Assessing the economic impact of stress[mdash ]The modern day hidden epidemic
Abstract
This article examines the economic effects of all forms of stress[mdash ]work-related stress, home stress, and post-traumatic stress disorder (PTSD)[mdash ]as health hazards. Such an approach inherently broadens the analysis from a few well-defined, quantitative variables, such as those most commonly studied by economists who traditionally examine job stress alone. It also enables us to draw conclusions regarding the socioeconomic factors and the psychology of stress and helps in understanding the larger question of the economic cost of stress in today's global environment. Stress and its related comorbid diseases are responsible for a large proportion of disability worldwide. The World Health Organization (WHO) Global Burden of Disease Survey estimates that mental disease, including stress-related disorders, will be the second leading cause of disabilities by the year 2020. Although the term [ldquo ]stress[rdquo ] is used in a wide variety of contexts, it has consistently been demonstrated that individuals with stress and related disorders experience impaired physical and mental functioning, more work days lost, increased impairment at work, and a high use of health care services. The disability caused by stress is just as great as the disability caused by workplace accidents or other common medical conditions such as hypertension, diabetes, and arthritis. We present evidence that calls for early recognition of workplace stress and for businesses to allocate more resources to stress management in the workplace.
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Effect of recurrent task-induced acute stress on task performance, vagally mediated heart rate variability, and task-evoked pupil response
2024, International Journal of PsychophysiologyAdvances in wearable sensor technologies can be leveraged to investigate behavioral and physiological responses in task-induced stress environments. Reliable and valid multidimensional assessments are required to detect stress given its multidimensional nature. This study investigated the effect of recurrent task-induced acute stress on task performance, vagally mediated heart variability measures (vmHRV) and task-evoked pupillary response (TEPR). Task performance, vmHRV measures, and TEPR were collected from 32 study participants while they performed a computer-based task in a recurrent task-induced acute stress environment. Mixed-effects modeling was used to assess the sensitivity of each outcome variable to experimental conditions. Repeated measures correlation tests were used to examine associations between outcome variables. Task performance degraded under stress. vmHRV measures were lower in the stress conditions relative to the no stress conditions. TEPR was found to be higher in the stress conditions compared to the no stress conditions. Task performance was negatively associated with the vmHRV measures, and degraded task performance was linked to increased TEPR in the stress conditions. There were positive associations between vmHRV measures. TEPR was negatively associated with vmHRV measures. Although task-induced stress degrades task performance, recurrent exposure to that stress could alter this effect via habituation. Further, our findings suggest that vmHRV measures and TEPR are sensitive enough to quantify psychophysiological responses to recurrent task-induced stress.
Effects of participant-selected versus researcher-selected music on stress and mood – The role of gender
2023, PsychoneuroendocrinologyPrevious research suggests differential effects of participant-selected (PS) vs. researcher-selected (RS) music on emotional responses to music listening. This study investigates whether such selection strategies, as well as gender, influence (1) stress and (2) mood responses. Additionally, we examine the role of (3) stimulus-induced emotions and (4) emotion regulation strategies.
Participants (N = 61) listened to auditory stimuli (PS music, RS music, sound of lapping water (LW); randomized) on three days and underwent a cold pressor test (CPT) while listening. Stress parameters (subjective acute stress, heart rate, parameter RMSSD, salivary alpha-amylase, salivary cortisol), mood dimensions (calmness, valence, energetic arousal), emotions, and emotion regulation strategies were measured. Multilevel and mediation analyses were conducted.
(1) There were no direct effects of selection strategy or gender on stress responses, but interaction effects indicated that women showed the strongest subjective stress response and the longest HR recovery with PS music, while men showed the lowest HR response to the CPT with PS music. (2) No mood differences emerged between PS and RS music overall. Women showed stronger variability in calmness overall as well as perceived higher arousal when listening to PS music compared to men. (3) Higher stimulus-induced anger in men compared to women and with LW compared to PS was associated with lower calmness and valence, while no consistent pattern emerged for the stress responses. (4) Women scored higher on reappraisal, associated with a decrease in parasympathetic activity, whereas men scored higher on suppression, associated with an increase in endocrine activity.
Music selection and gender appear to have no direct impact on stress and mood responses overall, although men tend to benefit more from self-selected music than women. Our findings provide first indications that avoiding music stimuli that induce anger may facilitate mood management via music. Furthermore, finding alternative emotion regulation strategies to the strategy of suppression may be a helpful approach to improve music-based stress management.
Economic pressures on airlines’ safety performance
2022, Safety ScienceWe investigate if general economic conditions influence aviation safety across the whole sector. Specifically, the study explores the relationship among aviation accidents and incidents for Part 121 US commercial airlines with fuel prices, stock market volatility, industrial production growth, and treasury bill rates. Our findings suggest that most of the variables under consideration exhibit a strong association with airline safety. Importantly, we examine two plausible channels that may explain these results; managerial decisions and the effect on “human factor”. Analysis of airline financial data, health, and safety violations, along with airline employee satisfaction levels, suggests that it is more likely that the economy influences aviation safety through managerial decisions. This study confirms theoretical predictions about reductions on firms’ quality standards in periods of financial stress and liquidity constraints. The findings of the study have important implications for regulators and other stakeholders.
Chronic stress and executive functioning: A specification-curve analysis
2022, Physiology and BehaviorTo investigate the association between chronic stress and executive functioning (EF), we assessed 514 young to middle-aged adults in three EF tasks (i.e., Number-Letter, 2-Back, Go/Nogo) that assessed shifting, updating, and inhibition. Chronic stress was assessed by various self-report measures and hair cortisol concentrations as indicators of subjective and objective chronic stress, respectively. In order to test the association between chronic stress and EF, we fit a structural equation model with a latent common EF factor predicted by subjective and objective chronic stress on Kaplan-Meier estimates of response times. Controlling for participants' sex, age household income and the delay between cognitive testing and hair sample collection, neither subjective nor objective chronic stress showed a meaningful association with common EF. Exploratory analyses suggested a moderation effect of income on the association between subjective chronic stress and common EF, with a smaller association for high-income participants. Additionally, we conducted a specification-curve analysis on the association between chronic stress and EF to assess the influence of different analysis choices on results in our dataset. This analysis confirmed the absence of a coherent association between chronic stress and EF by showing that the majority of analytical choices produced null effects and only a small number of analytical choices produced meaningful associations (negative or positive). Taken together, our findings suggest that common EF likely remains preserved under the influence of chronic stress. Our specification-curve analysis, however, also shows that chronic stress may also have either a positive or a negative effect on EF, depending on the choice of covariates and measures of chronic stress and EF. Consequently, more research on the role of these factors for the association between chronic stress and EF is needed to avoid the interpretation of non-replicable stress-EF associations caused by analytical choices or selection bias.
Addressing depression and behavioral health needs through a digital program at scale
2021, HealthcareCitation Excerpt :Approximately 17.3 million Americans live with depression and it is associated with increased mortality, reduced quality of life,2,5 and negative economic consequences.2,3,6–8 When compared to patients without depression, patients with depression have worse medical outcomes and higher costs of care, and this is compounded in those with chronic comorbid health conditions.3,9–11 In the United States, the economic burden of depression was estimated at $83.1 billion in the year 2000, including $51.5 billion in indirect workplace costs (absenteeism from work and presenteeism while at work) related to untreated disease.1
Depression and anxiety disorders are prevalent mental health conditions; yet they are often unrecognized, under-addressed and/or under-treated, and specialty treatment for these conditions is oftentimes difficult to access. By acting either as a bridge to therapy or as a form of therapy, digital tools, such as those that provide internet-based cognitive behavioral therapy (iCBT), may help clinicians support their patients’ mental health needs.
At one academic health system, a digital mental health program was deployed in primary care and outpatient behavioral health programs to help patients meet needs identified through screening or clinical visits. Over the first two years of operation, 138 clinicians (40% of eligible clinicians) prescribed the program to 2,228 unique patients, from which 1,117 (48.9%) enrolled. Patients who enrolled tended to be younger and healthier than non-enrollees. On average, enrolled patients spent 114.6 minutes within the iCBT program. Clinical improvement was assessed using pre- and post PHQ-9 and GAD-7 scores for depression and anxiety, respectively. Pre/Post scores were compared using Wilcoxon Rank Sum test. Patients with at least moderate depression had an average 23% reduction in PHQ-9 scores (median change -3(interquartile range 7), p<0.001) and those with at least moderate anxiety had a 26% reduction in GAD-7 scores (-4(7), p<0.001). Improvements were clinically and statistically significant. Future steps include performing a cost analysis to understand whether models utilizing iCBT are net cost-saving for health systems.
Wireless, continuous monitoring of daily stress and management practice via soft bioelectronics
2021, Biosensors and BioelectronicsStress has become a significant factor, directly affecting human health. Due to the numerous sources of stress that are inevitable in daily life, effective management of stress is essential to maintain a healthy life. Recent advancements in wearable devices allow monitoring stress levels via the detection of galvanic skin response on the skin. Some of these devices show the capability of assessing stress relief methods. However, prior works have been limited in a controlled laboratory setting with a short period assessment (<1 h) of stress intervention. The existing systems' main issues include motion artifacts and discomfort caused by rigid and bulky electronics and mandatory device connection on active fingers. Here, we introduce soft, wireless, skin-like electronics (SKINTRONICS) that offers continuous, portable daily stress and management practice monitoring. The ultrathin, lightweight, all-in-one device captures the change of a subject's stress over six continuous hours during everyday activities, including desk work, cleaning, and resting. At the same time, the SKINTRONICS proves that typical stress alleviation methods (mindfulness and meditation) can reduce stress levels, even in the middle of the day, which is supported by statistical analysis. The low-profile, wireless, gel-free device shows enhanced breathability and minimized motion artifacts compared to a commercial stress monitor. Collectively, this study shows the first demonstration of soft, nanomembrane bioelectronics for long-term, continuous assessment of stress and intervention effectiveness throughout daily life.