International Journal of Stress Management

Effect of a nonpharmacological psychological stress management intervention on major cardiovascular events and mortality in patients with coronary artery disease: A systematic review and meta-analysis of randomized clinical trials.
Psychological stress is associated with major adverse cardiovascular events (MACE). The objective of this systematic review (SR) is to evaluate the effect of nonpharmacological psychological stress management interventions on MACE and mortality in patients with coronary artery disease. SR and meta-analysis of randomized clinical trials of adult patients with coronary artery disease undergoing nonpharmacological psychological stress management interventions. MEDLINE, Cochrane, LILACS, APA PsycInfo, Clinical Trials databases, and gray literature were used for the search. There were no limits regarding publication status, year, or language. The analyzed outcome was a combination of MACE (cardiovascular mortality, nonfatal infarction, revascularization, nonfatal stroke, and cardiovascular hospitalization). The secondary outcomes were total mortality. Results were expressed as risk ratio (RR) with their 95% confidence interval (95% CI). The random effects model was used for the analyses, the Cochrane Risk of Bias 2 tool to risk of bias and RStudio for the statistical analyses. Prospective International Register of Systematic Reviews and meta-analysis (CRD42021275198). This SR included seven randomized clinical trials (n = 1,908). There was no effect attributable to the intervention on reducing MACE (34.54% vs. 39.05%; RR = 0.84; 95% CI [0.63, 1.12], p = .24; 95% PI [0.35, 2.02]; I² = 74.7%, p = .001) or on the analysis of isolated events. The intervention reduced the risk of total mortality by 37% (8.58% vs. 13.62%; RR = 0.63; 95% CI [0.42, 0.95], p = .03; 95% PI [0.18, 2.25]; I² = 23.8%, p = .27). This meta-analysis showed no significant decrease in psychological intervention for stress management in MACE, but a significant decrease in mortality. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Parenting stress and its impact on parental and child functioning during the COVID-19 pandemic: A meta-analytical review.
Amidst the COVID-19 pandemic, prolonged periods of physical and social isolation imposed significant challenges on parents and children, disrupting their socioeconomic stability and psychological well-being. This study examined the effects of parenting stress on aspects of parents’ and children’s functioning during the COVID-19 pandemic. A comprehensive search of studies from eight electronic sources, including the World Health Organization’s COVID-19 database, yielded 42 studies focusing on the associations between parenting stress, as measured by standardized scales, and child and parental outcomes. Multilevel random-effect models were used to analyze weighted effect sizes. Our findings revealed medium-to-large effect sizes (ranging from r = .29 to .55) in the associations between parenting stress and (a) externalizing child behaviors (r = .41), (b) internalizing child behaviors (r = .48), (c) negative parents’ behavioral engagements (r = .29), (d) parents’ mental health (r = .46), and (e) poor parent–child relationship quality (r = .55). These results underscore the significance of addressing parenting stress during a pandemic. Practice implications suggest that governmental or community support, along with tangible assistance, can alleviate parenting stress and positively impact the well-being and functioning of parents and children in the pandemic and postpandemic era, especially in light of the current global mental health crisis. Furthermore, considering the influence of parenting stress on treatment engagement and motivation, family- or parent-oriented interventions that address parenting stress can be more effective at reducing the negative consequences of a pandemic on children and their parents. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
A reverse perspective on emotion work and well-being: Connecting chronic burnout to emotion regulation from an antecedent perspective.
This study examined the relationship between burnout and emotion work from an antecedent perspective. We hypothesized that chronic burnout predicts the use of surface acting and emotional deviance in emotionally demanding customer interactions, thereby influencing momentary exhaustion and self-rated service performance. Moreover, we expected a moderating role of the burnout dimensions. In a diary study involving 59 flight attendants and 285 interaction logs, multilevel structural equation models showed that all burnout dimensions positively predicted the use of surface acting and emotional deviance. Surface acting and emotional deviance, in turn, were positively related to momentary exhaustion and negatively to performance. Moderation analyses yielded complex results: Surface acting did not increase momentary exhaustion among employees with high chronic exhaustion and low professional efficacy. Yet, both dimensions positively predicted momentary exhaustion. High levels of cynicism mitigated surface acting’s negative impact on momentary exhaustion, confirming its role as a coping strategy. Regarding service performance, all burnout dimensions moderated the negative impact of surface acting on performance, with cynicism also directly affecting performance. For emotional deviance, high chronic exhaustion and low efficacy reduced its association with momentary strain, whereas cynicism had no moderating effect. Last, all burnout dimensions exacerbated the negative relationship of emotional deviance with performance. Thus, this study contributes to a deeper understanding of the impact of chronic well-being on how employees perform emotion work in emotionally stressful customer interactions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Psychological detachment matters right after work: Engaging in physical exercise after stressful workdays.
While regular physical exercise as a recovery activity has an important role regarding employees’ well-being, employees seem to engage less in physical exercise after stressful workdays—pointing to a paradoxical pattern. Extending the recovery paradox (Sonnentag, 2018) applied to physical exercise and drawing from perspectives on energetic and self-regulatory resource loss and recovery, we integrate psychological detachment right after work as an explaining psychological mechanism in the paradoxical pattern between job stressors, physical exercise, and energetic well-being. We collected daily diary data from 93 employees on 514 days over two consecutive workweeks. Results of our two-level path model suggest that psychological detachment right after work explains the paradoxical pattern between job stressors (workload and self-control demands) and time spent on physical exercise. However, we did not find a serial indirect effect from job stressors to next-morning energetic well-being (vigor and fatigue) via psychological detachment and time spent on physical exercise. Our study suggests a new perspective on the role of psychological detachment, namely as a prerequisite instead of an outcome of physical exercise after stressful workdays. This new perspective has implications for future research and practical interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Ups and downs: Workers with fluctuations in chronic pain and work–health management interference.
Most adults will experience at least one chronic health condition (CHC) during their working lives, and many will continue working despite the challenges that these conditions present. One common challenge faced by workers with CHCs is work–health management interference (WHMI) or competing pressures that arise from the need to manage a CHC while also meeting work demands. Prior studies have shown that WHMI predicts between-person differences in work outcomes (e.g., increased burnout, decreased work ability), but workers with CHCs tend to have “good days” and “bad days,” making the within-person experience of WHMI an issue worth investigating. Additionally, job resources have not been examined as a possible buffer against the negative effects of WHMI. In a twice-daily diary study of 76 full-time workers with chronic pain, we found that approximately one fifth of the variability in WHMI occurred within persons, and end-of-day WHMI was predicted by midday severity in pain symptoms, both within and between persons. As hypothesized, we found that midday WHMI predicted end-of-day burnout (positively) and engagement (negatively) at both the within- and between-persons levels. Job control buffered the effects of WHMI on lagged burnout (but not engagement) at a between-persons level, but a similar effect was not observed for supervisor support on either burnout or engagement. Our findings provide an improved understanding of WHMI as an experience that varies within persons and suggest that efforts to support workers with CHCs may need to be individualized both to the person and to the day. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Better off alone? Linking organizational politics, embeddedness, and withdrawal behavior.
Many organizations seek to embed their employees by fostering strong bonds between the employees and their work. Although this typically helps organizations retain employees, identity theory suggests that job embeddedness may amplify strain that results from impediments to employee’s perceived role fulfillment and self-identity. We propose that embedded employees have high work identity salience that may be threatened when managers put their own interests before that of the organization or other employees (i.e., perception of organizational politics). Using data from a sample of 382 South Korean employees who provided data over 1 year, we found that embedded employees, when faced with organizational politics, reported more job search behavior, and in turn, a greater likelihood of turnover behavior. However, this finding did not extend to a nonrole-inhibiting stressor (i.e., workload), such that it seems unlikely this finding applies broadly across stressors. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Cognitive reserve as a protective variable against psychological stress in individuals with high anxiety.
The aim of the present study was to evaluate the interaction of cognitive reserve (CR) and state anxiety in adrenocortical and electrodermal responses. Thirty-nine healthy, middle-aged men completed the State–Trait Anxiety Inventory and Escala de Reserva Cognitiva (Cognitive Reserve Scale). Following this, they performed a cognitively demanding task adapted from the Trier Social Stress Test. Electrical skin conductance level and cortisol concentrations were recorded during the task. These measures were used as indicators of stress response. Our results seem to indicate that CR has a protective effect against cortisol responses in stressful situations. This effect was observed in participants who showed high CR and high state anxiety. At the same time, CR showed a positive correlation with “recovery to baseline conductance level” after the occurrence of stressful events. As a whole, these results suggest that having high CR could protect against the development of allostatic load. The regulatory system of physiological and endocrine activity would be more efficient in individuals with high scores in CR, thus avoiding the development of allostatic load. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Effort–reward imbalance in PhD students: Adaptation and validation of the Effort–Reward Imbalance Scale for doctoral students.
The effort–reward imbalance (ERI) model is a theoretical model in the work context that identifies stressors and their adverse effects on health. This article attempts to apply the ERI theory to the PhD context and describes the adaptation and validation of the ERI scale for doctoral students (ERI-PhD) in a sample of 1,275 PhD students gaining a doctoral degree in Germany. We calculated item-total correlations and McDonald’s Omega to assess the internal consistency and used exploratory and confirmatory factor analysis to test the theoretical and factorial structure of the scale. The factorial time invariance was tested with a 6-week follow-up design (n = 705). The relationship between ERI and different PhD groups was examined to test discriminant validity. Linear regression analyses of the ERI-PhD with mental health (Patient Health Questionnaire–4) were examined to test the criterion validity. Exploratory factor analysis using a randomized half of the sample yielded a four-factor structure solution. Using the other half of the sample, confirmatory factor analysis confirmed that the four-factor solution fitted the data the best. Also, the ERI level varied among demographic and PhD-related variables and contributed to the explanation of poor mental health. The PhD version of the ERI questionnaire is a valid and reliable new instrument for assessing the perceived social reciprocity between efforts and rewards and its effects on mental health (i.e., depression and anxiety). In light of stress-related PhD conditions (e.g., isolation, work–life conflicts) and many PhD students leaving academia, the tool can provide valuable explanations. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

International Journal of Stress Management - Vol 31, Iss 3