motivational factors related to energy drink consumption as well as any health or safety implications that might be associated.

La discriminación percibida, la empleabilidad y el bienestar psicológico en los inmigrantes latinoamericanos en Chile / Perceived discrimination, employability, and psychological well-being among Latin American immigrants in Chile

Los estudios que indagan en el funcionamiento psicológico de los inmigrantes ponen de relevancia el impacto negativo de la discriminación sobre el bienestar psicológico. Así también existe consenso respecto de la importancia del trabajo en su ajuste en países receptores; no obstante, escasamente se ha estudiado el efecto de la empleabilidad en su bienestar. Este trabajo indaga en las relaciones entre la discriminación percibida, la empleabilidad y el bienestar psicológico de 100 inmigrantes latinoamericanos asentados en Chile. Se buscó determinar la contribución de la discriminación y la empleabilidad en la explicación del bienestar y establecer la incidencia de la empleabilidad en la relación entre discriminación y bienestar psicológico. La discriminación percibida y la empleabilidad explicaron el 31.5% de la variabilidad del bienestar y la empleabilidad medió la relación entre discriminación y bienestar. Se discute acerca de la empleabilidad como recurso psicosocial en el contexto de la inmigración

Research about immigrants' psychological functioning emphasizes the negative impact of discrimination on psychological well-being. Although there is agreement about the relevance of job access to immigrants' adjustment to host countries, employability's effects on immigrants' well-being have been scarcely studied. The purpose of this study was to examine the relationships between perceived discrimination, employability, and psychological well-being in a sample of 100 Latin-American immigrants settled in Chile. We aimed to determine the contribution of discrimination and employability on well-being's explanation, and to establish the incidence of employability on the relation between discrimination and well-being. Perceived discrimination and employability explained the 31.5% of well-being's variability, and employability mediated the relation between discrimination and well-being. Employability's role as a psychosocial resource in a migratory context is discussed

How well do cancer survivor self-classifications of anxiety, depression and stress agree with a standardised tool? Results of a cross-sectional study.

BACKGROUND: There is poor uptake of psychosocial interventions offered to people with cancer who record high scores on distress screening scales. Intervention uptake may be influenced by a mismatch between consumer (bottom-up) and professional (top-down) paradigms of wellbeing. The current research aims to compare cancer survivors' 'self-judgements' about their levels of anxiety, depression and stress, to classifications derived via a professional-driven measure, the Depression, Anxiety and Stress Scale (DASS-21). METHODS: A cross-sectional study was undertaken with haematological cancer survivors recruited from three population-based cancer registries in Australia. Consenting participants were mailed a questionnaire package; and non-responders received a second questionnaire package after 3-weeks and a reminder call after 6-weeks. The consumer-driven perspective was assessed via three separate single items asking survivors to self-classify their levels of anxiety, depression and stress over the past week on a scale from 'normal' to 'extremely severe'. The professional-driven classification was assessed via the DASS-21. Kappa statistics were used to assess agreement between consumer- and professional-driven measures. RESULTS: Of 2,971 eligible haematological cancer survivors, 1,239 (42%) provided written consent and were mailed a questionnaire package. Of these, 984 (79%) returned a completed questionnaire. The simple kappa for agreement between the DASS-21 and self-classified measures for anxiety was 0.47 (95% CI: 0.39 to 0.54, p<0.0001). The weighted kappa for agreement between the DASS-21 and self-classified measures of depression was 0.60 (95% CI: 0.53 to 0.67, p<0.0001) and for measures of stress was 0.51 (95% CI: 0.44 to 0.59, p<0.0001). CONCLUSIONS: Moderate agreement between self-classification and professional-driven assessments was found. The value of screening is predicated on the assumption that those with identified needs will be offered and take up services that will benefit them. Our results suggest that to improve the utility of distress screening it may be important to include assessment of survivor views about their symptoms.

The Importance of DS-14 and HADS Questionnaires in Quantifying Psychological Stress in Type 2 Diabetes Mellitus.

Background and Objectives: The comorbid association between type 2 diabetes mellitus (T2DM) and a psychological profile characterized by depression and/or anxiety has been reported to increase the risk of coronary heart disease (CAD), the most striking macrovascular complication of diabetes. The purpose of the present study was to quantify anxiety, depression and the presence of type D personality, and to correlate the scores obtained with cardiovascular risk factors and disease severity in diabetic patients. Materials and methods: The retrospective study included 169 clinically stable diabetic patients divided into two groups: group 1 without macrovascular complications (n = 107) and group 2 with CAD, stroke and/or peripheral vascular disease (n = 62). A biochemical analysis and an assessment of psychic stress by applying the Hospital Anxiety and Depression Scale (HADS)and the Type D scale (DS-14) to determine anxiety, depression and D personality scores were done in all patients. Statistical analysis was made using SPSSv17 and Microsoft Excel, non-parametric Kruskal-Wallis and Mann-Whitney tests. Results: Following application of the HAD questionnaire for the entire group (n = 169), anxiety was present in 105 patients (62.2%), and depression in 96 patients (56.8%). Group 2 showed significantly higher anxiety scores compared to group 1 (p = 0.014), while depression scores were not significantly different. Per entire group, analysis of DS-14 scores revealed social inhibition (SI) present in 56 patients (33%) and negative affectivity (NA) in 105 patients (62%). TheDS-14 SI score was significantly higher in group 2 compared to group 1 (p = 0.036). Type D personality, resulting from scores above 10 in both DS-14 parameter categories, was present in 51 patients of the study group (30%). There was a direct and significant correlation (r = 0.133, p = 0.025) between the Hospital Anxiety and Depression Scale-Anxiety (HAD-A) score and the LDL-c values. Conclusions: The results of this study demonstrated that more than a half of patients with diabetes had anxiety and/or depression and one third had Type D personality, sustaining that monitoring of emotional state and depression should be included in the therapeutic plan of these patients. New treatment strategies are needed to improve the well-being of diabetic patients with psychological comorbidities.

The Validity of Daily Self-Assessed Perceived Stress Measured Using Smartphones in Healthy Individuals: Cohort Study.

BACKGROUND: Smartphones may offer a new and easy tool to assess stress, but the validity has never been investigated. OBJECTIVE: This study aimed to investigate (1) the validity of smartphone-based self-assessed stress compared with Cohen Perceived Stress Scale (PSS) and (2) whether smartphone-based self-assessed stress correlates with neuroticism (Eysenck Personality Questionnaire-Neuroticism, EPQ-N), psychosocial functioning (Functioning Assessment Short Test, FAST), and prior stressful life events (Kendler Questionnaire for Stressful Life Events, SLE). METHODS: A cohort of 40 healthy blood donors with no history of personal or first-generation family history of psychiatric illness and who used an Android smartphone were instructed to self-assess their stress level daily (on a scale from 0 to 2; beta values reflect this scale) for 4 months. At baseline, participants were assessed with the FAST rater-blinded and filled out the EPQ, the PSS, and the SLE. The PSS assessment was repeated after 4 months. RESULTS: In linear mixed-effect regression and linear regression models, there were statistically significant positive correlations between self-assessed stress and the PSS (beta=.0167; 95% CI 0.0070-0.0026; P=.001), the EPQ-N (beta=.0174; 95% CI 0.0023-0.0325; P=.02), and the FAST (beta=.0329; 95% CI 0.0036-0.0622; P=.03). No correlation was found between smartphone-based self-assessed stress and the SLE. CONCLUSIONS: Daily smartphone-based self-assessed stress seems to be a valid measure of perceived stress. Our study contains a modest sample of 40 healthy participants and adds knowledge to a new but growing field of research. Smartphone-based self-assessed stress is a promising tool for measuring stress in real time in future studies of stress and stress-related behavior.

Classification of Perceived Mental Stress Using A Commercially Available EEG Headband.

Human stress is a serious health concern, which must be addressed with appropriate actions for a healthy society. This paper presents an experimental study to ascertain the appropriate phase, when electroencephalography (EEG) based data should be recorded for classification of perceived mental stress. The process involves data acquisition, pre-processing, feature extraction and selection, and classification. The stress level of each subject is recorded by using a standard perceived stress scale questionnaire, which is then used to label the EEG data. The data are divided into two (stressed and non-stressed) and three (non-stressed, mildly stressed, and stressed) classes. The EEG data of 28 participants are recorded using a commercially available four channel Muse EEG headband in two phases i.e., pre-activity and post-activity. Five feature groups, which include power spectral density, correlation, differential asymmetry, rational asymmetry, and power spectrum are extracted from five bands of each EEG channel. We propose a new feature selection algorithm, which selects features from appropriate EEG frequency band based on classification accuracy. Three classifiers i.e., support vector machine, the Naive Bayes, and multi-layer perceptron are used to classify stress level of the participants. It is evident from our results that EEG recording during the pre-activity phase is better for classifying the perceived stress. An accuracy of [Formula: see text] and [Formula: see text] is achieved for two- and three-class stress classification, respectively, while utilizing five groups of features from theta band. Our proposed feature selection algorithm is compared with existing algorithms and gives better classification results.