The temporal dynamics of perceived stress and depression in college students: An ecological momentary assessment.

Previous studies have implied that stress is a risk factor for depression, but relatively little is known about how healthy individuals' stress dynamically affects depression as a mood in daily life. Therefore, an ecological momentary assessment study was conducted among 141 college students to test the temporal dynamic effect of daily perceived stress on depression and the underlying mediating and moderating role of rumination. Perceived stress, state rumination, and depression were measured using self-compiled questionnaire three times a day over 12 days. Trait rumination was measured with the Nolen-Hoeksema Ruminative Response Scale. Hierarchical linear models with HLM 7.0 were adopted to examine the mediation and moderation effects. In the mediation model, the greater the daily perceived stress at time t, the higher the state rumination at time t + 1, and state rumination at t + 1 positively predicted college students' depression at t + 2. In the moderation model, trait rumination significantly facilitated perceived stress-induced depression. These results verified that daily perceived stress could affect college students' depression directly or indirectly through the critical mediating mechanism of state rumination, and this effect would be exacerbated with a higher level of trait rumination.

An Examination of Perceived Stress and Emotion Regulation Challenges as Mediators of Associations Between Camouflaging and Internalizing Symptomatology.

Background: Camouflaging involves the masking of autism traits, potentially creating an outer impression of "non-autisticness." Although associations of camouflaging with anxiety and depression in autistic adults are widely reported, factors that mediate these associations are unclear. We examined two potential mediators of the association between camouflaging and anxiety/depression: perceived stress and emotion regulation (ER) challenges. Methods: Seven hundred eighty-seven autistic adults (18.2-78.2 years) recruited through Simons Powering Autism Research (SPARK) Research Match completed questionnaires, including the Camouflaging Autistic Traits Questionnaire (CAT-Q), and measures of autistic traits, depressive and anxious symptomatology, perceived stress, and ER challenges. Four moderated mediation models were tested. In all models the independent variable was CAT-Q total score, and the moderator variable was sex designated at birth. The dependent variable was depressive or anxious symptomatology, and the mediator variable was perceived stress or ER challenges. Results: We found that more camouflaging, increased ER challenges, and higher levels of perceived stress were associated with greater depressive and anxious symptomatology. We also found that perceived stress and ER challenges significantly mediated the associations between camouflaging and both depression and anxiety. In the model with perceived stress and anxiety, sex moderated the mediation, with females showing a stronger mediation. There was no significant moderation in any of the other models. Conclusion: We contextualize the findings within the broader literature on camouflaging as a response to stigma and other facets of minority stress. We discuss how the results of this study support the idea that the day-to-day stress of living in a neurotypical world, the cognitively demanding nature of camouflaging, and the constraints that camouflaging place on autistic people's behaviors in social contexts (e.g., contributing to suppressing ER strategies such as stimming), create a cycle that contributes to elevated rates of anxiety and depression in autistic people.

Why is this an important issue? Camouflaging describes behaviors that can mask social differences. Camouflaging includes things such as "copying" other people's hand movements or facial expressions. Some autistic people say camouflaging feels like they are "pretending" to be someone they are not. Camouflaging is associated with depression and anxiety. We do not know exactly what other factors may be related to these associations between camouflaging and depression and anxiety. Autistic adults have high rates of depression and anxiety. It is important to understand factors that might make autistic adults more vulnerable to depression and anxiety. What was the purpose of this study? The purpose of this study was to look at possible factors related to associations between camouflaging and anxiety and depression. We looked at two factors: perceived stress and emotion regulation challenges. Perceived stress is how stressed a person feels in their day-to-day life. Emotion regulation is how a person handles their emotions across different situations. We looked at perceived stress and emotion regulation challenges for three main reasons. First, autistic adults report high levels of perceived stress and challenges with emotion regulation. Second, perceived stress and emotion regulation challenges are both associated with depression and anxiety in autistic people. Third, camouflaging is associated with increased stress in autistic people. What did the researchers do? We asked 787 autistic adults living in the United States to complete surveys. Participants answered questions about camouflaging. Participants rated their anxiety and depression. Participants reported on how stressed they felt and how they handled their emotions. We looked at associations between camouflaging and depression and anxiety. We also looked at whether different amounts of perceived stress or different challenges handling emotions were associated with camouflaging, depression, and anxiety. We tested whether all of these associations differed for autistic people designated male sex at birth relative to those designated female sex at birth. What were the results of the study? We found that more camouflaging, increased emotion regulation challenges, and higher levels of perceived stress were all associated with more depression and anxiety. We also found that perceived stress and emotion regulation challenges each significantly related to the associations between camouflaging and both depression and anxiety. For the most part, these associations did not differ for autistic people who were designated male sex at birth relative to those who were designated female sex at birth. What do these findings add to what is already known? These findings support the idea that the day-to-day stress of living in a neurotypical world play a part in elevated rates of anxiety and depression in autistic people. What are the potential weaknesses in the study? We collected information from autistic people at one point in time. This limits how we can interpret the associations we found. How will these findings help autistic adults now or in the future? These findings may help us to better understand why autistic adults are at risk for depression and anxiety. The findings may show us ways to improve the mental health of autistic adults.

A Study of Psychological Features in Patients With Type 2 Diabetes Mellitus.

AIM: There is a lack of multidisciplinary studies examining the link between psychological factors and glycemic control in individuals with chronic illnesses. The aim of this study is to investigate the relationship between psychological factors such as resilience, perceived stress, emotional regulation, aggressiveness, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes. Additionally, the study seeks to determine the predictive value of perceived stress and resilience on HbA1c levels and to explore the role of anger expression and emotion regulation strategies in glycemic control, comparing diabetic patients to healthy controls. MATERIALS AND METHODS: The study was conducted between November 2021 and November 2023 at the Clinic of Endocrinology and Metabolic Diseases at the St. George University Hospital, Bulgaria, and the Department of Science and Research at the Medical University of Plovdiv, Bulgaria. Of these 84 individuals were diagnosed with type 2 diabetes, divided into two groups of 42 individuals each, who had poor and fair glycated hemoglobin. The third group was a healthy control consisting of 42 individuals in the same age group who had no established chronic diseases. RESULTS: When comparing the study groups on HbA1c and individual psychological characteristics, there were statistically significant differences in resilience, perceived stress, emotion regulation suppression, and anger expression. When comparing the mean values of mental resilience with glycated hemoglobin levels, we find that there are statistically significantly higher mean values between the poor HbA1c control and the healthy group. From the regression analysis, we conclude that the psychological characteristics positively associated with perceived stress (ß=0.502; p<0.001) and inversely associated with mental resilience (ß=-0.359; p<0.001) are the most predictive. Less influential was the straight correlation with emotion regulation-expressive inhibition (ß=0.226; p<0.05), the positive correlation with anger (ß=0.170; p<0.001), and general aggressiveness (ß=0.151; p<0.05). CONCLUSION: From the present study, we note that glycated hemoglobin level is strongly influenced by two psychological predictors, namely subjective perception of stressful situations and resilience level.

Psychometric properties of the Sinhala perceived stress questionnaire (PSQ8-11) in Sri Lankan primary school children.

Background: Stress influences examination performance among Sri Lankan students. Validated tests are required to evaluate stress levels among elementary students in Sri Lanka. Therefore, the Perceived Stress Questionnaire 8-11 (PSQ8-11) was translated into a Sinhala version. The aim of this study was to examine the psychometric properties of the translated and adapted scale among elementary level school children in Sri Lanka and examine invariance across male and female children. Methods: The participants were 1021 students from seven schools. After removing missing values, responses from 693 students (mean age = 9.65 ± 0.478 years, 51.8% male) were analysed for participant characteristics. Cronbach's alpha, Spearman's correlation, and confirmatory factor analysis with measurement invariance models were conducted after adding one item to the original PSQ8-11 version. Results: The Cronbach's alpha value for the 20-item modified PSQ8-11 Sinhala version was.788. The two subscales, psychological stress (Cronbach's alpha = 0.615) and physiological stress (Cronbach's alpha = 0.711), indicated a satisfactory level of internal consistency. Furthermore, a statistically significant correlation (p < 0.01; 2-tailed) was reported among each of the subscales. Confirmatory factor analyses demonstrated a satisfactory goodness-of-fit across the two models by confirming the theoretical constructs of the PSQ8-11 translated version with its two subscales. The two-factor model has better model fit indices compared to the unidimensional model (χ2/df = 1.447, CFI = 0.947, TLI = 0.938, WRMR = 0.028, RMSEA = 0.026, SRMSR = 0.0341, and PCLOSE = 1 of the two-factor model). Measurement variance across gender was supported by the establishment of configural and metric invariances. Conclusion: Acceptable psychometric properties for the PSQ8-11 Sinhala version were observed in elementary schoolers in Sri Lanka.

The Effectiveness of a Digital Mental Fitness Program (Positive Intelligence) on Perceived Stress, Self-Compassion, and Ruminative Thinking of Occupational Therapy Undergraduate Students: Longitudinal Study.

BACKGROUND: Health care students often endure numerous stressors throughout their undergraduate education that can have lasting negative effects on their mental well-being. Positive Intelligence (PQ) is a digital mental fitness program designed to enhance self-mastery and help individuals reach their potential by strengthening various "mental muscles." OBJECTIVE: This study aims to evaluate the effectiveness of a 6-week app-delivered PQ program in reducing perceived stress, increasing self-compassion, and decreasing rumination tendencies among health care undergraduates. We hypothesized that students would show reductions in perceived stress, increases in self-compassion, and decreases in rumination tendencies by the end of the PQ program, compared with their preprogram scores. We adopted an exploratory approach for the 5-month follow-up due to the limited research consensus on the sustained effects of app-based programs over varying periods. METHODS: The PQ program includes weekly hour-long videos, weekly group meetings, and daily 15-minute app-guided practices. Participants were first-year students from the occupational therapy program at a university in Singapore. Participants completed surveys measuring self-compassion, perceived stress, and rumination levels before and after the PQ program, and again at a 5-month follow-up. Data were analyzed using repeated measures ANOVA to assess differences across the pretest, immediate posttest, and follow-up posttest. RESULTS: Out of 87 students enrolled in the study, the final sample consisted of 64 students (n=47, 73%, female; mean age 23 years, SD 5.06 years) with complete data. At the end of the 6 weeks, students exhibited significant increases in self-compassion (before the intervention: mean 3.07, SD 0.35; after the intervention: mean 3.34, SD 0.35; P<.001) and reductions in rumination tendencies (before the intervention: mean 3.57, SD 0.40; after the intervention: mean 3.27, SD 0.34; P<.001). However, no significant change in perceived stress levels was observed (before the intervention: 2.99, SD 0.14; after the intervention: mean 2.97, SD 0.16; P=.50). These effects were not influenced by the daily app-based practice of PQ exercises, and there were no sustained effects on self-compassion (mean 3.17, SD 0.27; P=.09) or rumination tendencies (mean 3.42, SD 0.38; P=.06) at the 5-month follow-up. Additionally, there was a significant increase in perceived stress at follow-up (mean 3.17, SD 0.21; P<.001) compared with pre- and postintervention levels. CONCLUSIONS: The PQ program did not directly alter stress perceptions but may have reframed students' automatic negative thought processes, increased their awareness of self-sabotaging behaviors, and enhanced their self-compassion while reducing ruminative thinking. These findings highlight the importance of self-awareness for students' well-being. Students can benefit from practices such as mindfulness and peer discussions to enhance self-compassion and reduce rumination. Educators trained in the PQ program can foster a supportive environment that encourages self-compassion, challenges negative self-talk, and helps students manage stress.

Urban green space, human heat perception and sleep quality: a repeated cross-sectional study.

Urban heat poses significant challenges to public health, as exposure to high temperatures is associated to heat stress, resulting in heat strain, sleep deprivation, and cardiovascular morbidity and mortality. As the frequency of heat waves is increasing due to global warming, urban green spaces are often proposed as a nature-based solution to mitigate urban heat stress. This study investigated the impact of urban green space on perceived heat stress and sleep quality, using questionnaires and detailed land cover data. We surveyed 584 respondents during four heat and four control events in the summers of 2021 and 2022, assessing perceived heat stress, sleep quality, and mental health. Using structural equation models, this study analysed the influence of both tree cover and grass and shrub cover on perceived heat stress and sleep quality, while controlling for risk and vulnerability factors. The outcomes revealed that during heat events, enhanced tree cover was associated with reduced heat stress (B = -0.484, 95% CI [-0.693, -0.275], p = 0.001), while increased grass and shrub cover was associated with both reduced heat stress (B = -0. 361 [-0.529, -0.193], p = 0.000) and improved sleep quality (B = -0. 241 [-0.399, -0.083], p = 0.003). Conversely, during control events, stress indicators were more strongly associated with individual vulnerability factors rather than surrounding green space. These results emphasize the importance of combining trees with lower vegetation in urban planning to mitigate heat-related stress and enhance sleep quality, thereby improving overall well-being during heat events.

Narrative therapy online intervention improves post-traumatic stress disorder symptoms, perceived stress, anxiety, and depression in nurses: A randomized controlled trial.

BACKGROUND: Clinical nurses have symptoms of post-traumatic stress disorder (PTSD), anxiety and depression, which seriously affect their physical and mental health. Narrative therapy (NT), a therapy for trauma-related psychological disorders, may be an effective intervention. OBJECTIVE: The aim of this study was to evaluate the effect of NT on improving PTSD symptoms, perceived stress, anxiety and depression in nurses. METHODS: A total of 92 participants who were clinical nurses and had positive PTSD symptom screening results were randomly assigned (1:1) to the intervention and control groups. The intervention group received NT and a psychological stress leaflet, while the control group received only a psychological stress leaflet. PTSD, perceived stress, anxiety, and depression were measured before and after the intervention to assess the effect of NT. RESULTS: After the intervention, the intervention group showed significantly lower levels of PTSD symptoms (P=0.025), perceived stress (P=0.033), anxiety (P=0.004), and depression (P=0.015) compared with the control group. Regarding the dichotomous outcomes of PTSD, anxiety, and depression, there was a statistically significant decrease in the number of positive cases of PTSD (P=0.030) and anxiety (P=0.002), while there was no statistically significant change in the number of positive cases of depression (P=0.060). CONCLUSIONS: NT is expected to alleviate PTSD symptoms, stress, anxiety, and depression among clinical frontline nurses, and healthcare professionals should consider applying NT to improve nurses' mental health.

Associations Among Racial Discrimination, Perceived Stress, and Birth Satisfaction in Black Women in the Postpartum Period.

OBJECTIVE: To examine associations among experiences of racial discrimination, perceived stress, and birth satisfaction and to test if perceived stress mediates the relationship between racial discrimination and birth satisfaction among Black women in the postpartum period. DESIGN: Secondary analysis of data from the Biosocial Impact on Black Births study. SETTING: A postpartum unit of a large hospital in Central Florida. PARTICIPANTS: Black women (N = 155) in the postpartum period. METHODS: Participants completed the lifetime Experiences of Discrimination scale, Perceived Stress Scale and Birth Satisfaction Scale-Revised between 24 hours and 23 days after birth. We calculated descriptive statistics and Spearman's ρ correlation coefficients to evaluate associations among variables. We used multiple linear regression to evaluate perceived stress as a mediator between racial discrimination and birth satisfaction. RESULTS: Racial discrimination had a positive association with perceived stress (ß = 2.445, p = .03), and perceived stress had a negative association with birth satisfaction (ß = -0.221, p = .02). Racial discrimination had no significant direct effect on birth satisfaction (ß = -0.091, p = .94); therefore, perceived stress did not mediate the relationship. CONCLUSION: More experiences of discrimination over the life span were associated with higher levels of perceived stress. Participants who reported higher levels of perceived stress reported lower levels of birth satisfaction. Our study adds to the body of knowledge regarding associations between racial discrimination and perceived stress and perceived stress and birth satisfaction.

Can family resources and place of residence play a beneficial role in explaining burnout levels in working men?

INTRODUCTION AND OBJECTIVE: The phenomenon of occupational burnout is a common factor affecting employees' health. In a study on occupational burnout it may happen that variables that are not among the main predictors of burnout can noticeably affect burnout and the main independent variables. The aim of this study was to verify hypotheses about the role of demographic variables in explaining levels of stress and burnout, based on the example of men working as firefighters and 112 emergency operators. MATERIAL AND METHODS: A total of 823 men employed as firefighters and 112 emergency number operators were surveyed. The study applied the LINK Occupational Burnout Questionnaire, the PSS-10 Perceived Stress Scale and a demographic questionnaire. It was followed by an analysis of covariance of qualitative variables and quantitative predictors (ANCOVA). RESULTS: The study showed that living in rural areas was associated with lower levels of burnout among the men in the examined group. A similar relationship was detected for marital status, having children and secondary education. The other main variable, the level of perceived stress and age, showed typical associations with occupational burnout. CONCLUSIONS: The search for the causes of occupational burnout should not be narrowed only to stressors related to the demands of the workplace. Demographic variables are important elements of an employee's non-work environment and often a source of personal strengths. However, it should be remembered that the same factor can have both a protective function as well as a source of additional stress.

Perceived stress and prenatal depression symptoms among couples with gestational diabetes mellitus: The mediating role of dyadic coping.

PROBLEM: No studies have been conducted to examine the relationships between perceived stress, positive/negative dyadic coping, and prenatal depression symptoms in Chinese couples with gestational diabetes mellitus (GDM). BACKGROUND: GDM is a stressful event for pregnant women and their partners, which may result in clinically significant prenatal depression symptoms in couples. AIM: This study aims to examine the relationships and differences in perceived stress, positive/negative dyadic coping, and prenatal depression symptoms between Chinese pregnant women with GDM and their partners and to explore the mediating role of positive/negative dyadic coping. METHODS: A cross-sectional study was conducted in Guangzhou, China, from January to October 2021. 402 pairs of GDM couples completed the questionnaires, including the Edinburgh Postnatal Depression Scale, the Chinese version of the Dyadic Coping Inventory, and the Perceived Stress Scale. Dyadic data was analyzed using the actor-partner interdependence mediation model. FINDINGS: 37.6 % of pregnant women with GDM and 24.6 % of their partners experienced clinically significant prenatal depression symptoms. Depression symptoms in couples mutually influence each other. Perceived stress was directly or indirectly related to their and partners' prenatal depression symptoms in GDM couples, with negative dyadic coping acting as a mediator. Maternal negative dyadic coping was also a partner-mediator. DISCUSSION: The findings of the present study may provide healthcare professionals with a better understanding of the effect of the interpersonal interaction between the couples as a dyad on prenatal depression symptoms in Chinese context. CONCLUSION: There were intrapersonal and interpersonal associations among perceived stress, negative dyadic coping, and prenatal depression symptoms in pregnant women with GDM and their partners. It suggests a need for screening clinically significant prenatal depression symptoms and decreasing perceived stress and negative dyadic coping among couples with GDM with a focus on pregnant women with GDM.

Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL).

BACKGROUND: Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function. METHODS: In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale-International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up. DISCUSSION: This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00029171 . Registered 22 July 2022.

Stress and Sleep Deprivation Experienced by Bus Drivers of Government Bus Depots in an Urban Area of Chengalpattu District in South India.

Background Driving a bus is far more stressful than other professions. Bus drivers also take more sick leave than other workers because of the physical and mental demands of their employment. Bus drivers are especially vulnerable because of their intense work environment, poor sleep, and poor food pattern. The aim of the study was to assess stress and sleep deprivation of the government bus drivers in Chengalpattu District in Tamil Nadu and to identify the sociodemographic factors influencing them. Methodology An analytical cross-sectional study was conducted among 429 government bus drivers working under Tamil Nadu State Transport Corporation (TNSTC )in selected government bus depots in the urban area of Chengalpattu District in Tamil Nadu, India. The principal investigator collected the data by using a semi-structured questionnaire which comprises six parts, i.e., sociodemographic variables, job-related factors, comorbidity, habits, stress assessed by using the Perceived Stress Scale (PSS-10), and sleep deprivation assessed by using the Epworth Sleepiness Scale (ESS). Results In the present study, the mean age of participants was 47.683 years. Hindus comprise 95.3% of the sample, and 96.7% are married. Approximately 47.6% of the drivers have achieved a higher secondary education. The average time spent working as a heavy vehicle driver was 20.4 years. About 37.1% (159 individuals) have hypertension, making it the most prevalent comorbidity. In this study, 47.3% (203 participants) reported very poor sleep, 35.7% (153 participants) reported average sleep, and 17.0% (73 participants) reported good sleep. Inferential statistics revealed that those drivers who were degree holders took less than three breaks in duty time, slept over six hours at night, had the habit of smoking and drinking alcohol, and took more than 60 minutes to fall asleep experienced very poor sleep according to the ESS. In this study, 57.1% (245 participants) reported moderate stress levels, 24.2% (104 participants) showed high levels of perceived stress, and 18.6% (80 participants) reported low stress levels. Inferential statistics revealed that those drivers who were Muslims, degree holders, those with primary education, smokers, alcohol consumers, drivers with very poor sleep, and those who took more than six days of casual leave in the past six months experienced high stress according to the PSS-10. Conclusion Implementing effective health management strategies and minimizing work-related stress will lead to a decrease in work-related disorders among drivers. TNSTC should ensure enough lodging facilities for drivers at depots, bus terminals, and outstations. They require a minimum of eight hours of sleep every day to maintain optimal physical well-being.

Influence of perceived stress on fertility intention among women of childbearing age without children: multiple mediating effect of anxiety, family communication and subjective well-being.

BACKGROUND: In recent years, there has been a significant decrease in the desire to have children among Chinese women of childbearing age, particularly for the first child. This trend has sparked a growing interest in understanding the underlying factors. Although perceived stress has been speculated as an important factor in decreasing fertility intention, the precise mechanism is unclear. The current study, therefore, aims to investigate the psychological mechanisms linking perceived stress to fertility intentions among women of childbearing age without children, a topic of significant relevance and importance. METHODS: Data were sourced from Chinese residents' psychology and behavior investigation (PBICR-2022). A multistage random sampling method was applied to recruit eligible participants. The Mplus8.3 software constructed a chain path model among the variables. RESULTS: The median fertility intention was 30(3-60) on a scale of 0 to 100. The mediation analysis revealed a significant negative influence of perceived stress on fertility intention (ß = - 0.076, P < 0.001). Additionally, a more intricate pattern of chain-mediating effect was observed involving perceived stress, anxiety (ß = 0.037, P < 0.05), family communication (ß = 0.106, P < 0.001), subjective well-being (ß = 0.088, P < 0.001) and fertility intention. CONCLUSIONS: Perceived stress not only directly suppressed fertility intention but also indirectly affected it through anxiety, family communication, and subjective well-being. Effective family communication and favorable subjective well-being emerged as factors that could augment fertility intentions among women of childbearing age without children.

The mediating role of perceived stress in the association between family resilience and psychological distress among gynecological cancer patients: a cross-sectional study.

BACKGROUND: Gynecological cancer patients face various stressors and suffer from severe psychological distress. The activation of family resilience supports patients to overcome daily stressors, yet the relationship between family resilience and psychological distress is poorly understood. The purpose of this study is to investigate the degree of psychological distress in patients diagnosed with gynecological cancer, and whether perceived stress mediate the relationship between family resilience and psychological distress. METHODS: A cross-sectional study was undertaken on 358 gynecological cancer patients in China from September 2021 to November 2022. The participants completed surveys that included the Chinese Version of the Family Resilience Assessment Scale, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, the Distress Management Screening Measure, and socio-demographic questions. Using Pearson's correlation analysis to investigate the association between variables, and the bias corrected bootstrapping method was utilized to establish perceived stress as a mediator. RESULTS: Chinese patients with gynecological cancer experienced a moderate psychological distress. In addition, psychological distress exhibited a negative correlation with family resilience and a positive correlation with perceived stress in gynecological cancer patients (both P < 0.01). Perceived stress partially mediated the correlation between family resilience and psychological distress (ß=-0.182; 95% CI: -0.224 to -0.140; P < 0.001). The total indirect effect value was - 0.182, and the total effect value was - 3.060. CONCLUSIONS: The findings indicate that higher family resilience and lower perceived stress can reduce psychological distress in gynecological cancer patients, and family resilience also tends to reduce perceived stress in cancer patients. Clinical staff and psychologist should consciously cultivate patients' family resilience to reduce psychological distress. Meanwhile, identifying potential mediators between family resilience and psychological distress are able to promote the development and assessment of interventions in the future.

The influence of organizational caring on mobile phone addiction in undergraduate nursing students: The chain mediating role of perceived stress and self-control.

Background: The incidence of mobile phone addiction (MPA) is increasing in undergraduates and may lead to depression, anxiety, and sleep disorders. Undergraduate nursing students are important group for clinical services; therefore poor mental health has an important implications for the quality of future nursing work and the relationship between nurses and patients. Objectives: To explore the connection between organizational caring and MPA in Chinese undergraduate nursing students and to investigate the mechanisms of perceived stress and self-control in this relationship by constructing a chain mediation model. Design: A cross-sectional study. Methods: A total of 900 participants (age range 18-25 years, M = 20.99, SD = 1.58, 94.0 % female) were recruited from 10 universities in China. Data were collected using an online survey between February and March 2023. Organizational caring, subjective stress, self-control ability, and MPA among undergraduate nursing students were assessed. Results: (1) The prevalence of MPA was 34.9 % (314/900). (2) MPA in undergraduate nursing students was negatively correlated with self-control (r = -0.468, p < 0.001) and organizational caring (r = -0.156, p < 0.001), and positively correlated with perceived stress (r = 0.362, p < 0.001). (3) Perceived stress and self-control mediated the relationship between organizational caring and MPA, and the relative mediating effect values were 16.6 % and 17.2 %, respectively. (4) Organizational caring had an indirect effect on MPA through the chain mediation effect of perceived stress and self-control, and the relative mediating effect value was 19.1 %. Conclusion: Organizational caring, perceived stress and self-control directly influenced MPA among undergraduate nursing students. Additionally, organizational caring indirectly affected MPA through perceived stress and self-control. To further mitigate MPA among students, nursing managers and educators should enhance organizational caring, reduce perceived stress, and improve self-control abilities.

Comparative Analysis of Stress Levels Among Undergraduate Students at St. John's College, Agra.

Background Stress is prevalent among college students, impacting their mental health and academic performance. Understanding the distribution and determinants of stress levels in students is crucial for developing effective interventions. This study aims to assess the prevalence of stress and its association with sociodemographic factors among undergraduate students at St. John's College, Agra, India. Materials and methods A descriptive cross-sectional study was conducted between August 1, 2023, and December 31, 2023, involving 160 undergraduate students from B.A., B. Com., and B.Sc. programs. Students were selected using a stratified random sampling technique. Stress levels were measured using the Perceived Stress Scale (PSS), which classifies low, moderate, and high levels. Data were collected through a validated, semi-structured questionnaire administered via Google Forms. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York), with descriptive statistics and chi-square tests used to examine associations between stress levels and sociodemographic variables. Results The study found that 103 (64.4%) of students experienced moderate stress, 34 (21.3%) reported high perceived stress, and 23 (14.4%) had low stress. A significant association was observed between stress levels and gender (p = 0.022), with female students more likely to experience high stress. Additionally, urban students reported higher stress levels than their rural counterparts (p = 0.012). However, no significant differences in stress levels were found across different courses. Conclusion The study reveals a substantial prevalence of moderate to high stress among college students, particularly among females and those from urban areas. These findings suggest the need for targeted stress management interventions to support student well-being. Further research is recommended to explore the underlying causes of stress and develop comprehensive stress reduction strategies in the student population.

Depressive Symptoms, Perceived Stress, and Associated Socio-Demographic and Diabetes-Related Factors in People With Type 2 Diabetes in Nepal.

The aim of this study was to assess the prevalence and associated factors of depressive symptoms and perceived stress among people with Type 2 diabetes mellitus (T2DM) in Nepal. Using a cross-sectional design, we collected data from 481 participants with T2DM in Kavrepalanchok and Nuwakot districts of Nepal. Depressive symptoms and perceived stress were assessed using Patient Health Questionnaire (PHQ-9) and Perceived Stress Scale, respectively. Associated independent variables were examined using binary logistic regression analyses. Of 481 participants, 123 (25.8%) had depressive symptoms (PHQ-9 score ≥5) and 156 (32.4%) experienced perceived stress. Low monthly income (

Effects of perceived stress on college students' sleep quality: a moderated chain mediation model.

BACKGROUND: Perceived Stress has been shown as a key contributor to sleep quality, but the underlying mechanism between perceived stress and sleep quality remains unknown. This study aimed to investigate the impact of perceived stress on sleep quality of college students and the chain mediating roles of presence of meaning in life (PML) and depression, as well as the moderating role of search for meaning in life (SML). METHODS: Participants were 8178 college students (4599 boys and 3579 girls; Mage = 19.10 years, SD = 1.08) who completed self-report questionnaire, including the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Meaning in Life Questionnaire (MLQ), and the Patient Health Questionnaire-9 (PHQ-9). RESULTS: The results showed that higher perceived stress was directly related to poorer sleep quality. This negative impact on sleep quality was mediated through the chained roles of PML and depression. Additionally, the study found that SML moderates the influence of perceived stress, PML and depression on sleep quality. Specifically, for individuals actively search for meaning, the adverse effects of perceived stress and depression on sleep quality are diminished. Concurrently, the positive influence of PML on sleep quality is enhanced. CONCLUSION: This study revealed that the PML and depression mediate the effect of perceived stress on sleep quality, with SML playing a significant protective role. These results emphasize the necessity of integrating strategies to enhance PML and SML into interventions designed to improve emotion management and sleep quality among college students.

Association between perceived stress, emotional eating, and adherence to healthy eating patterns among Saudi college students: a cross-sectional study.

BACKGROUND: College students are vulnerable to high perceived stress (PS) and emotional eating (EE) levels, which are associated with their food consumption. In this study, we aimed to examine the links between perceived stress, emotional eating, and adherence to a healthy eating index. Furthermore, we aimed to test whether sociodemographic data and health measures, including body mass index and physical activity, are associated with perceived stress, emotional eating, or healthy eating index. METHODS: This study included students from King Abdulaziz University. The participants completed validated perceived stress, emotional eating, and short healthy eating index surveys via an online questionnaire from September to December 2022. Univariate linear regression analysis was performed to examine the association between perceived stress, emotional eating, and adherence to healthy eating index using the short healthy eating index. RESULTS: Of 434 students (49.8% male, mean age 21.7 ± 3.0 years), 11.3% had low, 72.0% moderate, and 16.7% high perceived stress. Students with moderate perceived stress had the highest short healthy eating index score (P = 0.001), outperforming those with low and high perceived stress for fruit juice (P = 0.002), fruits (P[Formula: see text]0.001), vegetables (P=0.03), greens and beans (P<0.001), whole grains (P=0.009), and seafood/plant proteins (P = 0.001) consumption. Also, emotional eating was significantly associated with short healthy eating index score (P = 0.04), fruit juice (P = 0.01) fruit consumption (P<0.001), added sugar (P=0.02) and saturated fatty acids (P = 0.03). Academic major was associated with perceived stress (P = 0.006) and emotional eating (p=0.04). Higher physical activity levels were associated with low perceived stress levels (P<0.001) and high short healthy eating index score (P=0.001), while high body mass index was associated with high emotional eating score (P<0.001). CONCLUSIONS: The findings confirmed that students are highly vulnerable to moderate and high perceived stress levels. Furthermore, high perceived stress is inversely associated with adherence to a healthy eating index, especially for fruits, vegetables, greens and beans, whole grains, and seafood and plant proteins consumption. Emotional eating, also, associated with students dietary pattern. Physical activity will be beneficial for reducing the level of perceived stress and improving overall dietary patterns.

Insomnia and stress: the mediating roles of frontoparietal network.

Insomnia is a widespread health problem among adults, and it impairs cognitive control and emotional regulation functions. Stress and insomnia are positively correlated, and their vicious cycle has been widely reported. In this study, we explore the neural biomarkers of insomnia from the perspective of whole-brain functional connectivity and investigate the neural mechanisms underlying the association between stress and insomnia. The current study was conducted on a cross-sectional sample (N = 430). First, we investigated the correlation between perceived stress and insomnia. Second, we applied connectome-based predictive modeling (CPM) to determine the neuromarkers of insomnia. Finally, we explored the neural basis underlying the association between perceived stress and insomnia. A significant positive correlation was found between perceived stress and insomnia in the present research. Results of CPM revealed the following as the neural substrates supporting insomnia: the emotion regulation circuit involving repetitive negative thinking and the cognitive control circuit involving attention control. According to further results from mediation analysis, the frontoparietal network supporting cognitive emotion regulation is an important neural mechanism that maintains the correlation between stress and insomnia. The present study offers a profound insight into the alterations of brain activity related to insomnia, and it further investigates the neural underpinnings of the robust association between stress and insomnia. This study also opens new avenues for neural interventions to alleviate stress-related insomnia.