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Workplace Cyberbullying and Interpersonal Deviance: Understanding the Mediating Effect of Silence and Emotional Exhaustion

Anwar A, Kee DMH, Ahmed A

Cyberpsychol Behav Soc Netw, 2020 May;23(5):290-296.
PMID: 32282237 DOI: 10.1089/cyber.2019.0407

Workplace cyberbullying (WCB) is a new form of hostility in organizations in which information technology is used as a means to bully employees. The objective of this study is to determine the association between WCB and the interpersonal deviance (ID) of victims through parallel mediation through the ineffectual silence of employees and emotional exhaustion (EE). Conservation of resource (COR) theory and affective events theory were used as the study's guiding framework, and data were drawn from 351 white-collar employees who were employed in a variety of industries-such as banking, telecommunications sector, education, health care, insurance, and consultancy-in Lahore, Pakistan. The results show that ineffectual silence negatively mediated the relationship between cyberbullying and deviance, decreasing the level of deviance of employees who used silence as a coping mechanism. EE, however, positively mediated the relationship between cyberbullying and deviance. This means that when employees felt emotionally overwhelmed they retaliated by engaging in deviant behaviors and acting as a bully toward colleagues. Drawing on the COR theory and the affective events theory, the findings show that WCB has an impact on ID. From a practical standpoint, the study reveals that WCB can lead to ID and it also may associate with large financial costs and workplace disruptions. Thus, organizations should establish a culture that prevent employees from engaging in WCB and adopt practices of prevention and intervention because it is not only harmful to the employees but also to the organization.

Matched MeSH terms: Stress, Psychological
A comparison of parenting stress between mothers of children with spina bifida and able-bodied controls

Ong LC, Norshireen NA, Chandran V

Dev Neurorehabil, 2011;14(1):22-8.
PMID: 21241175 DOI: 10.3109/17518423.2010.523057

To compare parenting stress between mothers of children with spina bifida (SB) and able bodied controls.

Matched MeSH terms: Stress, Psychological/psychology*
Fulltext The effectiveness of an emotion-focused educational programme in reducing diabetes distress in adults with type 2 diabetes mellitus (VEMOFIT): a cluster randomized controlled trial

Chew BH, Vos RC, Stellato RK, Ismail M, Rutten GEHM

Diabet Med, 2018 06;35(6):750-759.
PMID: 29505098 DOI: 10.1111/dme.13615

AIMS: To evaluate the effectiveness of a brief, value-based emotion-focused educational programme (VEMOFIT) in Malay adults with Type 2 diabetes mellitus compared with a programme of active listening to participants' emotional experiences, social support and their opinion on the health clinic diabetes care services (attention control).

METHODS: Malay adults with severe diabetes distress [Diabetes Distress Scale (DDS-17) mean score ≥ 3] were included. VEMOFIT consisted of four biweekly group sessions, a booster session after 3 months and a follow-up 6 months post intervention. The attention control programme consisted of three sessions over the same period. Outcomes included diabetes distress, depressive symptoms, self-efficacy and disease control. Required total sample size was 165.

RESULTS: Participants (n = 124) were randomized to either VEMOFIT (n = 53) or the attention control programme (n = 71). Participants had a mean (sd) age of 55.7 (9.7) years, median diabetes duration of 7.0 (8.0) years and mean HbA1c level of 82 mmol/mol (9.7%). The mean DDS-17 level decreased significantly in both the VEMOFIT and the attention control programmes (3.4 to 2.9 vs. 3.1 to 2.7, respectively). The adjusted between-group DDS-17 difference was not significant [-0.01, 95% confidence interval (CI) -0.38, 0.35]. The proportion of individuals with severe diabetes distress decreased in both groups, from 89% to 47% vs. 69% to 39% (odds ratio 0.88; 95% CI 0.26, 2.90). Other outcomes did not differ between groups.

CONCLUSIONS: Both interventions decreased diabetes distress significantly. The theory-based VEMOFIT programme was not superior to the attention control programme. The latter approach is a simpler way to decrease severe diabetes distress (Trial registration: NCT02730078; NMRR-15-1144-24803).

Study site: Klinik Kesihatan, Negeri Sembilan, Malaysia

Matched MeSH terms: Stress, Psychological/prevention & control*
Fulltext Tocotrienol and alpha-tocopherol reduce corticosterone and noradrenalin levels in rats exposed to restraint stress

Nur Azlina MF, Nafeeza MI

Pharmazie, 2008 Dec;63(12):890-2.
PMID: 19177905

This study investigates the effects of tocotrienol (TT) or alpha-tocopherol (TF) supplementation on corticosterone level, noradrenalin level and gastric lesions in rats exposed to restraint stress. Twenty-four male Sprague Dawley rats were randomly assigned into 4 equally sized groups; two control groups were given olive oil, while the treated group was supplemented with either tocotrienol of tocopherol orally at a dose of 60 mg/kg body weight. After 28 days of treatment, one control group, TT group and TF group were subjected to restraint stress, 2 hours daily for 4 consecutive days. After the last exposure to stress, plasma samples were taken to determine the corticosterone and noradrenalin levels, after which the rats were sacrificed. The stomach was excised for the evaluation of gastric lesions. Our findings showed that TT and TF were able to maintain the corticosterone level to the prestress values, while only TT was able to maintain the noradrenalin level in rats exposed to stress. Tocotrienol was found to be better in preventing formation of gastric lesions compared to TF. As a conclusion, the protective effect of vitamin E was related to the ability to inhibit stress induced elevation of corticosterone and noradrenalin levels.

Matched MeSH terms: Stress, Psychological/blood*; Stress, Psychological/complications
Documenting the impact of stroke in a middle-income country: a Malaysian case study

Mairami FF, Warren N, Allotey PA, Mak JS, Reidpath DD

Disabil Rehabil, 2020 01;42(1):102-113.
PMID: 30183424 DOI: 10.1080/09638288.2018.1493544

Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC).Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia.Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies.Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality.Implications for rehabilitationThe impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries.Support from the family and reinforcement of religious coping were judged to successfully aid recovery.Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed.

Matched MeSH terms: Stress, Psychological/physiopathology
Maternal blood pressure in pregnancy and newborn irritability

Chisholm JS, Woodson RH, da Costa Woodson EM

Early Hum Dev, 1978 Jul;2(2):171-8.
PMID: 720272

The neonatal period is being recognized as an important period for the development of patterns of interaction between mother and infant, and infant state has been shown to have a significant impact on mother--infant interactions. A major dimension of infant state, with implications for this interaction and for the development of later behaviour disorders, is the infant's irritability. Research with Navajo, Malay, Chinese and Tamil mothers and infants showed that normal variation in maternal blood pressure during pregnancy was related to newborn irritability as assessed with the Brazelton Scale. This relationship is discussed in terms of possible underlying mechanisms.

Matched MeSH terms: Stress, Psychological/complications
Academic burnout and eating disorder among students in Monash University Malaysia

Kristanto T, Chen WS, Thoo YY

Eat Behav, 2016 08;22:96-100.
PMID: 27131097 DOI: 10.1016/j.eatbeh.2016.03.029

This study examined the prevalence of academic burnout and the relationship between academic burnout and eating disorder among Monash university students for a period of one year. One hundred and thirty-two participants were recruited for the study via advertisement. They were invited to complete three instruments, namely Demographic Questionnaire, Maslach Burnout Inventory - Student Survey (MBI-SS) and Three Factor Eating Questionnaire-Revised 18-item (TFEQ-18). In addition, anthropometric measurements such as weight, height, body mass index (BMI), body fat percentage and waist circumference were taken. All data were collected at baseline and after 6-8weeks. Analysis of Variance (ANOVA), Kruskal-Wallis and Bonferroni pairwise comparison tests were performed using Stata version 13. The prevalence of academic burnout after 6-8weeks was revealed to be 17.4% and 73.5% respectively for moderate and high level of academic burnout respectively. Emotional eating (EEat) scores were significantly different over levels of academic burnout after 6-8weeks (p=0.0103) while no significant differences was observed in other subscales such as cognitive restraint (CR) and uncontrolled eating (UE). These findings evidenced partial associations between academic burnout and eating disorder.

Matched MeSH terms: Stress, Psychological*
The role of historical Persian gardens on the health status of contemporary urban residents: gardens and health status of contemporary urban residents

Rostami R, Lamit H, Khoshnava SM, Rostami R

Ecohealth, 2014 Sep;11(3):308-21.
PMID: 24859923 DOI: 10.1007/s10393-014-0939-6

The inherent economic and social challenges in major cities have been known to foster stress among the urban population. Frequent stress over long periods may well have serious damaging outcomes, resulting in ailments such as burnout syndrome, sleeplessness and exhaustion, depression, feelings of panic, among others. Therefore, providing access to resources that may enable people to cope with the stress of urban life has become a crucial phenomenon in the twentieth century. Increasing empirical evidence indicates that the presence of natural areas can contribute to enhancing the quality of life in many ways. This study examines two historical Persian gardens from the residents' perspective in well-known, historic cities of Iran: Isfahan and Kerman. The data were collected through questionnaires (n = 252), semi-structured interviews (n = 20), and visual observation techniques. The findings demonstrate that nature, diversity and the gardens' historical background, and coherence motivate the residents' frequent visits to the gardens, which help to address their social, psychological, and physical needs. In addition, the residents' involvements and the variety of experiences that occur in the gardens lead to the creation of deeper meanings and values associated with the gardens. Subsequently, these construct functional and emotional attachment that evokes a sense of place and identity and may contribute to society's health and well-being.

Matched MeSH terms: Stress, Psychological/psychology*
Fulltext A longitudinal study of relationships between previous academic achievement, emotional intelligence and personality traits with psychological health of medical students during stressful periods

Yusoff MS, Esa AR, Mat Pa MN, Mey SC, Aziz RA, Abdul Rahim AF

Educ Health (Abingdon), 2013 Jan-Apr;26(1):39-47.
PMID: 23823672 DOI: 10.4103/1357-6283.112800

CONTEXT: There is considerable evidence that emotional intelligence, previous academic achievement (i.e. cumulative grade point average (GPA)) and personality are associated with success in various occupational settings. This study evaluated the relationships of these variables with psychological health of first year medical students during stressful periods.
METHODS: A 1-year prospective study was done with students accepted into the School of Medical Sciences, Universiti Sains Malaysia. Information on emotional intelligence, GPA and personality traits were obtained prior to admission. The validated Universiti Sains Malaysia Emotional Quotient Inventory and Universiti Sains Malaysia Personality Inventory were used to measure emotional intelligence and personality traits, respectively. Stress, anxiety and depression were measured by the 21-item Depression Anxiety Stress Scale during the end-of-course (time 1) and final (time 2) examinations.
RESULTS: At the less stressful period (time 1), stress level was associated with agreeableness and the final GPA, anxiety level was associated with emotional control and emotional conscientiousness and depression level was associated with the final GPA and extraversion. At the more stressful period (time 2), neuroticism associated with stress level, anxiety level was associated with neuroticism and emotional expression, and depression level was associated with neuroticism.
CONCLUSIONS: This study found that neuroticism was the strongest associated factor of psychological health of medical students during their most stressful testing period. Various personality traits, emotional intelligence and previous academic performance were associated factors of psychological health during a less stressful period. These data suggest that early identification of medical students who are vulnerable to the stressful environment of medical schools might help them maintain psychological well-being during medical training.

Matched MeSH terms: Stress, Psychological/etiology; Stress, Psychological/psychology*
Fulltext A cross-sectional examination of the relationship between approaches to learning and perceived stress among medical students in Malaysia

Behzadnia A, Smith DR, Goodson ML

Educ Health (Abingdon), 2018 12 12;31(2):80-86.
PMID: 30531049 DOI: 10.4103/efh.EfH_280_17

Background: Learning approaches have been proposed to affect the experience of psychological stress among tertiary students in recent years. This relationship becomes important in stressful environments such as medical schools. However, the relationship between stress and learning approaches is not well understood, and often studies done cannot be generalized due to different sociocultural differences. In particular, no study in Malaysia has looked at learning approaches among medical students.

Aims: To address this gap, we examined the relationship between perceived stress and learning approaches by considering sources of stress.

Methodology: The Perceived Stress Scale (PSS-10), Medical Student Stressor Questionnaire, and the Revised Two-Factor Study Process Questionnaire were answered by the preclinical and final-year students studying MBBS in a Malaysian campus of British University.

Results: Deep learning was positively and surface learning negatively associated with perception of coping with stress. In this study, neither approaches were associated with psychological stress as opposed to previous reports. We found surface learners to report higher level of stress associated with social stressors. We found students' self-perception of feeling incompetent and feeling they need to do well to be significant sources of stress.

Discussion: Deep learning promotes psychological resilience. This is of paramount importance in learning environments where stress is highly prevalent such as medical school. Promotion of deep learning among medical students is required at earlier stages as they tend to solidify their approach through their university years and carry that approach beyond school into their workplace.

Matched MeSH terms: Stress, Psychological/psychology*
Fulltext Prevalence and risk factors of stress, anxiety and depression among house officers in Kota Kinabalu, Sabah

Shakir Aizat Shahruddin, Pradheeksha Saseedaran, Aishah Salleh, Che Amira Ahmad Azmi, Nik Harriz Izwan Mohammad Alfaisal, Rusli Abdullah, et al.

Education in Medicine Journal, 2016;8(1):31-40.
MyJurnal

House officers who are suffering from stress, anxiety or depression are at risk of harm to themselves, colleagues and even patients, as well as affecting their livelihood. Objective: This
study is aimed to find the prevalence of stress, anxiety and depression among house officers working
in Kota Kinabalu, Sabah. Method: A cross-sectional study was done using a self-administered
questionnaire containing socio-demographic factors and Depression, Anxiety and Stress Scale (DASS)
21. Results: Prevalence of stress, anxiety and depression were 57.1%, 63.7%, and 42.9% respectively. Multiple logistic regression analysis found that house officers who thought of quitting Housemanship was associated with stress (adjusted OR = 3.64, 95% CI: (1.44, 9.20), p = 0.006), and depression (adjusted OR = 8.26, 95% CI: (2.96, 23.02), p < 0.001). House officers who perceives that they are bullied is associated with anxiety (adjusted OR = 4.16, 95% CI: (1.33, 13.07), p = 0.015). Work
experience of the house officers in months have a protective effect to stress (adjusted OR = 0.92, 95%
CI: (0.87, 0.97), p = 0.004), anxiety (adjusted OR = 0.93, 95% CI: (0.88, 0.98), p = 0.006) and
depression (adjusted OR = 0.92, 95% CI: (0.87, 0.98), p = 0.006). Conclusion: The prevalence of
stress, anxiety and depression among house officers in Kota Kinabalu, Sabah is high. Management
should look into the findings and understand the importance of addressing this problem as it may
affect patient care and safety, and the livelihood of house officers. Future studies identifying why
house officers are thinking of quitting service and why they do feel that they are being bullied may be
warranted.

Matched MeSH terms: Stress, Psychological
Fulltext Prevalence and sources of stress among medical students in Universiti Sains Malaysia and Universiteit Maastricht

Liew, Yen Yee, Muhamad Saiful Bahri Yusoff

Education in Medicine Journal, 2013;5(4):34-41.
MyJurnal

Introduction: Various studies had been done on medical students stress, but there is yet no comparative study done between universities in Asia and Europe. Universiti Sains Malaysia (USM) and Universiteit Maastricht (UM) share a lot in common in terms of medical education as both actively apply PBL-oriented education into their curriculum. It will be interesting to find out the effect of differing culture, one Eastern and another Western, on the prevalence of stress and stressors among medical students of both universities.

Method: A comparative study was conducted on medical students from USM and UM. Psychological distress was measured by the 12 item General Health Questionnaire and stressors were measured by the 40 item Medical Student Stressor Questionnaire. The calculated sample size was 215 per university. The collected data was analyzed using Statistical Package for Social Sciences (SPSS) version 20.

Result: Results showed that the overall prevalence of psychological distress among medical students of USM and UM was 25.9% and no significant difference was found between the two universities. Binary logistic regression test showed that medical students in pre-clinical phase were 1.84 times more likely to develop psychological distress than medical students in clinical phases (B = 0.612, odd ratio (CI95%) = 1.84 (1.16, 2.93), p = 0.010). The major stressors were related to academic requirements, UM medical students perceived the stressors as causing less stress than USM medical students (t-stat (df) = 5.33 (380), p-value < 0.001).

Conclusion: Psychological health among medical students in the two universities was comparable. Academic requirements were the most stressful events as perceived by the students, but UM medical students had more positive perception toward the stressors than USM medical students. Pre-clinical students experienced higher psychological pressures than the clinical students. The medical schools should provide more attention to pre-clinical students because they might need psychological support from them.

Matched MeSH terms: Stress, Psychological
Fulltext A systematic review on validity evidence of Medical Student Stressor Questionnaire

Yusoff MSB

Education in Medicine Journal, 2017;9(1):1-16.
MyJurnal

Introduction: Detecting sources of stress of medical students is important for planning wellness
program to improve their psychological wellbeing. One of instruments to detect the sources of stress
is the Medical Student Stressor Questionnaire (MSSQ). A systematic review was performed to find
out evidence to support its validity in term of content, response process, internal structure, relation
to other variables, and consequences. Method: The author planned, conducted and reported this
study according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses)
standard of quality for reporting meta-analyses. Systematic search was performed on EBSCOhost,
Scopus, Proquest, PubMed, Web of Science and Google Scholar databases. Result: The author
yielded 613 relevant articles based on search terms, 44 articles had used MSSQ, and after critical
appraisal, only 18 articles provided evidence to support validity MSSQ and thus were included in
the systematic review. Conclusion: This systematic review supports the validity of MSSQ in relation
to content, response process, internal structure, relations to other variables, and consequences of
its scores. MSSQ is a valid tool to detect sources of stress in medical students and its results can be
utilised as a guide to plan wellness program or intervention to improve medical students’ wellbeing.

Matched MeSH terms: Stress, Psychological*
Fulltext Theoretical background, first stage development and adaptation of a novel Integrative Adapt Therapy (IAT) for refugees

Tay AK, Miah MAA, Khan S, Badrudduza M, Morgan K, Balasundaram S, et al.

Epidemiol Psychiatr Sci, 2019 Aug 23;29:e47.
PMID: 31441397 DOI: 10.1017/S2045796019000416

AIMS: Refugees are confronted with the task of adapting to the long-term erosion of psychosocial systems and institutions that in stable societies support psychological well-being and mental health. We provide an overview of the theoretical principles and practical steps taken to develop a novel psychotherapeutic approach, Integrative Adapt Therapy (IAT), which aims to assist refugees to adapt to these changes. This paper offers the background informing ongoing trials of IAT amongst refugees from Myanmar.
METHODS: A systematic process was followed in formulating the therapy and devising a treatment manual consistent with the principles of the Adaptation and Development After Persecution and Trauma (ADAPT) model. The process of development and refinement was based on qualitative research amongst 70 refugees (ten from West Papua and 60 Rohingya from Myanmar). The therapeutic process was then piloted by trained interventionists amongst a purposively selected sample of 20 Rohingya refugees in Malaysia.
RESULTS: The final formulation of IAT represented an integration of the principles of the ADAPT model and evidence-based techniques of modern therapies in the field, including a transdiagnostic approach and the selective use of cognitive behavioural treatment elements such as problem-solving and emotional regulation techniques. The steps outlined in refining the manual are outlined in relation to work amongst West Papuan refugees, and the process of cultural and contextual modifications described during early piloting with Rohingya refugees in Malaysia.
CONCLUSIONS: IAT integrates universal principles of the ADAPT model with the particularities of the culture, history of conflict and living context of each refugee community; this synthesis of knowledge forms the basis for participants gaining insights into their personal patterns of psychosocial adaptation to the refugee experience. Participants then apply evidence-based techniques to improve their capacity to adapt to the serial psychosocial changes they have encountered in their lives as refugees. The overarching goal of IAT is to provide refugees with a coherent framework that assists in making sense of their experiences and their emotional and interpersonal reactions to the challenges they confront within the family and community context. As such, the principles of a general model (ADAPT) are used as a springboard for making concrete, manageable and meaningful life changes at the individual level, a potentially novel approach for psychosocial interventions in the field.

Matched MeSH terms: Stress, Psychological/psychology; Stress, Psychological/therapy*
Mindfulness-based intervention to promote psychological wellbeing in people with epilepsy: A randomized controlled trial

Lai ST, Lim KS, Tang V, Low WY

Epilepsy Behav, 2021 05;118:107916.
PMID: 33743343 DOI: 10.1016/j.yebeh.2021.107916

BACKGROUND: We investigated the efficacy of mindfulness-based intervention (MBI) in promoting psychological wellbeing in people with epilepsy (PWE) using an assessor-blinded randomized controlled design.
METHODS: A total of 28 PWE were randomly assigned to either intervention (n = 14 cases) or control group (n = 14 controls). The intervention group received a six 2.5-hour weekly MBI, while the control group did not receive any intervention. They were assessed at three timepoints (T0: before intervention, T1: immediately after intervention, and T2: 6 weeks after intervention). Repeated measures of analyses of variance (RM-ANOVAs) were used for inter-group comparisons to determine intervention effect from baseline -to T1 and -to T2 for all outcome measures. The individual changes were calculated using the reliable change index (RCI). Key outcomes included depression (BDI-II), anxiety (BAI), epilepsy-related quality of life (QOLIE-31), satisfaction with life (SWLS), and level of mindfulness (MAAS).
RESULTS: Participants who participated in the MBI showed significant reduction in BDI-II (p = 0.001), significant increases in MAAS (p = 0.027) and QOLIE-31 (p = 0.001) at T1 when compared with the control group. However, BAI and SWLS were not significant. The trend was similar at 6-week follow-up, all outcome measures of MBI remained significant (p 

Matched MeSH terms: Stress, Psychological/etiology; Stress, Psychological/therapy
Fulltext Prevalence of psychological distress among cancer patients in Southeast Asian countries: A systematic review

Ostovar S, Modarresi Chahardehi A, Mohd Hashim IH, Othman A, Kruk J, Griffiths MD

Eur J Cancer Care (Engl), 2022 Nov;31(6):e13669.
PMID: 35934684 DOI: 10.1111/ecc.13669

Psychological distress (including depression and anxiety) is common in the first years of cancer diagnosis but can differ by country and region. The aim of the present paper was to review the prevalence of psychological distress among cancer patients in the Southeast Asia (SEA) region. A systematic literature search was carried out using several databases (i.e., PubMed, PsychARTICLES, Embase, CINAHI, Web of Sciences, Plus, Scopus, and AHMED). Papers originally published in English language were taken into consideration if they (i) were published from 2010 to 2021 and (ii) reported the prevalence of psychological distress among patients with different types of cancer. A total of 23 studies met the inclusion criteria. The most frequently employed psychometric instrument for anxiety and depression screening was the Hospital Anxiety and Depression Scale (HADS). The prevalence of anxiety (ranging from 7% to 88%) was wider than that of depression (ranging from 3% to 65.5%) among patients with different types of cancer and living in various countries in the SEA region. The overall prevalence rate of psychological distress among cancer patients from the SEA region was not fundamentally very different from that of general populations. These findings provide useful information for health professionals and cancer patients to understand the negative role of psychological distress in quality of life and health. The research findings demonstrate the importance of counselling for psychological distress among cancer patients as means of effectively resolving their psychological problems and ultimately improving the quality of oncology medical care. Clinical recommendations for cancer management should incorporate the early identification of (and therapy for) psychological distress, as well as their monitoring during treatment.

Matched MeSH terms: Stress, Psychological/psychology
The association of smartphone addiction, sleep quality and perceived stress amongst Jordanian dental students

Sanusi SY, Al-Batayneh OB, Khader YS, Saddki N

Eur J Dent Educ, 2022 Feb;26(1):76-84.
PMID: 33527620 DOI: 10.1111/eje.12674

INTRODUCTION: Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty.
MATERIALS AND METHODS: A sample of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress.
RESULTS: The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9 ± 23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r = 0.137, P =0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r = 0.348, P stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality.
CONCLUSIONS: Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational campaigns, counselling, psychotherapy and stress management.

Matched MeSH terms: Stress, Psychological/epidemiology
Stressful life events and recurrent abdominal pain in children in a rural district in Malaysia

Boey CC, Goh KL

Eur J Gastroenterol Hepatol, 2001 Apr;13(4):401-4.
PMID: 11338070

OBJECTIVE: The purpose of this study was to look at the correlation between recurrent abdominal pain and the presence of recent stressful life events among schoolchildren in a rural district in Malaysia.
METHOD: This is a cross-sectional study of schoolchildren aged 9-15 years based in Kuala Langat, a rural district located in the south-west of the Malaysian state of Selangor. Schoolchildren were selected randomly and given questionnaires to fill in. This was followed by interview with the children on the same day by one of the authors (CCMB) to ensure consistency of response. Recurrent abdominal pain was defined as 'at least three episodes of abdominal pain, severe enough to affect their activities over a period longer than three months' [1]. The children were also asked to answer either 'yes' or 'no' to whether they had experienced various life events in the previous year.
RESULTS: A sample of 1462 schoolchildren (722 boys and 740 girls) aged between 9 and 15 years were included in the study. There were 768 Malays, 393 Chinese and 301 Indians. Of these 1462 children, 161 (11.0%) had recurrent abdominal pain. On performing multiple logistic regression analysis, two life events were significantly associated with recurrent abdominal pain: death of a family member (P = 0.008; odds ratio 0.61, 95% CI 0.43-0.88) and a change in occupation of an immediate family member (P = 0.003; odds ratio 0.53, 95% CI 0.35-0.81).
CONCLUSION: This study suggests that recurrent abdominal pain in children is associated with recent stressful life events in the children's lives.

Matched MeSH terms: Stress, Psychological*
Flavonoid quercetin protects against swimming stress-induced changes in oxidative biomarkers in the hypothalamus of rats

Haleagrahara N, Radhakrishnan A, Lee N, Kumar P

Eur J Pharmacol, 2009 Oct 25;621(1-3):46-52.
PMID: 19744476 DOI: 10.1016/j.ejphar.2009.08.030

Quercetin is a bioflavonoid abundant in onions, apples, tea and red wine and one of the most studied flavonoids. Dietary quercetin intake is suggested to be health promoting, but this assumption is mainly based on mechanistic studies performed in vitro. The objective of this study was to investigate the effect of quercetin on stress-induced changes in oxidative biomarkers in the hypothalamus of rats. Adult male Sprague Dawley rats were subjected to forced swimming stress for 45 min daily for 14 days. Effect of quercetin at three different doses (10, 20 and 30 mg/kg body weight) on serum corticosterone and oxidative biomarkers (lipid hydroperoxides, antioxidant enzymes and total antioxidants) was estimated. Swimming stress significantly increased the serum corticosterone and lipid hydroperoxide levels. A significant decrease in total antioxidant levels and super oxide dismutase, glutathione peroxidase and catalase levels was seen in the hypothalamus after stress and treatment with quercetin significantly increased these oxidative parameters and there was a significant decrease in lipid hydroperoxide levels. These data demonstrate that forced swimming stress produced a severe oxidative damage in the hypothalamus and treatment with quercetin markedly attenuated these stress-induced changes. Antioxidant action of quercetin may be beneficial for the prevention and treatment of stress-induced oxidative damage in the brain.

Matched MeSH terms: Stress, Psychological*
Fulltext Results of the COVID-19 mental health international for the general population (COMET-G) study

Fountoulakis KN, Karakatsoulis G, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, et al.

Eur Neuropsychopharmacol, 2022 Jan;54:21-40.
PMID: 34758422 DOI: 10.1016/j.euroneuro.2021.10.004

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study.
MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively.
STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables.
RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed.
CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.

Matched MeSH terms: Stress, Psychological/etiology

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