Psychological Consequences of Chronic Ethnic Discrimination in Male Turkish Immigrants Living in Austria: A 30-Day Ambulatory Assessment Study.

BACKGROUND: Chronic ethnic discrimination may be associated with negative psychological consequences in ethnic minority groups. However, little is known about the impact of acute discriminatory events on people who experience chronic ethnic discrimination. PURPOSE: We examined the impact of chronic and acute ethnic discrimination on the daily lives of Turkish immigrants in Austria, a population often overlooked in discrimination research. METHODS: Ninety male Turkish immigrants living in Austria (60 experiencing chronic and 30 infrequent ethnic discrimination) reported discriminatory events in real time for 30 days. Additionally, subjective stress, reactivity to daily hassles, affect, and maladaptive coping were assessed daily. RESULTS: Participants experiencing chronic ethnic discrimination indicated higher daily values for stress, negative affect, reactivity to daily hassles, and anticipation and avoidance coping. Negative psychological states increased for all participants on days when discriminatory events occurred, but participants with chronic ethnic discrimination showed significantly stronger increases in maladaptive coping and reactivity to daily hassles, with the latter effect persisting until the next day. CONCLUSIONS: Our study is the first to demonstrate interaction effects of chronic and acute ethnic discrimination on psychological factors in daily life. The results may advance the understanding of the mechanisms that lead to health disparities in ethnic minority populations and may inform the development of targeted interventions.

This study investigated the impact of chronic and acute ethnic discrimination on the daily lives of Turkish immigrants in Austria, a population often overlooked in discrimination research. While it is established that experiences of ethnic discrimination are related to worse mental and physical health, the "how," that is, the underlying psychological mechanisms, remain incompletely understood. Ninety male Turkish immigrants took part in this study, with 60 experiencing ethnic discrimination on a regular basis. Over a 30-day period, we tracked their experiences of discrimination and their daily stress, emotional reactions, and coping strategies. We found that the participants with regular experiences of ethnic discrimination had higher stress levels and more negative emotions than the participants with fewer experiences of discrimination. In addition, they more strongly reacted to acute discriminatory events in their daily lives and had more problems coping with such events. They even were more stressed by daily hassles, which continued into the following day. These findings advance the understanding of the negative impact of ethnic discrimination on health disparities in ethnic minority populations and may inform the development of targeted interventions.

Long-term cortisol secretion in attention deficit hyperactivity disorder: roles of sex, comorbidity, and symptom presentation.

Low activity of the hypothalamic-pituitary-adrenal axis (HPAA) has been found in children with attention deficit hyperactivity disorder (ADHD). The condition may be related to the reduced attention regulation capacity and/or to comorbid oppositional defiant or conduct disorder (ODD/CD). Sex differences are probable but not sufficiently studied. We analyzed the HPAA activity and sympathetic nervous system reactivity (SR) in children with ADHD while accounting for ADHD symptom presentation, comorbidity, and sex differences. The sample comprised 205 children, 98 (61 boys, 37 girls) with ADHD and 107 (48 boys, 59 girls) healthy controls. DSM-5 phenotypic symptom presentation and comorbid ODD/CD were assessed using clinical interviews. Hair cortisol concentration (HCC) was used to assess the long-term, cumulative activity of the HPAA. SR was assessed via skin conductance response (SCR). For control purposes, comorbid internalizing symptoms and indicators of adverse childhood experiences (ACE) were assessed. Children were medication naive. Boys presenting with predominantly inattentive symptoms (ADHD-I) showed lower HCC than healthy boys. Girls presenting with combined symptoms (ADHD-C) showed higher HCC than did healthy girls (p's < 0.05, sex-by-group interaction, F (2,194) = 4.09, p = 0.018). Boys with ADHD plus ODD/CD showed a blunted SR (p < 0.001, sex-by-group interaction, F (2,172) = 3.08, p = 0.048). Adjustment for ACE indicators led to non-significant differences in HCC but did not affect differences in SR. HCC constitutes an easily assessable, reliable, and valid marker of phenotypic ADHD-related features (i.e. symptom presentation and comorbidity). It indicates more homogenous subgroups of ADHD and might point to specifically involved pathophysiological processes.

Physiological stress reactivity and self-harm: A meta-analysis.

OBJECTIVE: Self-harm is associated with alterations in the psychobiological stress response. Specifically, the reactivity of the autonomic nervous system (ANS) and the endocrine hypothalamic-pituitary-adrenal (HPA) axis may differ in individuals who engage in self-harm. However, evidence in this regard is inconsistent. BACKGROUND: We conducted a preregistered random-effects meta-analysis of sympathetic ANS, parasympathetic ANS, sympathetic-parasympathetic, i.e., mixed-influence ANS, and HPA axis reactivity following laboratory stress exposure in individuals who engage in self-harm and controls. Stress exposure consisted of paradigms using either social-evaluative (e.g., TSST), emotional (e.g., negatively valenced visual stimuli), or physical (e.g., cold pressor test) challenges. A total of 29 studies (self-harm: n = 954, controls: n = 1122, 74% females) were included in the analysis. RESULTS: Regarding ANS reactivity to stress, no differences emerged between the two groups. However, parasympathetic ANS activity was lower before stress (g = -0.30, CI -0.51 to -0.09) and after stressor cessation (g = 0.54, CI -1.07 to -0.01) in the self-harm group compared to controls. Regarding HPA axis reactivity, individuals who engage in self-harm showed significantly lower cortisol responses to stress than did controls (g = -0.26, CI -0.45 to -0.08). After stressor cessation (i.e., during stress recovery), cortisol was also lower in individuals who engage in self-harm compared to controls (g = -0.26, CI -0.43 to -0.08). CONCLUSIONS: Lower basal parasympathetic ANS activity and flattened cortisol responses indicate dysregulation of psychobiological stress systems in individuals who engage in self-harm. A better understanding of the psychobiological underpinnings of self-harm may allow for the establishment of biomarkers of risk stratification and treatment monitoring in affected individuals.

How is music listening purpose related to stress recovery? - two preliminary studies in men and women.

Introduction: Studies have suggested that listening to music can reduce psychological and biological responses to a stressor. However, it is unclear whether music has the same effect on stress recovery. According to field studies, people commonly use music in daily life for the specific purpose of relaxation. We explored whether individuals who generally use music for relaxation purposes show improved recovery from an acute stressor. Methods: In two independent studies, twenty-seven healthy female participants (Mage = 24.07) (Study 1) and twenty-one healthy male participants (Mage = 23.52) (Study 2) were separated into two groups based on their frequency of using music for relaxation purposes (low vs. high). All participants underwent a lab-based psychosocial stress test. Subjective stress levels were measured using visual analogue scales. Salivary cortisol and salivary alpha-amylase were measured to assess endocrine and autonomic stress responses, respectively. Subjective stress levels and saliva samples were measured nine times throughout the stress induction and recovery procedure. Chronic stress levels were assessed using the Perceived Stress Scale and the Screening Scale of Chronic Stress. Results: No significant differences were observed in subjective stress levels, salivary alpha-amylase activity, or cortisol concentration between the two groups in either of the two studies. Further analyses revealed that among male participants, increased use of music for relaxation purposes was related to more chronic stress levels (t (10.46) = 2.45, p = 0.03, r = 0.60), whereas female participants exhibited a trend in the opposite direction (t (13.94) = -1.92, p = 0.07, r = 0.46). Discussion: Contrary to our expectations, the results indicate that habitual music listening for relaxation purposes is not associated with improved recovery from a stressor. However, due to the small sample size, future exploration is necessary to enhance the statistical power of the results of the study.

Music for autism: a protocol for an international randomized crossover trial on music therapy for children with autism.

The notion of a connection between autism and music is as old as the first reported cases of autism, and music has been used as a therapeutic tool for many decades. Music therapy holds promise as an intervention for individuals with autism, harnessing their strengths in music processing to enhance communication and expression. While previous randomized controlled trials have demonstrated positive outcomes in terms of global improvement and quality of life, their reliance on psychological outcomes restricts our understanding of underlying mechanisms. This paper introduces the protocol for the Music for Autism study, a randomized crossover trial designed to investigate the effects of a 12-week music therapy intervention on a range of psychometric, neuroimaging, and biological outcomes in school-aged children with autism. The protocol builds upon previous research and aims to both replicate and expand upon findings that demonstrated improvements in social communication and functional brain connectivity following a music intervention. The primary objective of this trial is to determine whether music therapy leads to improvements in social communication and functional brain connectivity as compared to play-based therapy. In addition, secondary aims include exploring various relevant psychometric, neuroimaging, and biological outcomes. To achieve these objectives, we will enroll 80 participants aged 6-12 years in this international, assessor-blinded, crossover randomized controlled trial. Each participant will be randomly assigned to receive either music therapy or play-based therapy for a period of 12 weeks, followed by a 12-week washout period, after which they will receive the alternate intervention. Assessments will be conducted four times, before and after each intervention period. The protocol of the Music for Autism trial provides a comprehensive framework for studying the effects of music therapy on a range of multidimensional outcomes in children with autism. The findings from this trial have the potential to contribute to the development of evidence-based interventions that leverage strengths in music processing to address the complex challenges faced by individuals with autism. Clinical Trial Registration: Clinicaltrials.gov identifier NCT04936048.

Effects of participant-selected versus researcher-selected music on stress and mood - The role of gender.

OBJECTIVE: Previous research suggests differential effects of participant-selected (PS) vs. researcher-selected (RS) music on emotional responses to music listening. This study investigates whether such selection strategies, as well as gender, influence (1) stress and (2) mood responses. Additionally, we examine the role of (3) stimulus-induced emotions and (4) emotion regulation strategies. METHODS: Participants (N = 61) listened to auditory stimuli (PS music, RS music, sound of lapping water (LW); randomized) on three days and underwent a cold pressor test (CPT) while listening. Stress parameters (subjective acute stress, heart rate, parameter RMSSD, salivary alpha-amylase, salivary cortisol), mood dimensions (calmness, valence, energetic arousal), emotions, and emotion regulation strategies were measured. Multilevel and mediation analyses were conducted. RESULTS: (1) There were no direct effects of selection strategy or gender on stress responses, but interaction effects indicated that women showed the strongest subjective stress response and the longest HR recovery with PS music, while men showed the lowest HR response to the CPT with PS music. (2) No mood differences emerged between PS and RS music overall. Women showed stronger variability in calmness overall as well as perceived higher arousal when listening to PS music compared to men. (3) Higher stimulus-induced anger in men compared to women and with LW compared to PS was associated with lower calmness and valence, while no consistent pattern emerged for the stress responses. (4) Women scored higher on reappraisal, associated with a decrease in parasympathetic activity, whereas men scored higher on suppression, associated with an increase in endocrine activity. CONCLUSIONS: Music selection and gender appear to have no direct impact on stress and mood responses overall, although men tend to benefit more from self-selected music than women. Our findings provide first indications that avoiding music stimuli that induce anger may facilitate mood management via music. Furthermore, finding alternative emotion regulation strategies to the strategy of suppression may be a helpful approach to improve music-based stress management.

Effect of transcutaneous vagus nerve stimulation on stress-reactive neuroendocrine measures in a sample of persons with temporal lobe epilepsy.

OBJECTIVE: Dysregulation of stress-reactive neuroendocrine measures, as well as subjective stress, have been found to worsen epilepsy. Transcutaneous vagus nerve stimulation (tVNS) is a relatively new treatment option for epilepsy. We were interested in its effect on the activity of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) as well as subjective stress and tiredness in patients with temporal lobe epilepsy (TLE). METHODS: Twenty patients (age 44 ± 11 years, 13 women) were enrolled in the study. They were free of seizures for more than 1 year. All took part in two sessions with 4 h of stimulation (tVNS vs. sham) in a randomized order. Saliva samples and subjective stress and tiredness levels were measured at five time points each session (before and after stimulation and three time points every hour in between). Data were analyzed using repeated measures analysis of variance as well as paired t-tests. RESULTS: There was a dampened salivary cortisol (sCort) decrease during tVNS (time × condition effect: F[2.38, 38.15] = 6.50, P = 0.002, partial η2 = 0.29). Furthermore, we detected a dampened increase in salivary flow rate during tVNS (time × condition effect: F[3.28, 55.67] = 2.82, P = 0.043, partial η2 = 0.14). There was neither a difference in overall sCort or salivary alpha-amylase (sAA) levels nor in subjective stress or tiredness levels between conditions. sAA levels at the last measurement point were slightly higher during tVNS (t(19) = 2.26, P = 0.035, d = 0.51), but this effect failed to reach significance when controlled for multiple comparisons. SIGNIFICANCE: Our results partially support that tVNS influences the regulation of stress-reactive neuroendocrine systems (namely the HPA axis and ANS) in epilepsy. More research with larger samples is needed on the difference between short-term and repeated long-term stimulation.

Early adolescents' perspectives on factors that facilitate and hinder friendship development with peers at the time of school transition.

Supportive peer relationships are fundamental for mental health and well-being. Hence, peers and friends are a valuable resource, especially at the time of transition from primary to secondary school. Yet, current literature lacks both novel approaches to studying friendship development and how to involve early adolescents in research that is being conducted about them. Within the present study we used novel participatory research methods involving early adolescents who were active in the analysis of their own generated data. We aimed to better understand their perspectives on factors that facilitate and hinder friendship development with peers during the time of school transition between primary and secondary schools. A total of 916 pupils (Mage = 10.44 years, range = 9-16) participated in 54 participatory workshops that were conducted in Austria. We used reflexive thematic analysis to analyze qualitative data from portions of a large series of participatory workshop activities. Moreover, we actively involved participants in the analysis of their own generated data. Themes were structured into personal, interpersonal, and external factors. We found that early adolescents valued kind peers that (a) give them a feeling of safety, (b) show supportive and empathic actions, (c) manage conflicts, (d) avoid negative behavior, (e) spend time with them, and (f) communicate in the offline and online environments. Although shared norms of behavior can support friendship development, friendship jealousy and tolerating bigger friendship groups were identified as important potential barriers. Additionally, external factors (i.e., given circumstances), such as similarities, physical proximity, and duration of acquaintance were included in our data but were perceived as less important by early adolescents. Our results supplement the existing peer relationship literature by showing which factors early adolescents themselves chose as most relevant for friendship development. We conclude with a discussion regarding the implications for school psychology practice and future research.

Does workplace telepressure get under the skin? Protocol for an ambulatory assessment study on wellbeing and health-related physiological, experiential, and behavioral concomitants of workplace telepressure.

BACKGROUND: The daily working life of many employees requires the use of modern information and communication technology (ICT) devices such as computers, tablets, and smartphones. The double-edged nature of digital work environments has been increasingly highlighted. Benefits such as increased flexibility come at a personal cost. One of the potential downsides is workplace telepressure, i.e., the experience of urge and preoccupation to quickly reply to work-related messages and demands using ICT. There is initial - mainly survey-based-evidence that workplace telepressure may have negative effects on a variety of wellbeing and health outcomes. AIMS AND HYPOTHESES: Adopting the Effort-Recovery Model and the concept of allostatic load as theoretical frameworks, the present study aims to investigate the hypothesis that workplace telepressure is significantly associated with increased "wear and tear", in the form of more psychosomatic complaints, worse sleep quality (self-reported and actigraphy-based), worse mood, and biological alterations (lower cardiac vagal tone, lower anabolic balance defined as the ratio of salivary dehydroepiandrosterone to salivary cortisol, and higher salivary alpha-amylase). Additionally, the study aims to investigate the hypothesis that connection to work defined as work-related workload and work-related perseverative cognition plays a significant role in the mediation of these relationships. METHODS: To test our hypotheses, we will conduct an ambulatory assessment study with a convenience sample of 120 healthy workers regularly using ICTs for job communication. For one week, participants will be asked to complete electronic diaries assessing their level of workplace telepressure, psychosomatic complaints, sleep quality, mood, work-related workload, and work-related perseverative cognition. They will also continuously wear the Bittium Faros 180L ECG monitor, the wrist-worn actigraph MotionWatch 8, and perform saliva sampling five times per day. DISCUSSION: This study will be the most comprehensive ambulatory investigation of workplace telepressure and its psychophysiological concomitants to date and constitutes an important step towards understanding how high levels of workplace telepressure may lead in the long term to secondary alterations (e.g., hypertension, chronic inflammation) and disease (e.g., heart disease). The findings of this study are also anticipated to contribute to guiding the development and implementation of interventions, programs, and policies relevant to employees' digital wellbeing.

Homeostatic Regulation of Energetic Arousal During Acute Social Isolation: Evidence From the Lab and the Field.

Recent evidence suggests that social contact is a basic need governed by a social homeostatic system. Little is known, however, about how conditions of altered social homeostasis affect human psychology and physiology. Here, we investigated the effects of 8 hr of social isolation on psychological and physiological variables and compared this with 8 hr of food deprivation in a lab experiment (N = 30 adult women). Social isolation led to lowered self-reported energetic arousal and heightened fatigue, comparable with food deprivation. To test whether these findings would extend to a real-life setting, we conducted a preregistered field study during a COVID-19 lockdown (N = 87 adults; 47 women). The drop in energetic arousal after social isolation observed in the lab replicated in the field study for participants who lived alone or reported high sociability, suggesting that lowered energy could be part of a homeostatic response to the lack of social contact.

The effect of an internet-based intervention for depression on cortisol and alpha-amylase.

INTRODUCTION: Psychotherapeutic interventions for major depressive disorder (MDD) have been suggested to be associated with a normalization of biological stress system (i.e., the hypothalamic-pituitary-adrenal axis and the autonomic nervous system) dysregulation. Furthermore, pre-intervention cortisol parameters have been identified as prescriptive biological markers of treatment success. However, evidence of treatment effects on the biological stress systems is still sparse, and results are heterogeneous. The current study examined the effect of an internet-based intervention for MDD on salivary cortisol and alpha-amylase as well as hair cortisol concentrations. Moreover, the prescriptive capacity of pre-intervention cortisol and alpha-amylase concentrations on treatment response was explored. METHODS: Thirty-eight participants suffering from mild to moderate MDD collected saliva and hair samples throughout the intervention. Biological outcome parameters were salivary cortisol and alpha-amylase (awakening response, total diurnal output, diurnal slope) and hair cortisol concentrations. Treatment response was indicated by change in depression severity and perceived chronic stress. RESULTS: Treatment response on depression scores or chronic stress was not associated with changes in any of the cortisol or alpha-amylase parameters. Exploratory analysis indicated that non-responders showed a steeper alpha-amylase slope pre-intervention. DISCUSSION: The results indicate that changes in depressive symptoms did not correspond to changes of the biological stress systems, contradicting the suggested normalization of dysregulated hypothalamic-pituitary-adrenal axis or autonomic nervous system activity through a psychotherapeutic intervention. However, the results point to a potential role of pre-intervention alpha-amylase slope as a prescriptive marker of treatment response for depression.

Perceptions of Stress and Mood Associated With Listening to Music in Daily Life During the COVID-19 Lockdown.

Importance: Music listening is a universal human experience. People of all ages and cultures often use music to reduce stress and improve mood, particularly in times of crisis. However, ecologically valid research examining the real-time association of music listening with stress and mood during the COVID-19 pandemic is scarce. Objective: To explore the associations between listening to music and the perceptions of stress and mood using ecological momentary assessment during the COVID-19 lockdown period. Design, Setting, and Participants: In this cohort study conducted between April 1 and May 8, 2020, adults from the general population residing in Austria and Italy were prompted by an app on their smartphone to report data 5 times per day across 7 consecutive days. Participants provided data on their real-time and real-life experiences in their natural environment while strict lockdown measures were in place. Data analysis was performed from March 2021 to February 2022. Exposures: Data on self-reported music listening were recorded by means of mobile-based assessments. Perceived chronic stress was assessed once at the end of the study. Main Outcomes and Measures: Perceptions of momentary stress and mood were measured using visual analog scales (score range, 0-100, where 0 indicates not at all and 100 indicates very much) by means of mobile app-based assessments. Results: The final sample comprised 711 participants (497 women [69.9%]; median age, 27.0 years [IQR, 24.0-36.0 years]). Participants provided a total of 19 641 data points, including 4677 music listening reports. Music listening was prospectively associated with lower momentary stress levels (ß, -0.92; 95% CI, -1.80 to -0.04; P = .04) and improvements in mood valence (ß, 1.90; 95% CI, 1.17-2.63; P < .001), especially if the music was perceived as happy. Individuals with higher levels of chronic stress reported improved mood valence after music listening (ß, 0.12; 95% CI, 0.02-0.22; P = .02). Conclusions and Relevance: The present findings suggest that music listening may be a means to modulate stress and mood during psychologically demanding periods. Individuals experiencing heightened momentary and/or chronic stress because of the challenges brought about by COVID-19 pandemic-related restrictions might consider music as an easily accessible tool for the management of stress and mood in daily life.

The effects of social interactions on momentary stress and mood during COVID-19 lockdowns.

OBJECTIVE: Social interactions are vital for our well-being, particularly during times of stress. However, previous studies linking social interactions to psychological outcomes during the COVID-19 pandemic have largely been retrospective and/or cross-sectional. Thus, we tested four preregistered hypotheses (H1-H4) concerning the real-time effect of social interactions on momentary changes in stress and mood during two COVID-19 lockdowns. DESIGN: We used an ecological momentary assessment approach in 732 participants in spring 2020 (burst 1) and in a subsample of these participants (n = 281) during a further lockdown in autumn/winter 2020 (burst 2). METHODS: Participants reported their stress and mood in a smartphone app five times per day for 7 days and indicated the nature and frequency of their recent social interactions. RESULTS: Social interactions (H1) and their frequency (H2) improved momentary affect (e.g., social interactions increased mood valence: estimate = 2.605, p < .001 for burst 1). This was particularly the case for face-to-face interactions which, compared with other types of interactions, reduced momentary stress (e.g., estimate = -2.285, p < .001 for burst 1) and boosted mood (e.g., estimate = 1.759, p < .001 for burst 1) across both lockdowns, even when controlling for the pleasantness of the interaction and the closeness of the interaction partner (H3). We also show that individual differences in people's responsiveness to different social rewards modulated the impact of social interactions on momentary mood (H4). CONCLUSIONS: This study extends findings from cross-sectional and retrospective studies by highlighting the real-time affective benefits of social interactions during COVID-19 lockdown. The results have important implications for the (self-) management of stress and mood during psychologically demanding periods.

Hair brain-derived neurotrophic factor (BDNF) as predictor of developing psychopathological symptoms in childhood.

BACKGROUND: Dysregulation in the expression of neurotrophins is implicated in the pathophysiology of several mental disorders. Peripheral brain-derived neurotrophic factor (BDNF) can be measured in hair and might represent a marker of adequate neuroplasticity regulation. In early developmental periods, neuroplasticity regulation might be particularly important, but BDNF markers have not yet been analyzed in this regard. We used the hair-BDNF concentration (HBC) to investigate the prediction of emerging symptoms of anxiety/depressive and attention-deficit hyperactivity disorder (ADHD) in the developmentally crucial period from preschool to school age. METHODS: 117 children (58 girls, 59 boys) participated in a longitudinal study at the ages of 4-5 (T1) and 8 (T2) years. At T1, HBC was measured in a 3 cm hair segment. At T1 and T2, symptom domains were assessed using a multi-method (clinical interview, questionnaire) and multi-informant approach. RESULTS: T1 HBC was significantly negatively associated with T1 anxiety/depressive symptoms (r = -0.27) and predicted T2 anxiety disorder symptoms (r = -0.34) after controlling for the T1 symptoms. T1 HBC also predicted T2 depressive disorder symptoms (r = -0.18) but was not associated with ADHD symptom development. LIMITATIONS: BDNF hair analysis is a new method with a not yet large number of studies on methodological issues. Our study adds evidence to the validity of the method. CONCLUSIONS: Prediction of anxiety/depressive symptom development by HBC was shown. As this study was the first to use HBC in this context, cross-validation is necessary and worthwhile. HBC might prove to constitute a useful, non-invasive early marker of risk for anxiety/depressive disorders in childhood.

How audience and general music performance anxiety affect classical music students' flow experience: A close look at its dimensions.

Flow describes a state of intense experiential involvement in an activity that is defined in terms of nine dimensions. Despite increased interest in understanding the flow experience of musicians in recent years, knowledge of how characteristics of the musician and of the music performance context affect the flow experience at the dimension level is lacking. In this study, we aimed to investigate how musicians' general music performance anxiety (MPA) level (i.e., the general tendency to experience anxiety during solo music performances) and the presence of an audience influence the nine flow dimensions. The participants were 121 university music students who performed solo a music piece once by themselves (private performance) and once in front of an audience (public performance). Their general MPA level was measured with an adapted version of the STAI and ranged from 27 (very low MPA) to 76 (very high MPA). The level of the nine flow dimensions was assessed with the Flow State Scale-2 after each performance. The levels of "concentration on task at hand," "sense of control," and "autotelic experience" decreased significantly with increasing general MPA level. The levels of "unambiguous feedback" and "loss of self-consciousness" decreased significantly with increasing general MPA level during the public performance only. The level of "sense of control" was significantly lower during the public performance than the private performance across participants. The level of "unambiguous feedback" was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 47. The level of "loss of self-consciousness" was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 32. In contrast, the general MPA level and the audience did not significantly affect the levels of "challenge-skill balance," "clear goals," and "action-awareness merging." These results show that the effects of general MPA level and audience vary greatly across flow state dimensions. We conclude that musicians' flow state should be analyzed at the dimension level rather than as a global score. We discuss how our findings could inform the development and implementation of interventions.

An ecological momentary music intervention for the reduction of acute stress in daily life: A mixed methods feasibility study.

Background: Despite the growing potential of mobile-based technologies, innovative interventions targeting the reduction of acute stress in daily life remain under-researched. Music listening is an easy-to-administer activity that is associated with lower levels of biological and self-reported stress. However, the application of music as an intervention in moments of acute stress in daily life remains to be examined. We developed a just-in-time intervention delivering music in moments of stressful experiences in daily life and tested its feasibility using a mixed methods approach. Methods: In this uncontrolled pilot study, the ecological momentary music intervention (EMMI) was tested by 10 chronically stressed women aged 23.5 ± 3.3 years. Over 18 consecutive days, whenever participants reported stressful experiences, they were encouraged to listen to a self-compiled playlist. Subjective stress levels and saliva samples were assessed at three time points per stress report (T0, upon reporting a stressful situation; T1, directly after music listening/15 min after T0 in case of no music listening; T2, 15 min after T1). We analyzed app-based log data, in-the-moment responses, questionnaire data, and semi-structured interview data. Results: On average, participants' compliance with the study protocol lay at 70%. Overall, 65 stressful experiences were reported, 51 of which were followed by music listening, for an average duration of 12:53 min. Complete data (i.e., self-reports and saliva samples at all three time points) were provided for 46 stressful experiences. Participants reported immediate relaxation and distraction through music listening. The interviews revealed that the intervention was easy to use and that music listening in moments of perceived stress was viewed as a new and pleasant activity. Several aspects of the protocol (e.g., number of items and prompts) were identified, which should be improved in future studies. Conclusion: Since repeated stressful experiences in daily life can pose a threat to physical and mental integrity, interventions that are easily applicable and deliver support when needed most are necessary. Following minor adaptations, the EMMI can be considered as a feasible approach to target psychobiological stress responses in daily life, which is worthy of investigation in future larger-scale trials.

Does childhood trauma impact daily psychobiological stress in somatic symptom disorder? An ambulatory assessment study.

Objectives: Somatic symptom disorder is characterized by excessive thoughts, feelings, and behaviors dedicated to bodily symptoms, which are often medically unexplained. Although 13% of the population are affected by this disorder, its aetiopathogenesis is not fully understood. Research in medically unexplained conditions (e.g., fibromyalgia) points to increased psychosocial stress and alterations in stress-responsive bodily systems as a potential contributing factor. This pattern has often been hypothesized to originate from early life stress, such as childhood trauma. The aim of this study was to examine, for the first time, whether individuals with somatic symptom disorder exhibit elevated levels of self-reported daily stress and alterations in the autonomic nervous system and hypothalamic-pituitary-adrenal axis, both in comparison to healthy controls and individuals with depressive disorders, and whether reports of childhood trauma influence these alterations. Methods: A total of N = 78 individuals were recruited into this study. Of these, n = 27 had a somatic symptom disorder, n = 23 were healthy controls, and n = 28 had a depressive disorder. All individuals underwent a 14-day measurement period at home, with five assessments of self-reported stress, salivary alpha-amylase, and cortisol per day. Childhood trauma was assessed by the Childhood Trauma Questionnaire. Results: Individuals with somatic symptom disorder exhibited higher daily stress levels (p = 0.063) as well as a less pronounced alpha-amylase awakening response (p = 0.050), compared to healthy controls (statistical trends). Moreover, they were characterized by significantly attenuated diurnal cortisol concentrations (p < 0.001). A nearly identical pattern was observed in individuals with depression. In individuals with somatic symptom disorder and depressive disorders, childhood trauma was, by trend, associated with a more pronounced alpha-amylase awakening response (b = -0.27, p = 0.077). Conclusions: This study provides preliminary evidence for elevated daily stress and blunted sympathetic and hypothalamic-pituitary-adrenal axis activity in individuals with somatic symptom disorder and depressive disorders. Further studies will help to uncover the conditions under which these dysregulations develop into medically unexplained vs. depressive symptoms.

Psychobiological Evaluation of Day Clinic Treatment for People Living With Dementia - Feasibility and Pilot Analyses.

Background: Hospitalization is often stressful and burdensome for people living with dementia (PwD) and their informal caregivers (ICs). Day clinic treatment may provide a suitable alternative, but is often precluded by a diagnosis of dementia. Furthermore, it is often caregiver-based ratings that measure treatment success as the validity of self-reports in PwD is critically discussed. We therefore set out to examine the feasibility of psychobiological stress measures in PwD and ICs and to evaluate treatment trajectories considering both the day clinic context and the daily life of the dyads. Method: A total of 40 dyads of PwD (mean age: 78.15 ± 6.80) and their ICs (mean age: 63.85 ± 13.09) completed paper-and-pencil questionnaires (covering stress, depressive symptoms, and caregiver burden among others) in addition to the measurement of hair cortisol concentrations (HCC) at admission, discharge, and follow-up 6 months after day clinic treatment. As part of an ambulatory assessment, for 2 days at the beginning and 2 days at the end of the day clinic treatment, PwD and ICs collected six saliva samples per day for the analysis of salivary cortisol (sCort) and alpha-amylase (sAA). Results: Paper-and-pencil questionnaires and HCC assessments were more feasible than the ambulatory assessment. We found discrepancies between subjective and physiological markers of stress in PwD. Whereas HCC decreased over time, self-reported stress increased. Child-parent dyads reported decreases in neuropsychiatric symptoms, associated burden, and self-reported stress from admission to follow-up. In daily life, both PwD and ICs showed characteristic diurnal profiles of sAA and sCort, however, we found no differences in summary indicators of salivary stress markers over time. Discussion: The psychobiological evaluation was feasible and added informative value, underlining the potential of physiological stress markers to complement self-reports on stress in PwD and to objectively evaluate treatment trajectories. In this sample, HCC was more feasible and acceptable as biological marker of stress compared to saliva samples. Concerning treatment trajectories, differential effects on the dyads were found, with child-parent dyads benefiting more from day clinic treatment compared to spousal dyads.

The Impact of Coping Styles and Gender on Situational Coping: An Ecological Momentary Assessment Study With the mHealth Application TrackYourStress.

The aim of this study was to investigate the impact of different coping styles on situational coping in everyday life situations and gender differences. An ecological momentary assessment study with the mobile health app TrackYourStress was conducted with 113 participants. The coping styles Positive Thinking, Active Stress Coping, Social Support, Support in Faith, and Alcohol and Cigarette Consumption of the Stress and Coping Inventory were measured at baseline. Situational coping was assessed by the question "How well can you cope with your momentary stress level" over 4 weeks. Multilevel models were conducted to test the effects of the coping styles on situational coping. Additionally, gender differences were evaluated. Positive Thinking (p = 0.03) and Active Stress Coping (p = 0.04) had significant positive impacts on situational coping in the total sample. For women, Social Support had a significant positive effect on situational coping (p = 0.046). For men, Active Stress Coping had a significant positive effect on situational coping (p = 0.001). Women had higher scores on the SCI scale Social Support than men (p = 0.007). These results suggest that different coping styles could be more effective in daily life for women than for men. Taking this into account, interventions tailored to users' coping styles might lead to better coping outcomes than generalized interventions.

Alpha-2 Adrenoreceptor Antagonist Yohimbine Potentiates Consolidation of Conditioned Fear.

BACKGROUND: Hyperconsolidation of aversive associations and poor extinction learning have been hypothesized to be crucial in the acquisition of pathological fear. Previous animal and human research points to the potential role of the catecholaminergic system, particularly noradrenaline and dopamine, in acquiring emotional memories. Here, we investigated in a between-participants design with 3 groups whether the noradrenergic alpha-2 adrenoreceptor antagonist yohimbine and the dopaminergic D2-receptor antagonist sulpiride modulate long-term fear conditioning and extinction in humans. METHODS: Fifty-five healthy male students were recruited. The final sample consisted of n = 51 participants who were explicitly aware of the contingencies between conditioned stimuli (CS) and unconditioned stimuli after fear acquisition. The participants were then randomly assigned to 1 of the 3 groups and received either yohimbine (10 mg, n = 17), sulpiride (200 mg, n = 16), or placebo (n = 18) between fear acquisition and extinction. Recall of conditioned (non-extinguished CS+ vs CS-) and extinguished fear (extinguished CS+ vs CS-) was assessed 1 day later, and a 64-channel electroencephalogram was recorded. RESULTS: The yohimbine group showed increased salivary alpha-amylase activity, confirming a successful manipulation of central noradrenergic release. Elevated fear-conditioned bradycardia and larger differential amplitudes of the N170 and late positive potential components in the event-related brain potential indicated that yohimbine treatment (compared with a placebo and sulpiride) enhanced fear recall during day 2. CONCLUSIONS: These results suggest that yohimbine potentiates cardiac and central electrophysiological signatures of fear memory consolidation. They thereby elucidate the key role of noradrenaline in strengthening the consolidation of conditioned fear associations, which may be a key mechanism in the etiology of fear-related disorders.