International Journal of Stress Management

Assessing adherence and competence in delivering telehealth group cognitive behavioral stress management.
Treatment fidelity, or consistent therapist adherence and competence in intervention delivery, is an important component of intervention design and dissemination. Yet few systems have been developed to assess fidelity in telepsychology and related remotely delivered intervention venues. We sought to modify and evaluate a fidelity coding approach for a videoconference-delivered group cognitive behavioral stress management (CBSM) intervention. Although validated rating systems for treatment fidelity exist, they typically focus on individual therapy and are inappropriate for the structure of group stress management interventions. We modified the RAND Corporation Fidelity Coding Guide, which was initially designed for audio-recorded group cognitive behavioral therapy, for applicability to videotaped sessions of CBSM. Two raters applied the resulting CBSM Coding Guide to 146 session recordings taken from a CBSM trial for persons with chronic fatigue syndrome and their partners, with 40% of sessions double-coded. Reliability for eight adherence items and 15 competence items was moderate overall (average κw = .751) with 20 of the 23 items demonstrating at least moderate interrater reliability (i.e., κw > .600). Three items that did not meet this cutoff would benefit from more extensive operationalization and rater training. Our adapted system provides a means of assessing adherence and competence variables to validate the delivery of CBSM and of associating these with positive treatment outcomes to isolate the “active ingredients” of CBSM. Further, the successful modification and application of the RAND Corporation Fidelity Coding Guide support the adaptation of this system for a diverse range of remotely delivered cognitive behavioral group therapies. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Secondary school students, examination stress, and academic confidence: Understanding the effect of yoga lessons.
This study examined whether sustained yoga-based intervention with secondary school students mitigated examination stress and built their academic confidence. A 2-year multicity repeated measures design was used. Secondary schoolers in select Asian and African cities were randomly allocated to the yoga education program (YEP) and the control group. Two scales were used to measure the outcomes: Test Anxiety Scale and Academic Behavioral Confidence Scale. The YEP was effective and specifically so for students from Asian cities, girls, middle class, Hindus and Buddhists, pupils of international schools, and whose mothers were their primary caregivers. Attendance of the YEP lessons and regular self-practice were significant predictors of the outcomes. The YEP can be incorporated in the curricular schedules of secondary school students with some variations based on cultural and ethnic belief systems, gender, and family backgrounds. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Dyadic coping moderates the association between economic strain and psychological distress in low-income couples.
The field of relationship science has devoted greater attention to understanding the impact of contextual stressors (e.g., economic strain) on low-income and/or economically marginalized couples. However, little research has explored the ways in which specific couple behaviors (e.g., dyadic coping [DC]) might protect partners against the negative effects of such stress. The present study thus examined whether two types of positive dyadic coping—supportive dyadic coping (SDC) and common dyadic coping (CDC)—each moderate the association between economic strain and individual well-being (e.g., psychological distress, physical health) in a sample of low-income, different-gender couples (N = 148). Couples completed self-report measures to assess their economic strain, psychological distress, and global physical health. Results from structural equation models confirm what previous findings have suggested: More economic strain was associated with greater psychological distress and worse physical health, and greater engagement in SDC and CDC was linked to better psychological functioning regardless of gender. Furthermore, among females, each form of DC attenuated the relationship between economic strain and psychological distress. Among males, such moderation was only observed in relation to CDC (not SDC). It was also not observed in relation to physical health for either partner. These results suggest that among low-income couples, female partners may benefit from different interpersonal aspects of dyadic coping compared to males—and that testing the effects of dyadic coping on physical health may require longitudinal (not cross-sectional) research. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The Perceived Stress Scale revisited: Longitudinal clinical implications of a two-factor structure.
The Perceived Stress Scale (PSS) is a widely used instrument in both clinical and research settings. A two-factor structure has been identified in most psychometric evaluations of the scale, but the implications of this factor structure for clinical trial outcomes are ill-understood. This study used data from a randomized controlled trial investigating the effect of an internet-delivered cognitive behavioral therapy (ICBT) targeting chronic stress disorders versus a waitlist control condition (N = 100). We evaluated the internal consistency of the PSS-14 (the main outcome in the randomized controlled trial) and examined the fit of a two-factor model within an exploratory structural equation modeling framework. The factor analysis supported a two-factor solution, and parallel analysis confirmed that the retention of this solution was adequate. Both the “distress” and the “coping” factors, which were identified through factor analysis, demonstrated acceptable reliability. Mixed-effects modeling was employed to quantify the impact of treatment on its respective factor, treated as separate subscales in this study. Significant interaction effects between time and treatment group were found on both distress and coping, with the ICBT group showing marked improvements in these areas. In the ICBT group, the improvement in distress was slightly more pronounced than in coping at the 6-month follow-up. We conclude that PSS-14 sum scores may be valid for assessing treatment outcomes in clinical settings. However, our findings indicate that there may be differential effects on the distress and coping factors across time, which motivates further investigation of the factors in larger clinical trials. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
On the dimensionality, suitability of sum/mean scores, and cross-country measurement invariance of the Perceived Stress Scale 10 (PSS-10)—Evidence from 41 countries.
Applied researchers typically use mean/sum scores as simple scoring method for the 10-item Perceived Stress Scale (PSS-10). However, inferences from such scores can be biased when measures are not essentially unidimensional. A bifactor modeling approach is especially useful to evaluate whether and to what degree ignoring (potential) multidimensionality of the PSS-10 might affect person score estimates. However, so far only few studies on the PSS-10 have used this approach and have not yet fully exploited its potential. In addition, studies that investigate measurement invariance across countries are scarce. Thus, the present study aimed to (a) evaluate the dimensionality of the PSS-10 by means of an exploratory graph analysis and an item response theory bifactor modeling comparison approach, (b) assess conditional and marginal reliability, (c) investigate cross-country measurement invariance, and (d) examine whether the relationships between the PSS-10 and different validity criteria depend on the scoring method of the PSS-10. Therefore, community samples from 41 countries (N = 109, 264) of the COVIDiSTRESS Global Survey data were used. In most countries (i.e., n = 33) ignoring multidimensionality did not substantially affect person score estimates and only slightly overestimated reliability. Measurement invariance and differential item/test functioning analysis of the PSS-10 on these 33 countries revealed only minor differential test functioning across countries. Overall, the PSS-10 showed a concurring nomological network with the external criteria, although with some substantial differences in effect sizes between countries. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Binary work stressors and work procrastination: The mediating role of work attentiveness and emotional exhaustion and the moderating role of regulatory focus.
The high costs of work procrastination underscore the necessity of understanding this behavior. Drawing from the affective events theory and the regulatory focus theory, we adopt an emotion-based perspective to suggest differential effects of binary work stressors on work procrastination, mediated by two forms of emotions (work attentiveness and emotional exhaustion) and moderated by individual regulatory focus. A two-wave survey study (Study 1) tests the proposed model. The findings reveal that challenge stressors impede employees from engaging in work procrastination through increased work attentiveness, especially among those with a high promotion regulatory focus. However, hindrance stressors prompt work procrastination through increased emotional exhaustion, especially among employees with a high prevention regulatory focus. Two scenario experiments (Study 2a and Study 2b) strengthen the causal inference between binary work stressors and emotional responses. These findings have notable practical and theoretical implications. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Association of vagally mediated heart rate variability at work with exhaustion: The importance of trait neuroticism.
Vagally mediated heart rate variability (HRV) is a measure of parasympathetic modulation of the heart, which is considered an index of the ability to regulate emotional arousal attuned to environmental demands. The present study explores the association between HRV and exhaustion—the core symptom of burnout. Based on the multilevel model of employee well-being, we hypothesize that neuroticism moderates the relationship between HRV and exhaustion. We collected data among 271 workers (57.92% women, mean age M = 41.21 years, SD = 13.94), whose HRV was measured over the course of one working day, while exhaustion was measured at the end of the same working day. Neuroticism and covariates were measured at baseline, prior to the examined working day. Results from multiple linear regression models revealed that HRV was negatively related to exhaustion, even after controlling for exhaustion measured at baseline. In addition, as hypothesized, trait neuroticism moderated the negative association between HRV and exhaustion at the end of the working day such that it was stronger for workers high (i.e., +1 SD) versus low (i.e., −1 SD) in neuroticism. The test for constant variance pointed to high-neuroticism workers with low HRV as the group more at-risk of developing exhaustion-related symptoms. We discuss the theoretical and practical implications of these findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Different responses to facets of illegitimate tasks depending on job level: A multigroup path analysis.
This study aims to test the discriminant validity of two illegitimate tasks facets (unnecessary and unreasonable tasks) in relation to two burnout facets (exhaustion and cynicism), to examine the mediating effects of exhaustion on the pathways from the two facets of illegitimate tasks to cynicism, and to investigate the moderating effect of job level on the path model. The participants were 984 full-time employees in South Korea who completed a two-wave online survey with a 2-week interval. The results demonstrated that the two-factor model was better than the one-factor model for both data sets, despite the high correlation between the two illegitimate tasks facets. Although the magnitudes did not differ in the zero-order correlations of illegitimate tasks facets with burnout facets, different patterns were observed when the two facets of illegitimate tasks were entered into the mediational path model together. Specifically, exhaustion fully mediated the link from unnecessary tasks to cynicism, whereas it partially mediated the link from unreasonable tasks to cynicism. Moreover, these patterns were moderated by job level such that the same model was supported only by staff employees and middle managers. Based on these findings, we discussed academic and practical implications along with suggestions for future research. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

International Journal of Stress Management - Vol 31, Iss 4