Effects of cognitive behavioural therapy and return-to-work intervention for patients on sick leave due to stress-related disorders: Results from a randomized trial

The aim of this study was to evaluate specific effects for patients with adjustment or exhaustion disorder, the Stress subgroup (n = 152), regarding symptom severity and sick leave after CBT, a return-to-work intervention (RTW-I), and a combination of them (COMBO), using data from a randomized trial. In the original study, primary care patients on sick leave (N = 211) were randomized to CBT (n = 64), RTW-I (n = 67), or COMBO (n = 80). Blinded Clinician Severity Rating (CSR) of symptoms and sick leave registry data were primary outcomes. Subgroup analyses showed that for the Stress subgroup, CBT led to greater reduction of symptoms than RTW-I posttreatment, but COMBO did not differ from CBT or RTW-I. Regarding sick leave, there was no difference between treatments in the Stress subgroup. An exploratory analysis of the treatment effects in a subgroup of patients with depression, anxiety or insomnia indicates that RTW-I reduced sick leave faster than CBT. We conclude that CBT may be promising as an effective treatment of stress and exhaustion disorder.     

Children coping with uncontrollable stressors

Many of the negative events in children's lives cannot be controlled by them. Three strategies that children can be taught for coping adaptively with many uncontrollable events are presented: (a) reconstruing the event in more positive ways, (b) using positive imagery to dampen fear and frustration, and (c) developing reasonable proximal goals. How these strategies may be used in working with children living in poverty is discussed.     

Social anxiety and problematic cannabis use: evaluating the moderating role of stress reactivity and perceived coping

Despite epidemiological reports indicating an association between social anxiety disorder (SAD) and cannabis use disorders (CUD), there is a paucity of research exploring the nature of this relationship. The present investigation examined potential moderators of this relationship that are consistent with a tension-reduction model of addiction. Specifically, physiological reactivity to stress and perceived coping with stress were evaluated as moderators of the relation between symptoms of SAD and CUD. Physiological (SCR) and subjective (perceived coping) responses to unpredictable white noise bursts were collected from non-clinical participants (n=123). Lifetime symptoms of CUD and anxiety disorders were assessed using a structured diagnostic interview. CUD symptomatology was associated with symptoms of SAD but not with symptoms of any other anxiety disorder. Only perceived coping to unpredictable stimuli moderated the relationship between SAD and CUD symptoms. Findings are discussed in the context of tension-reduction models of co-occurring social anxiety and problematic cannabis use.     

Confirmatory Factor Analysis of the Depression–Anxiety–Stress Scales in Depressed and Anxious Patients

The Depression–Anxiety–Stress Scales (DASS; P. F. Lovibond & S. H. Lovibond, 1995) have shown considerable promise in their ability to differentially assess depression and anxiety symptoms. Most of the work to date has relied on normal or predominantly anxious clinical samples. To extend this research to a predominantly depressed sample, a psychiatric sample from a mood disorders program (N = 439) was used to investigate the factor structure of the DASS. Confirmatory factor analyses indicated that a 3-factor model for the 21-item DASS was supported. A 3-factor model with crossloading items for the 42-item version showed no practical improvement. Further confirmatory analyses evaluated the ability of item subsets from the DASS to represent the constructs specified in the tripartite model (L. A. Clark & D. Watson, 1991). Strong support was obtained for the DASS to represent the construct of anhedonia and physiological hyperarousal, and their relative importance is consistent with predictions of the tripartite model in understanding the relationship between anxiety and depression.     

Constructions of work stress and coping in a female- and a male-dominated department

In the present study the nature of stress and coping was investigated and considered as socially constructed. Thirty small group interviews were performed using the Critical Incident Technique in one female- and one male-dominated customer service department of a telecom company. The main themes about stress among both women and men were often expressed as collective phenomena and were connected to the organizational change and downsizing process, problems when carrying out the work and lack of autonomy. However, a striking difference between female and male interviews was found in the way that women to a greater extent expressed lack of autonomy and their working situation was described as strictly regulated. The findings illustrate that a traditional gender difference regarding autonomy could be found when comparing a female- and a male-dominated department even though they were performing the same type of job. Both women and men portrayed coping as a mixture of collective and individual strategies. They often mentioned collective acceptance, resignation and hardening. There is a need for further research about women and men at work, taking into consideration the interpersonal context and the collective nature of stress and coping.     

Learning from Spiritual Models and Meditation: A Randomized Evaluation of a College Course

Effects of two meditation and mindfulness-based spiritual interventions were examined in college undergraduates (N=44). Compared to a control group, both interventions decreased negative religious coping (d=−0.80, p<.01) and images of God as mainly controlling (d=−.73, p<.01). One intervention provided more training in tools for learning from community and tradition-based spiritual exemplars. It produced gains in famous or traditional spiritual exemplars’ perceived influence (d=+.81, p<.05) and availability (d=+.66, p<.10), in self-efficacy for learning from spiritual exemplars (d=+.92, p<.05), and in nonmaterialistic aspirations (d=+0.65, p<.05).     

Increased perceived stress is associated with blunted hedonic capacity: potential implications for depression research

Preclinical studies suggest that stress exerts depressogenic effects by impairing hedonic capacity; in humans, however, the precise mechanisms linking stress and depression are largely unknown. As an initial step towards better understanding the association between stress and anhedonia, the present study tested, in two independent samples, whether individuals reporting elevated stress exhibit decreased hedonic capacity. The Perceived Stress Scale (PSS) measured the degree to which participants appraised their daily life as unpredictable, uncontrollable, and overwhelming. Hedonic capacity was objectively assessed using a signal-detection task based on a differential reinforcement schedule. Decreased reward responsiveness (i.e., the participants' propensity to modulate behavior as a function of reward) was used as an operational measure of hedonic capacity. In both Study 1 (n=88) and Study 2 (n=80), participants with high PSS scores displayed blunted reward responsiveness and reported elevated anhedonic symptoms. Additionally, PSS scores predicted reduced reward responsiveness even after controlling for general distress and anxiety symptoms. These findings are consistent with preclinical data highlighting links between stress and anhedonia, and offer promising insights into potential mechanisms linking stress to depression.     

Rollercoaster asthma: when positive emotional stress interferes with dyspnea perception

The current study assessed how negative and positive stress is related to dyspnea perception. The participants were 25 young women with a medical diagnosis of severe asthma, and 15 matched controls. Stress was induced during repeated rollercoaster rides. Results showed that negative emotional stress and blood pressure peaked just before, and positive emotional stress and heart beat peaked immediately after rollercoaster rides. Dyspnea in women with asthma was higher just before than immediately after rollercoaster rides, even in women with asthma with a rollercoaster-evoked reduction in lung function. These results suggest that stressed and highly aroused individuals with chronic asthma tend to perceive dyspnea in terms of acquired, familiar associations between dyspnea and positive versus negative feeling states, favoring either underperception or overperception of dyspnea, depending on the emotional valence of a situation.     

Implicit need for achievement predicts attenuated cortisol responses to difficult tasks

The present research tested the hypothesis that the implicit need for achievement (n Achievement) predicts attenuated cortisol (C) responses to difficult tasks, because it represents a propensity to view difficulty as a cue to mastery reward. In two studies, n Achievement was assessed through content-coding of imaginative stories and salivary C was assessed both at baseline and post-task. In Study 1 (N = 108 US students), n Achievement predicted an attenuated C response to a one-on-one competition in the laboratory, regardless of whether participants won or lost. In Study 2 (N = 62 German students), n Achievement predicted an attenuated C response to the Trier Social Stress Test (Kirschbaum, Pirke, & Hellhammer, 1993), but not to a non-stressful control task. In Study 2 only, the attenuating effect of n Achievement was moderated by gender, with only men showing the effect. Across both studies, the average effect size of the association between n Achievement and C responses to difficult tasks was r = −.28. These findings point to a role of n Achievement in emotion regulation.     

Validity of the trait emotional intelligence questionnaire in sports and its links with performance satisfaction

ObjectiveThis research project consisted of two studies aimed at validating the trait emotional intelligence questionnaire (TEIQue) in a sports sample.DesignStudy 1 used a confirmatory factor analysis (CFA) to investigate if the original 4-factor structure of the TEIQue could be replicated in a sample of athletes. In addition, we explored the relationship between trait emotional intelligence (trait EI) and the demographic variables age, sex, type of sport (individual vs. team), expertise, and years of training. Study 2 used a path analysis approach to explore if trait EI is related to performance satisfaction through stress appraisal and coping behaviors.MethodIn Study 1, 973 athletes completed the TEIQue and a demographic questionnaire. In Study 2, 291 athletes completed the TEIQue. Moreover, with a recent competition in mind, they completed the Coping Inventory for Competitive Sports, as well as items on perceived intensity of stress, perceived controllability of stress, challenge and threat appraisals, coping effectiveness, and performance satisfaction.ResultsStudy 1 showed with a CFA that the original 4-factor structure of the TEIQue could be replicated in a sports sample. Of the demographic variables, only age showed a significant positive relationship with trait EI. Study 2 showed that trait EI was related to performance satisfaction through stress appraisal and coping variables.ConclusionsThis research showed that the TEIQue can be used with athletes and that trait EI is useful for understanding certain aspects of sports performance satisfaction.