Stress and Health

Huang, Huiqing; Wu, Xuebing; Hu, Jun; Hu, Yueqin; Gan, Yiqun

doi: 10.1002/smi.70085pmid: 40737208

Daily life is full of stressful events, but previous studies have inconsistent findings on how stress predicts daily activities. This study explored the relationship between perceived stress, activity choice, and happiness and meaning through an experience sampling method. Over 10 days, 205 participants reported their perceptions of momentary demands, resources, happiness, meaning, and activities four times a day, totaling 7362 observations. Stress was operationalised using both perceived demands and the ratio of demands to resources. Multilevel modelling showed that both concurrent demands and the demands‐to‐resources ratio were positively associated with meaning‐increasing activities (e.g., working and studying) and negatively associated with activities that promote both happiness and meaning (e.g., eating and shopping). The ratio also predicted greater engagement in meditation, which also increases both happiness and meaning. Additionally, higher prior demands predicted reduced physical activity‐an activity linked to increased happiness and meaning. These findings revealed behavioural tendencies and motivations under stress and offered implications for stress management in daily life.

Beckner, Meaghan E.; Stein, Jesse A.; Van Dam, Drew; Barringer, Nicholas; Smith, Tracey J.; Larsen, Matthew C.; Knapik, Joseph J.; Lieberman, Harris R.

doi: 10.1002/smi.70096pmid: 40792426

There are limited opportunities to study physiological and psychological factors that predict success in real world high stress environments where individuals must engage in controlled aggressive behaviour. All cadets attending the United States Military Academy must take a combatives course where they are taught to compete in hand‐to‐hand combat with peers and graded on performance. This study assessed, in this highly competitive environment, the physiological, psychological, and academic predictors of success in the course's final exam, a final hand‐to‐hand combat match. Male (n = 109) and female (n = 23) cadets completed self‐report assessments of resilience (Connor–Davidson Resilience Scale; CD‐RISC), mental toughness (Mental Toughness Questionnaire; MTQ‐10), and aggression (Buss‐Perry Aggression Questionnaire; BPAQ) upon enrolment in Combatives. Immediately preceding the final match, cadets provided saliva samples and completed mood state (Profile of Mood States; POMS), self‐confidence and competitive state anxiety (Competitive State Anxiety Inventory; CSAI‐2) questionnaires. Cortisol, testosterone, and secretory immunoglobulin A (SIgA) in saliva were assessed. Instructors provided match outcome, win versus loss, and each cadet's grade point averages (GPA; academic, military, and physical). Logistic regression analyses determined if physiological, psychological, or academic variables predicted match outcome. Sex, time of day, prior combatives experience, and midterm combatives performance were included as covariates. Greater self‐confidence (OR [95% CI]; 1.13 [1.03, 1.25]) and a better physical GPA (4.51 [1.52, 13.42]) were associated with increased odds of winning the final match, with an overall classification accuracy of 68.9% and explained 31% of the variance in match outcome. Greater cognitive anxiety independently decreased the odds of winning (0.93 [0.87, 0.99]), but not when combined with self‐confidence and physical GPA. No other factors significantly impacted odds of winning. Self‐confidence and physical performance are key contributors to success in hand‐to‐hand combat and may mediate the influence of anxiety on performance.

Liu, Yutong; Duan, Hongxia; Wu, Jianhui

doi: 10.1002/smi.70086pmid: 40714869

The present study explored the role of two types of uncertainty attitudes, that is, risk and ambiguity, in the relationship between childhood stress and depressive symptoms among 214 undergraduates. Participants completed an economic decision‐making task designed to assess their attitudes towards risk and ambiguity. Risk attitude and ambiguity attitude were quantified using a theoretical model of decision‐making under uncertainty. Childhood stress was measured by the Childhood Trauma Questionnaire (CTQ) and depressive symptoms by the Self‐rating Depression Scale (SDS). Results indicated that higher levels of childhood stress were significantly associated with greater risk aversion but not with ambiguity attitude. Moreover, risk attitude statistically moderated the relationship between childhood stress and depressive symptoms, with gender differences emerging in the direction of this effect. Specifically, among females, increased risk aversion strengthened the association between childhood stress and depressive symptoms. In contrast, in males, greater risk aversion weakened this relationship. These findings suggest that risk attitude may operates in a context‐dependent and gender‐specific manner, highlighting the need for tailored interventions.

Loh, May Young; Lee, Michelle Chin Chin; Dollard, Maureen; Gardner, Dianne; Kikunaga, Kazuki; Tondokoro, Tsukumi; Nakata, Akinori; Idris, Mohd. Awang; Bentley, Tim; Afsharian, Ali; Tappin, David; Forsyth, Darryl

doi: 10.1002/smi.70070pmid: 40637504

Occupational health and safety researchers and policymakers often rely on organisational theories and evidence to provide valuable information for effective policy making and understanding. Yet, most traditional and contemporary organisational theories are developed within a single nation, often in high‐income countries. Therefore, cross‐national validation is required for generalisable worldwide use. The current study focuses on an antecedent to workplace health and safety, that is, the psychosocial safety climate (PSC), and aims to investigate if PSC is an etic (i.e., universally applicable) or emic (i.e., nationally/context specific) theory. Across nations, we investigate the construct meaning of PSC by testing PSC measurement invariance and the invariance of a nomological network of PSC relationships, (1) PSC to co‐worker to work engagement (PSC extended Job‐Demands Resources (JD‐R) motivational pathway), (2) PSC to co‐worker support to psychological distress (PSC extended JD‐R health erosion pathway), and (3) the moderation of PSC on the co‐worker to outcomes relationship. A total of 5854 employees from four nations (Australia = 1198, New Zealand = 2029, Malaysia = 575, Japan = 2052) participated in the study. Multi‐group structural equation modelling suggested that there was measurement invariance in a four‐factor PSC model across the four samples. Findings from multigroup analyses support both the PSC extended motivational and health erosion pathways across nations, as well as the moderation effect of PSC in the Australian and Japanese samples. Together, the results largely support the etic nature of PSC construct and theory, with a few national nuances.

Erdem, Nergiz; Roth, Guy; Weinstein, Netta

doi: 10.1002/smi.70066pmid: 40727961

Emotional integration involves ways of responding to one's emotions: receptive attention (i.e., open and nonjudgmental attention to emotions) and intentional exploration (i.e., active and motivated pursuit of one's own emotions. Across two studies (Study 1: two waves longitudinal, N = 239; Study 2: daily diary, N = 132), we compared these two dimensions of integrative emotion regulation (i.e. receptive attention and intentional exploration) in adaptive and maladaptive coping styles (i.e., specific strategies to shape one's response to stress) and daily well‐being. In Study 1, both forms of integrative emotion regulation were positively associated with adaptive coping (e.g., the use of active coping, acceptance, planning, and positive reframing) 1 month later, but only intentional exploration (and not receptive attention) showed benefits for well‐being in a 7‐day daily diary context (Study 2). Intentional exploration was negatively associated with perceived daily stress and positively associated with constructive self‐reflection, a marker of productive processing of emotions, and daily day satisfaction. In all, both forms of emotion regulation promote adaptive coping, but intentional exploration showed more consistent benefits across our studies. This research highlights the independent importance of motivated pursuit of emotional information in the coping process.

Little, Abbie L.

doi: 10.1002/smi.70098pmid: 40792649

Breathwork ‐ deliberately altering the way one breathes ‐ has gained growing attention as an emerging non‐pharmacological intervention for mental health and stress regulation. A novel yet ancient method that remains largely underexplored in the literature, breathwork requires structured, evidence‐based investigation to optimize its application. This review analyses the existing literature on slow, diaphragmatic, nasal breathing and breath‐holding techniques, to propose the A52 Breath Method—a theoretically grounded approach for enhancing stress resilience. A narrative review of breathwork literature was conducted that focused on the physiological and psychological mechanisms underpinning stress reduction. Medical databases were searched: 465 articles were screened and 30 studies underwent full‐text review. Studies examining slow breathing (≤ 6 breaths per minute), diaphragmatic activation, nasal breathing, and breath holds were analyzed for their effects on autonomic nervous system regulation, heart rate variability (HRV), and psychological resilience. The findings indicate that slow, nasal, diaphragmatic breathing significantly improves vagal tone, HRV, parasympathetic activity, and emotional control, while reducing cortisol, anxiety, stress, and PTSD. The integration of these elements in the 5‐s inhale, 5‐s exhale, 2‐s hold pattern (A52 Breath Method) provides a structured approach to breathwork with potential applications in high‐stress professions, including emergency responders, military personnel, healthcare workers, and everyday life. The A52 Breath Method represents a novel, evidence‐informed breathwork framework designed to optimize stress regulation. Future research should validate its efficacy through randomised controlled trials, particularly in populations exposed to chronic and acute stress. This conceptual model has the potential to inform clinical and occupational interventions for mental health and stress resilience.

Halsøy, Øyvind; Ebrahimi, Omid V.; Johnson, Sverre Urnes; Hoffart, Asle; Cogo‐Moreira, Hugo; Fjermestad, Krister

doi: 10.1002/smi.70082pmid: 40726151

Individuals with chronic conditions are at increased risk of developing depressive symptomatology. While the COVID‐19 pandemic increased the risk of mental health problems in the general population, there remains a gap in understanding the association between chronic conditions and depressive symptoms throughout the COVID‐19 pandemic. Using data from MAP‐19: A representative study of the Norwegian population during the COVID‐19 pandemic, longitudinal design with nine measurements was implemented to follow 2564 individuals over the 2‐year period using Generalised Estimating Equations (M age = 39 years, SD = 13.8; 77% females, 23% males). Individuals with chronic conditions exhibited a differing trajectory of depressive symptomatology compared to those without throughout the COVID‐19 pandemic, when controlling for shared socioeconomic status and psychosocial risk factors. We found a significant main effect of time β = −0.16, 95% confidence interval (CI) [−0.235–0.0832] indicating a decrease in depressive symptomatology for controls and a significant interaction effect between group and time β = 0.22, CI [ 0.115–0.331], indicating an increase in depressive symptoms for individuals with chronic conditions (β = −0.16 + β = 0.22 = 0.04). Moreover, individuals with chronic conditions were more likely to seek mental health treatment from a professional (doctor, psychiatrist, clinical psychologist) compared to those without a chronic condition (OR = 1.45, 95% CI [1.20, 1.75]). Individuals with chronic conditions exhibited increasing levels of depressive symptomatology across 2 years of the pandemic, highlighting the need for routine screening for depressive symptomatology in individuals with chronic conditions in primary care.

Wang, Jun; Drossaert, Constance H. C.; Knevel, Maleah; Chen, Liyan; Bohlmeijer, Ernst T.; Schroevers, Maya J.

doi: 10.1002/smi.70090pmid: 40719190

Self‐compassion has emerged as a protective factor for psychological health and well‐being. Interest has grown in understanding the mechanisms that explain how self‐compassion contributes to improved psychological outcomes. This systematic review aimed to identify and synthesise the results of studies that investigated the mediators underlying the relationship between self‐compassion and psychological outcomes. Potential eligible studies were searched on Embase, APA PsycINFO, PubMed, and Web of Science (search up till January 2025). Included were peer‐reviewed, English‐language studies investigating mediators between self‐compassion and psychological outcomes. Study quality was assessed using the Mediation Quality Checklist. A total of 113 studies were included, and most were cross‐sectional and focused on psychological symptoms rather than well‐being. Repetitive negative thinking, such as worry and rumination, was the most studied process and found to be significantly mediating self‐compassion and reduced psychological symptoms across studies. There is also growing evidence for experiential avoidance and mindfulness as significant mediators. Limited studies precluded drawing conclusions about other coping strategies, self‐concept, and social factors. This systematic review points toward a significant mediational role of maladaptive (e.g. repetitive negative thinking, experiential avoidance) and adaptive (e.g. mindfulness) emotion regulation and coping strategies, that explain the association of self‐compassion with psychological outcomes. Future studies with more rigorous designs including intensive longitudinal and experimental designs are needed to clarify causality.

Shigemoto, Yuki; Bhattarai, Muna

doi: 10.1002/smi.70067pmid: 40600670

The existing literature on posttraumatic growth has supported the mediating role of deliberate rumination (DR) between intrusive rumination (IR) and posttraumatic growth (PTG). However, limited studies have examined the interplay between the change components of rumination and PTG, limiting our understanding to the momentary association at a given time. Therefore, this study aimed to distinguish the rumination and PTG variables into intercept and slope factors and examine the mediation effect. Participants were 552 adults (Mage = 38.27, SDage = 12.15) recruited from Amazon's Mechanical Turk. In total, data collection occurred at nine timepoints, starting in April 2020 and ending in April 2023. Consistent with the existing cross‐sectional research, we found a full mediation model where DR mediated the relation between IR and PTG, all measured at Time 1. However, we found none of these scores measured at Time 1 of our data were associated with the change components of rumination and PTG. Similarly, when focussing on the change components, we identified a full mediation model between IR and PTG via DR. However, no significant association was found with the Time 1 scores of the variables. These results highlight the importance of focussing on the changes in rumination when predicting changes in PTG and supporting the continuous engagement of intentional rumination over time in predicting future changes in PTG.

Kühner, Christin; Emmelkamp, Julie; Goudriaan, Anneke E.; Waal, Marleen M.; Thomaes, Kathleen

doi: 10.1002/smi.70079pmid: 40767146

The literature has consistently demonstrated that being the victim of interpersonal violence increases the risk of future interpersonal violence (i.e., revictimisation). In this context, post‐traumatic stress disorder (PTSD) is highly important since it has been investigated as a risk factor and consequence of revictimisation. The aim of the current study was to (a) compute a rate of revictimisation across types of interpersonal violence, and (b) examine which factors are associated with observed rates of revictimisation. We conducted a pre‐registered systematic search in PubMed, APA PsycInfo, PTSDpubs, Web of Science, and Scopus, that resulted in N = 1286 individual records and n = 19 inclusions (PROSPERO ID: CRD42023446788). Criteria for inclusion were: adult human sample, assessment of PTSD symptoms that precedes assessment of interpersonal revictimisation, published in a peer‐reviewed journal, longitudinal study design. Most studies focused on intimate partner revictimisation, followed by sexual revictimisation. The pooled rate of revictimisation was 39.2% for the overall group, and 53.4% for those experiencing intimate partner revictimisation. Only the proportion of females was positively associated with the observed rate of revictimisation. None of the other factors: presence of severe PTSD symptoms, mode of assessment (PTSD), type of sample, or duration of the follow‐up period, were associated with the rates of revictimisation. We recommend the use of gold‐standard assessment for PTSD, more representative and more clearly defined samples, and the development of a validated measure of revictimisation. For clinicians, we recommend paying attention to and providing psychoeducation about revictimisation and potential ways to prevent this. In sum, revictimisation is highly prevalent, but remains poorly understood. This gap may be addressed by rigorous methodological improvements (research) and psychoeducation (clinical practice).