Stress-related conditions like clinical burnout and exhaustion disorder (ED) are associated with enduring cognitive problems. We have previously demonstrated that the addition of computerised cognitive training (CCT) and aerobic training (AT) to a multimodal rehabilitation programme (MMR) yielded greater improvements in cognitive function compared to MMR alone in patients with ED. These effects were maintained at the 1-year follow-up for CCT, but not for AT. Building on these findings, the present study examined the extended long-term effects of CCT and AT on cognitive function, psychological health, and work ability, 4.5 years after the interventions. Participants were recruited from a stress-rehabilitation clinic and 56 of the initial 132 participants returned for the 4.5-year follow-up. Assessments were conducted before (T1), immediately after (T2), 1-year after (T3) and 4.5-years after (T4) the interventions. Mixed model analyses assessed changes in the intervention groups relative to the control group from T1 to T4, with follow-up comparisons examining within-group stability of outcomes between T3 to T4. The primary outcome was cognitive performance on a global cognitive score. Secondary outcomes included domain-specific cognitive functioning, self-reported cognitive function, psychological health (burnout, depression, anxiety, and fatigue), and work ability. The analysis revealed sustained long-term effects on the global cognitive score, a trained updating task and episodic memory in the CCT group, with stable performance between one- and 4.5-year follow-up. The addition of AT did not yield any extended long-term effects on cognitive performance. Both groups showed extended long-term improvements in self-reported memory problems, although findings were mixed. Extended long-term improvements were observed on burnout for both groups, with additional effects on anxiety and work ability in the AT group. Notably, these effects were not present at the 1-year follow-up and are more plausibly explained by selective attrition rather than a delayed intervention effect. In conclusion, the result indicates that cognitive interventions such as CCT can have lasting positive effects on cognitive function in patients with ED, whereas the long-term psychological effects should be interpreted with caution. TRIAL REGISTRATION: ClinicalTrials.gov: NCT0073772.
Mindfulness-based interventions are found to effectively reduce stress and improve mental health outcomes. Yet, it is not always clear how the mindfulness skills of attention and acceptance develop throughout the intervention. This knowledge gap is especially pertinent for novice meditators learning these skills for the first time, including whether some individuals are more prone to learning them. Using a randomized waitlist-controlled trial, we tested the effect of the app Headspace on changes in attention and acceptance over 8 weeks among participants new to mindfulness meditation. Further, we tested the moderating effects of trait mindfulness and perceived stress. Non-faculty university employees were randomized to a Headspace or waitlist control condition. Trait mindfulness and perceived stress were measured at baseline. Ecological momentary assessment survey data for attention and acceptance were collected five times a day in 4-day bursts at baseline and 2, 5, and 8 weeks post-randomisation. Attention and acceptance were significantly higher at Week 8 compared to baseline for the Headspace group, but not the control group. For the Headspace group, both skills showed significant change by Week 2. Trait mindfulness moderated this effect with those who were lower in trait mindfulness displaying greater increases in attention, but not acceptance. Perceived stress also moderated this effect with those who were lower in perceived stress displaying greater increases in attention and acceptance. Our discussion draws attention to implications for matching intervention content to individual needs to ensure participants reporting different levels of characteristics benefit from mindfulness training.
Both childhood trauma as a stressful event and perceived stress as stress appraisal increase the risks of sleep problems, particularly among adolescents. However, how childhood trauma and perceived stress exert a combined effect on the development of sleep problems in adolescence remains unclear. The present study investigated the heterogeneous developmental trajectories of sleep problems among adolescents, and whether childhood trauma and perceived stress sequentially or interactively affected the heterogeneous trajectories of sleep problems. Altogether 197 adolescents completed the Childhood Trauma Questionnaire at T1 (Nov. 2021), the Perceived Stress Scale at T2 (May 2023), and the Pittsburgh Sleep Quality Index at T1, T2, and T3 (May 2024). Results revealed three heterogeneous trajectories of sleep problems, including the low group, the high-increasing group, and the moderate-increasing group. In addition, higher perceived stress rather than childhood trauma independently predicted a greater likelihood of being in the high-increasing group or moderate-increasing group relative to the low group. Perceived stress mediated the relationship between childhood trauma and the heterogeneous trajectories of sleep problems. However, the interaction effect of childhood trauma and perceived stress on the heterogeneous trajectories of sleep problems was non-significant. These findings suggest that childhood trauma and perceived stress sequentially rather than interactively affect the heterogeneous developmental trajectories of adolescent sleep problems.
Exercise is suggested to help regulate emotions; however, its role in the underlying cognitive emotion regulation process-starting with a cue, cognitive actions to modify emotions, and desirable emotional changes-has not yet been demonstrated. This study therefore investigates whether (a) exercise up-regulates positive emotions and down-regulates negative emotions after recalling a stressor; (b) cognitive emotion regulation strategies mediate these effects; and (c) this process is more pronounced in emotionally intelligent (EI) individuals. University students (N = 134) recalled a stressor and were randomly allocated to one of three 30-min tasks during which they reflected on this stressor: (a) exercise; (b) puzzle-solving (active control); or (c) rest (passive control). EI was measured at the start (T0). Four different types of emotions-activated and deactivated, both positive and negative-were measured before (T1) and after (T2) after the 30-min tasks. Cognitive emotion regulation during the tasks was measured immediately after (T2) the 30-min tasks. Results show that participants in the exercise and active control condition reported higher positive activated emotions at T2 than passive controls. Exercisers used more cognitive emotion regulation strategies compared to active and passive controls, explaining their higher positive and lower negative activated emotions at T2. EI had a minor influence on the proposed process. Altogether, this study suggests that exercise optimises the cognitive emotion regulation process, which helps to repair emotions after a stressor.
Regular physical activity is associated with improved mental health, yet its role following mass trauma-and the differential contributions of motivational versus behavioural components-remains insufficiently understood. Drawing on stress-buffering and self-determination frameworks, this study examined whether value-based motivation for fitness and weekly vigorous physical activity are differentially associated with well-being as a function of trauma-exposure severity. A cross-sectional design was used with three groups (N = 306): survivors of the October 7, 2023 Nova music-festival attack (direct exposure; n = 74), university students assessed in 2024 (vicarious exposure; n = 82), and students assessed in 2022 (pre-event, non-exposed; n = 150). Measures included value fitness commitment (VFC), weekly vigorous physical activity (WPA), subjective happiness, somatic complaints, and PTSD symptoms (directly exposed group only). Group differences were examined using ANOVA/MANOVA. Associations and moderation effects were tested with correlation analyses and Hayes' PROCESS models controlling for age and family status. Directly exposed participants reported lower subjective happiness and higher somatic complaints than comparison groups. WPA was associated with fewer somatic complaints in the full sample and with lower PTSD symptom severity among directly exposed participants. VFC was associated with greater subjective happiness and fewer somatic complaints among directly exposed participants. Moderation analyses showed that the inverse association between VFC and somatic complaints was significant only in the directly exposed group, whereas WPA-well-being associations were not moderated by exposure level. Both motivational and behavioural physical-activity indices were linked to better well-being following trauma, but through partially distinct and context-dependent pathways. Value-based fitness commitment functioned as a protective resource specifically under conditions of severe trauma, consistent with stress-buffering and psychological-flexibility models, whereas actual vigorous activity showed a more general association with reduced somatic distress and PTSD symptoms. Low-cost, scalable physical-activity-related interventions that target both engagement and motivational processes may support post-trauma recovery.
Older adults exposed to prolonged sociopolitical violence often experience chronic stress that may undermine adaptive coping processes. Instrumental reminiscence, which focuses on recalling past experiences of successfully managing adversity, has been proposed as a strategy potentially associated with greater coping flexibility in later life. This study examined whether participation in an instrumental reminiscence programme was associated with changes in coping strategies among older adults registered as victims of armed conflict in Catatumbo, Colombia. A quasi-experimental controlled design with repeated measures (pre-intervention, post-intervention, 2-month follow-up) was conducted with 64 community-dwelling adults aged 60 years and older (intervention n = 37; control n = 27). The intervention consisted of 8 weekly 90-min instrumental reminiscence sessions, while the comparison group received psychoeducational sessions. Coping strategies were assessed using the Coping with Stress Questionnaire. Linear mixed-effects models were used to examine Group × Time interactions. Significant interactions were observed for problem-solving focus, positive reappraisal, social support seeking, overt emotional expression, negative self-focus, and avoidance (all p < 0.001). Compared with controls, the intervention group was characterised by higher post-intervention scores on problem-solving focus, positive reappraisal, social support seeking, and avoidance, and lower scores on overt emotional expression and negative self-focus; these differences were maintained at follow-up. No significant effects were found for religious coping. Participation in the instrumental reminiscence programme was associated with changes in multiple self-reported coping strategies among older adults exposed to chronic conflict-related stress.
Previous research has suggested that employees tend to 'catch' burnout from their coworkers and then to perform less satisfactorily. This burnout contagion mechanism cannot, however, explain why some individuals are able to take preemptive actions to defend themselves against a vulnerable environment. Using a social information processing perspective of the conservation of resources theory, we theorized that coworker burnout (i.e., the average burnout level of all team members, excluding the focal employee) serves as a social cue that guides individuals regarding the amount of effort they should put into their work in order to maintain a high level of work performance. The results revealed that coworker burnout was negatively related to employee work performance through reduced work effort when most coworkers (rather than a few) within a work group experienced high levels of burnout (i.e., there was a high consistency of coworker burnout) and when the focal employees had low levels of mastery goal orientation. This negative indirect relationship was buffered when either the coworker burnout consistency was low or the employees' mastery goal orientation was high. This conditional, indirect linkage between coworker burnout and employee work performance, via work effort, maintained its significance even after controlling for the burnout contagion mechanism (i.e., the extent to which the focal employee caught coworker burnout).
This study consolidated the association of mindfulness with perceived stress found across studies. A meta-analysis examined the relationship between mindfulness and perceived stress in 56 samples, which included a total of 24,494 participants. The weighted effect size of r(55) = -0.40, 95% CI [-0.36, 0-44], p = 0.0001, showed that greater mindfulness was associated with less perceived stress. Studies assessing mindfulness using the Mindful Attention Awareness Scale or the Five Facet Mindfulness Questionnaire showed substantial effect sizes, as did studies assessing stress using the Perceived Stress Scale. Even though the present meta-analysis does not show causality, the results suggest a possible bidirectional relationship between mindfulness and perceived stress. The nonjudgmental awareness comprising mindfulness may facilitate an appraisal of life events and challenges that results in events and challenges as being perceived as less stressful. Lower perceived stress may free cognitive resources that promote mindfulness.
Adverse childhood experiences (ACEs) and genetic burden of depression are key factors influencing depression, but their joint effects remain unclear. This study explores the joint effects on depressive symptoms and examines the mediating role of ACEs. This study was based on data from the prospective cohort Health and Retirement Study (HRS), in which 6204 adults of European ancestry aged 50 years and older were analysed. ACEs were measured using the Psychosocial and Lifestyle Questionnaire (PLQ), and genetic burden was assessed via polygenic risk scores (PRS). Depressive symptoms (total, cognitive-affective, somatic) were evaluated with the Centre for Epidemiological Studies Depression Scale (CES-D). Multivariate Cox regression models were used to assess independent and joint effects, and mediation analysis tested whether genetic burden increased depression risk through ACEs. ACEs were associated with higher risks of total (HR = 1.305, 95% CI: 1.174, 1.451), somatic (1.337, 1.206-1.482), and cognitive-affective (1.247, 1.114-1.395) depressive symptoms. Increased genetic burden was also associated with elevated risks of total (HR = 1.088, 95% CI: 1.033, 1.147) and somatic (1.089, 1.035-1.147) depressive symptoms. Compared to those with no ACEs and low genetic burden, individuals with ACEs and high genetic burden had significantly higher risks of depressive symptoms (total: 60%, somatic: 63%, cognitive-affective: 43%). ACEs mediated the link between genetic burden and somatic symptoms. Both ACEs and genetic burden of depression are associated with an increased risk of depressive symptoms, and their joint effects significantly increase the risk of all types of depressive symptoms. Furthermore, genetic burden also indirectly elevates the risk of somatic depressive symptoms by influencing ACEs.
Burnout syndrome (BOS) represents an enduring challenge for preventive medicine. While biomarkers of chronic stress have been explored within the allostatic load framework, BOS lacks a consistent physiological signature, hindering early and comprehensive identification of individuals at risk. This systematic review synthesises current evidence on BOS-related biomarkers, aiming to identify potential physiological correlates. We conducted a comprehensive search of PubMed and EMBASE, yielding 111 studies evaluating 36 biomarkers in adult populations. Our analysis revealed inconsistent associations across most physiological systems, including the hypothalamic-pituitary-adrenal axis (e.g., cortisol, DHEA), the immune system, and cardiovascular parameters. While some biomarkers such as HbA1c and blood glucose showed relatively more consistent associations with BOS, the overall findings remain largely inconclusive. Overall, the current biological evidence is insufficient to identify a BOS biosignature that could support routine clinical diagnosis. Future research should prioritise a more unified and comprehensive definition of BOS and investigate physiological patterns within more standardized research frameworks to advance objective identification and prevention strategies.
A cancer diagnosis is frequently accompanied by significant psychological distress, particularly during radiotherapy (RT). Given that many established risk factors for distress are largely immutable, identifying resilience resources that promote adjustment during RT is a central clinical priority. The present longitudinal study examined whether emotional entitlement, gratitude, and perceived social support predict end-of-treatment anxiety, depression, and life satisfaction beyond baseline psychological status. Participants were 146 cancer patients undergoing RT (Mean age = 56.17 years, SD = 11.65; 89.9% female). Data were collected at three time points across the RT regimen: at the pre-treatment RT simulation session, during the first RT session, and at treatment completion, approximately 3-6 weeks later. Measures included anxiety and depression symptoms, life satisfaction, emotional entitlement, gratitude, and perceived social support. Results indicated that anxiety decreased and life satisfaction increased from baseline to treatment completion, whereas depressive symptoms remained stable over time. Hierarchical regression analyses were performed to predict post-treatment outcomes while controlling baseline levels of the respective variables. Across all models, baseline psychological status emerged as a robust predictor of end-of-treatment outcomes. However, resilience resources contributed additional explanatory power for depression and life satisfaction. Higher emotional entitlement to positive emotions predicted greater life satisfaction and lower depressive symptoms, whereas reduced perceived friend support was associated with higher depression. Unexpectedly, higher gratitude was associated with lower life satisfaction at treatment completion. In contrast, anxiety was predicted exclusively by baseline anxiety. These findings suggest distinct predictive patterns across psychological outcomes during RT. Whereas end-of-treatment anxiety was predicted primarily by initial anxiety levels, depression and life satisfaction were also associated with modifiable emotional and interpersonal resources. The results underscore the importance of early psychological screening and targeted psychosocial interventions aimed at strengthening emotional resources and peer support during radiotherapy.
College student mental health issues are receiving increasing attention from various stakeholders. However, research on the longitudinal trends of college student mental health remains scarce. This study enrolled 5479 college students from a Chinese university. Using Latent Profile Analysis (LPA), it identified distinct classes characterising comorbid patterns of severe psychological crisis with internalising and externalising psychological problems during the period from 2022 to 2024. Latent Transition Analysis (LTA) was then employed to examine the stability of these classes across the three-year period. For the comorbid pattern of severe psychological crisis and internalising problems, the LPA yielded four distinct mental health classes: Secure Group, Low Internalising Problems Group, Low Crisis-High Internalising Problems Group, and High-Risk Group. Similarly, for the comorbid pattern of severe psychological crisis and externalising problems, four classes emerged: Secure Group, Low Crisis Group, Sub-High-Risk Group, and High-Risk Group. Longitudinal analysis via the LTA model revealed that, within both comorbid patterns, the Secure Group exhibited the highest stability, while the remaining classes demonstrated varying degrees of change. These findings underscore the need for stakeholders to prioritise college student mental health concerns and develop timely intervention strategies to accurately guide mental health promotion, prevention, and intervention efforts.
This study investigated whether physical activity buffers the association between negative life events and life satisfaction, distinguishing between dependent (e.g., divorce) and independent (e.g., bereavement) stressors as well as within- and between-person processes across one- and 2-year intervals (indicating short- and medium-term intervals, respectively). Data from two large panel studies (N = 98,224) were analysed. Participants were classified as high (weekly or more) versus low (less than weekly) in physical activity. Three-variable multiple-group random intercept cross-lagged panel models separated within-person dynamics from between-person associations. Dependent events predicted declines in life satisfaction across both datasets. This effect was attenuated among physically active individuals over 2-year intervals but not over 1-year intervals. Independent events showed no consistent medium-term effects on life satisfaction. However, in the 1-year interval, independent events were associated with subsequent declines in life satisfaction only among physically active individuals, whereas no association emerged among those with low physical activity. With respect to the reversed pathways, life satisfaction predicted subsequent dependent events across both groups and intervals. In contrast, higher life satisfaction was associated with a lower likelihood of subsequent independent events only among active individuals. At the between-person level, buffering effects emerged only for the 2-year association between independent events and life satisfaction. Physical activity is not a uniform buffering factor but relates to stress-well-being dynamics in a manner that depends on stressor type, temporal scale, and analysis level. Effects are conditional and context-specific rather than broadly protective.
Negative emotion differentiation-the capacity to make fine-grained distinctions between discrete negative emotions-plays a foundational role in adaptive emotion regulation, psychological well-being, and effective goal pursuit. Despite its theoretical and practical significance, research on this emotional competency within entrepreneurship remains nascent. Integrating an experience sampling methodology with a 2-year time-lagged design, this study investigated the antecedents and consequences of entrepreneurs' negative emotion differentiation. Results demonstrated that stressor variability-rather than mean levels of stressors-undermines negative emotion differentiation, which in turn positively predicts both work engagement and entrepreneurial orientation. These findings advance theoretical understanding of entrepreneurial emotions, stressor dynamics, and their downstream implications for well-being and performance outcomes.
Alcohol Use Disorder (AUD) is a multifactorial condition shaped by genetic predispositions and neurophysiological, behavioural, and environmental factors. Chronic stress and trauma are key drivers of harmful alcohol use. This study aimed to investigate, in a Brazilian admixed population, the associations and interactions between genetic variants related to the CRFergic, noradrenergic, and glucocorticoid receptor systems and exposure to childhood and adulthood stressors, as well as perceived stress, in individuals with and without AUD. We evaluated 227 inpatients with AUD and 174 controls. Alcohol involvement was assessed using the AUDIT and IDS-42. Childhood trauma, adult-life stressors, and perceived stress were measured using the CTQ, LES, and PSS, respectively. Genetic variants were characterised using next-generation sequencing. Individuals with AUD showed more severe childhood trauma, more adverse adult-life experiences, and higher perceived stress. Two CRHR2 variants were significantly associated with AUD after correction for multiple testing (rs8175360 increasing risk; rs41417745 decreasing risk). Stress-related genetic variation, particularly in CRHR2, was associated with AUD diagnosis in interaction with environmental stressors across the lifespan. These findings highlight the importance of integrating genetic and environmental factors to better understand the heterogeneity of AUD and may inform future approaches to personalised prevention and intervention strategies.
University students face obstacles while pursuing their goals, and these challenges risk undermining their mental health. Goal flexibility has been identified as beneficial for promoting well-being and protecting mental health; however, the relationship between goal flexibility and mental health challenges remains underexplored. This study aims to understand how students engage in goal flexibility during periods of mental health challenges. We interviewed Australian university (n = 20) and university college (n = 1) students, comprising predominantly psychology students (81%), recruited through purposive and snowball sampling and analyzed data using reflexive thematic analysis. We identified two predominant perceptions of goal flexibility: (1) modifying the pathway to a long-term goal; and (2) acceptance that not all goals are achievable and moving on. Participants described using three strategies to promote goal flexibility: (1) health and social behaviors; (2) contemplative practice; and (3) 'practical' strategies. Participants reported a range of mental health challenges-most commonly stress, anxiety, and depressive symptoms, alongside longer-term diagnosed conditions (e.g., ADHD), and we identified different patterns in how these affected participants' capacity to engage in goal flexibility. Goal flexibility processes were in turn experienced as supportive of mental health, primarily by reinforcing personal agency, with participants describing specific processes (e.g.., goal revision, freezing, and reengagement) as helpful for the specific challenge(s) they were facing. Participants expressed concerns that being "too flexible" with goals could have negative mental health consequences and undermine agency. Future research should conduct more targeted studies examining goal flexibility among individuals experiencing specific mental health challenges. Additionally, research should include diverse populations, such as students on-campus, from varied disciplines, ages, socioeconomic, and cultural backgrounds.
Drawing on conservation of resources theory and hierometer theory, this study examines how and for whom leader-member exchange (LMX) ambivalence is associated with social cyberloafing. We propose that LMX ambivalence is linked to emotional exhaustion through a resource-depletion logic, and that emotional exhaustion, in turn, is associated with social cyberloafing as a comparatively accessible and socioemotionally oriented response. We further theorise that this indirect process is stronger among employees high in grandiose narcissism, who attach greater status value to leader-member relationships. Using a three-wave field survey and a vignette-based experiment, we test the proposed model in the field and provide experimental evidence for the upstream effect of LMX ambivalence on emotional exhaustion. The findings suggest that LMX ambivalence can function as a relational stressor rooted in conflicted exchange perceptions and identify grandiose narcissism as a key boundary condition. This research contributes to the literature on leadership, relational ambivalence, and digital responses.
Smoking represents a significant public health problem and exploring the factors that may influence its development in youth is of major importance. The research on adolescent populations that addresses the impact of posttraumatic stress on smoking over time, especially using ethnicity and gender perspectives, remains limited. The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2596; 53.5% female; age 11-16 years old (M(SD) = 12.75(1.27)); 58.8% African-American, 25.5% Hispanic American, 13.6% White). Self-reported information was obtained on smoking, symptoms of posttraumatic stress and depression in year 1 and on smoking in year 2. Generalised Linear Models were used to explore the association between posttraumatic stress in year 1 and smoking in year two in youth from the different ethnic groups, while controlling for their baseline levels of smoking, depressive symptoms, age and socio-economic status. Posttraumatic stress was related to smoking one year later, and the association remained significant while also adjusting for the baseline variables. Sensitivity analyses indicated that the association was primarily driven by smoking frequency rather than smoking quantity. The association between posttraumatic stress and smoking did not differ by gender or ethnicity, although more females than males reported smoking both at baseline and one year later, and fewer African American adolescents reported smoking, as compared to White and Hispanic American adolescents. The findings emphasize the importance of the timely recognition of traumatic exposure and may inform targeted prevention and early interventions.
A growing body of research links problematic internet use (PIU) in youth to anxiety, depression, and stress, yet the dynamic interactions between these negative emotions, heterogeneous PIU trajectories, and their dimensional drivers remain unclear. To address this gap, a two-wave longitudinal study of 5108 Chinese students (Mage = 18.28, SD = 0.84; 67.6% female) identified distinct PIU trajectories based on empirical longitudinal data and used cross-sectional/cross-lagged network analyses to explore these dynamics. Cross-sectional findings showed that the Remitted group had lower negative emotion levels and inter-network connection strength over time, whereas the Incident group exhibited the reverse; specific anxiety symptoms (e.g., "restlessness" in Incident PIU) also had the strongest links to overall emotional network cohesion. Cross-lagged analyses further indicated that in the Persistent/Incident groups, stress symptoms acted as the primary trigger for subsequent negative emotions. Moreover, their cross-lagged emotional networks had significantly higher global strength than those of the Remitted/Persistent Non-PIU groups. These findings suggest that emotional network features vary by PIU trajectory group and that stress symptoms may be the core driver of emotional deterioration in the Persistent/Incident groups. The study emphasises intervention priorities: prioritise stress management for Persistent/Incident groups to prevent emotional deterioration, and monitor residual emotional connections in Remitted groups to avoid recurrence.
