Stress could increase delay discounting in subjects with bulimia nervosa and alcohol use disorder (AUD), meaning that the short-term benefits of coping through eating or drinking outweigh the long-term negative consequences. Therefore, this study explores differences in delay discounting between patients and healthy controls, the impact of stress on food and alcohol delay discounting and associated changes in brain activity.

A total of 102 female participants (AUD, 27; bulimia nervosa, 25; healthy controls, 50) underwent repeated functional magnetic resonance imaging scanning. Initially, all participants performed a monetary delay discounting task (DDT), followed by a food or alcohol DDT before and after stress induction. Specifically, those with bulimia nervosa completed a food DDT, those with AUD completed an alcohol DDT and healthy controls were randomly allocated to one or either DDT.

Participants with AUD, but not healthy controls, displayed a higher discounting of alcohol after stress. Healthy controls, but not those with bulimia nervosa, had nominally higher discounting rates of food following stress, although not significant following multiple testing correction. Participants with AUD displayed a lower activity of the right supplementary motor area while discounting alcohol after stress. Healthy controls showed a lower activity of the frontal cortex and a higher activity of the motor cortex while discounting food after stress, while those with bulimia nervosa displayed a higher activity of the occipital cortex.

The results suggest that, in subjects with AUD, stress induces neurobiological changes that cause them to prefer more immediately available alcohol. However, the results observed in participants with bulimia nervosa suggest a more complex relation between stress and food.

Cognitive and behavioral factors contribute to the mitigation of stress-related health outcomes in later life. Given that stress management interventions for older adults are an important target for healthcare, there is a need for a relatively short and standardized assessment tool to comprehensively measure stress and coping in later adulthood while minimizing the burden on participants. The Stress Assessment Inventory (SAI), a 123-item measure designed to assess stress and coping resources in younger adults.

The objective of this study was to examine the psychometric properties of the SAI in 294 older adults.

The SAI was evaluated on its dimensionality, reliability, and validity.

A shortened SAI is proposed for older adults, with good internal consistency and criterion validity. The Revised SAI was found to have a three-factor model that captures Adaptive Cognitive Resources, Maladaptive Behavioral and Cognitive Habits, and Adaptive Health Habits.

The current study supports the use of the Revised SAI in community-dwelling older adult populations as a comprehensive tool to assess stress and coping for use by researchers and healthcare professionals.

Cortisol is a well-established biomarker of stress, assessed through salivary or blood samples, which are intrusive and time-consuming. Speech, influenced by physiological stress responses, offers a promising non-invasive, real-time alternative for stress detection. This study examined relationships between speech features, state anger, and salivary cortisol using a validated stress-induction paradigm.

Participants (N = 82) were assigned to cold (n = 43) or warm water (n = 39) groups. Saliva samples and speech recordings were collected before and 20 minutes after the Socially Evaluated Cold Pressor Test (SECPT), alongside State–Trait Anger Expression Inventory (STAXI) ratings. Acoustic features from frequency, energy, spectral, and temporal domains were analysed. Statistical analyses included Wilcoxon tests, correlations, linear mixed models (LMMs), and machine learning (ML) models, adjusting for covariates.

Post-intervention, the cold group showed significantly higher cortisol and state anger. Stress-related speech changes occurred across domains. Alpha ratio decreased and MFCC3 increased post-stress in the cold group, associated with cortisol and robust to sex and baseline levels. Cortisol–speech correlations were significant in the cold group, including sex-specific patterns. LMMs indicated baseline cortisol influenced feature changes, differing by sex. ML models modestly predicted SECPT group membership (AUC = 0.55) and showed moderate accuracy estimating cortisol and STAXI scores, with mean absolute errors corresponding to ∼ 24–38% and ∼16–28% of observed ranges, respectively.

This study demonstrates the potential of speech features as objective stress markers, revealing associations with cortisol and state anger. Speech analysis may offer a valuable, non-invasive tool for assessing stress responses, with notable sex differences in vocal biomarkers.

Chronic pain activates the HPA axis stress response resulting in the release of cortisol, although empirical associations are often contradictory. Quantile regression models of hair cortisol may help us measure HPA-axis dysregulation more accurately and establish more robust associations with chronic pain. We also examined whether people with chronic pain characterised by HPA-axis dysregulation are at risk of future mental ill-health.

This study examined data from the English Longitudinal Study of Ageing (ELSA, n = 4,560) and the UK Household Longitudinal Survey-Innovation Panel (UKHLS-IP, n = 473) to assess whether quantile regression methods enable us to assess more robust associations between hair cortisol and chronic pain, and whether older adults with chronic pain characterised by HPA-axis dysregulation are at risk of future mental ill-health.

In ELSA, chronic pain was associated with a 15% (CI: 6%–23%) increase in cortisol at the 10th percentile of the hair cortisol distribution among older adults and a 19% (CI: 2%–37%) increase at the 80th percentile, but no association was found at the 30th or 40th percentiles. Having a low cortisol response to chronic pain protected against the recurrence of depression. These patterns of association were replicated in the UKHLS-IP sample.

The associations demonstrated across two longitudinal population surveys from the UK indicate that quantile regression analysis of hair cortisol may be useful in identifying individuals resilient to chronic pain. Hair cortisol is a promising biomarker that can be measured in population studies to quantify the stress response and resilience to future mental ill-health.

Core premenstrual disorders (PMDs), including premenstrual syndrome (PMS) and premenstrual dysphoric disorder, can cause significant impairment. Despite evidence linking stress and premenstrual symptoms, a systematic synthesis is lacking.

To systematically review the literature and meta-analyse evidence on the relationship between premenstrual symptoms and stress.

Four databases (Web of Science, PubMed, PsycINFO, Scopus) and Google Scholar were searched for studies indexed before 27 August 2024 (no language/year restrictions) assessing the relationship between self-reported stress and premenstrual symptoms in regularly menstruating individuals (PROSPERO: CRD42021244503). Three multilevel meta-analyses estimated (a) the correlation between stress and premenstrual symptom severity, (b) stress differences between individuals with and without core PMD across the menstrual cycle and (c) the impact of traumatic experiences on the occurrence of premenstrual symptoms. Study quality and publication bias were assessed.

We synthesised 188 effect sizes from 66 studies (N = 38 344), indicating (a) a positive correlation (r = 0.29, 95% CI 0.23–0.36); (b) higher stress levels in participants with core PMD (d = 0.79, 95% CI 0.32–1.26), particularly during the luteal phase (dlut = 1.01, 95% CI 0.46–1.57); and (c) over twofold higher odds (odds ratio 2.45, 95% CI 1.87–3.23) of PMS in individuals with a history of trauma. Heterogeneity was high (I2 = 84.64–91.38%); one meta-analysis (c) showed evidence of publication bias.

The results indicate an association between stress and premenstrual symptoms, an effect of cycle phase and trauma as a risk factor for PMS. Future research should explore underlying biopsychosocial mechanisms.

Literature has shown that a significant minority of bereaved people are at risk of prolonged grief disorder (PGD). However, studies on its prevalence and correlates within Italian samples remain scarce.

This study aimed to explore the prevalence and correlates of PGD symptom severity among 1603 bereaved Italian adults.

Self-reported data on PGD, suicidal ideation, depression, anxiety and stress were gathered. Descriptive characteristics and bereavement-related information were also collected.

Among participants who lost a close other person at least 12 months prior, the prevalence of probable PGD and severe suicidal ideation was 7.7% (n = 104) and 0.7% (n = 9), respectively. The overall prevalence of severe suicidal ideation in the sample was 4.5%, rising to 18.2% among those with probable PGD. The probable PGD diagnosis showed minimal agreement with reported depression (phi = 0.25), anxiety (phi = 0.19), and stress (phi = 0.26), suggesting potentially limited overlap and supporting their distinctiveness. The severity of PGD symptoms was significantly positively associated with older age and suicidal ideation, and negatively associated with lower educational background and time since loss. PGD severity also varied by kinship, cause of death and place of residence. Specifically, bereaved individuals who lost a grandparent due to natural causes associated with ageing and lived in small- to medium-sized cities reported lower PGD symptom severity relative to others.

These findings contribute to the understanding of PGD symptomatology in bereaved individuals in Italy, although the results may not generalise to the entire Italian population.

Young adulthood is a transitional period between childhood and adulthood characterised by unique stressors that increase the risk of food insecurity and poor mental health. This study examined the association between food insecurity and mental health outcomes among U.S. young adults aged 18–25.

A cross-sectional survey was completed by young adults between the ages of 18 and 25 years between January and April 2022. Key measures included food insecurity, perceived stress, anxiety, depressive symptoms and insomnia. Descriptive statistics and linear regression analyses were used to determine the prevalence of and associations between food insecurity and mental health outcomes, controlling for key demographic and social factors.

Online survey.

1630 U.S. young adults.

Among the analytic sample of 1041 young adults, nearly 70 % of participants identified as being food insecure in the last year. Participants reported moderate to high levels of perceived stress, anxiety, depressive symptoms and insomnia. Food insecurity was positively associated with each mental health outcome including perceived stress (β = 2·28, P< 0·01), anxiety (β = 2·84, P< 0·01), depressive symptoms (β = 2·74, P< 0·01) and insomnia (β = 1·28, P< 0·01) after controlling for all other factors.

Food insecurity is associated with mental health problems among young adults. Future efforts should explore the directionality of this relationship to determine if food insecurity initiates or exacerbates poor mental health outcomes or if poor mental health contributes to food insecurity. Interventions to improve food security status may also help support mental health among young adults.

Stress, a major risk factor for mental health problems, is influenced by hormonal fluctuations from the menstrual cycle and hormonal oral contraceptives (OC). Despite widespread use, the impact of hormonal intrauterine devices (IUDs) on stress is limited to one study.

This study examines psychoendocrine stress responses in women using IUDs, OCs and women with a natural, regular menstrual cycle (NC) to better understand how endogenous and exogenous hormones influence stress.

Using a repeated-measures design, we investigated stress responses in IUD and OC users and NC women. The Maastricht Acute Stress Task and its control task were applied twice within 4 months to assess subjective, endocrine and physiological stress correlates. Detailed endogenous and exogenous hormonal profiles were obtained, and women completed a 7-day diary (via ecological momentary assessment) after each appointment.

Based on subjective, physiological and cortisol responses, stress induction was successful in all groups. IUD users reported higher subjective stress, negative affect and anxiety and lower positive affect compared to NC women. OC users exhibited a blunted cortisol response and higher heart rate but reported less acute stress and negative emotions than the other groups in the 7-day diary. Oestradiol and progesterone were suppressed in OC and IUD users compared with NC women. Progesterone, testosterone and oestradiol were differently associated with skin conductance, socio-emotional stress and negative affect.

IUD and OC use distinctly affect stress response, possibly because of their diverging metabolic pathways and hormone levels. IUD users showed higher emotional reactivity to stress in both lab and daily life, while OCs influenced physiological correlates. These findings highlight that exogenous hormone administration, previously thought to have limited systemic effects, affects women’s psychological well-being, underscoring the need for further research into stress-related disorders among women using hormonal contraceptives.

This study aimed to evaluate the effects of relaxation-based exercises on individuals experiencing post-earthquake stress-related symptoms in an earthquake-prone region.

This randomized, waitlist-controlled, parallel group study included 46 participants with moderate post-traumatic stress levels (Posttraumatic Stress Diagnostic Scale, PDS) and anxiety for over 1 month (Beck Anxiety Inventory, BAI score > 8). Participants were randomly assigned to a relaxation-based exercise group (REG, n = 24) or a waitlist control group (CG, n = 25). The REG received relaxation-based structured, supervised exercises for 4 weeks, while the CG awaited treatment. Assessments included the PDS, BAI, Beck Depression Inventory, Perceived Stress Scale-10, Pittsburgh Sleep Quality Index, and SF-12 Quality of Life Scale at baseline and 4 weeks post-intervention.

Within-group analysis showed significant improvements in anxiety (P = 0.001), depression (P = 0.001), perceived stress (P = 0.001), and sleep quality (P = 0.001) for the REG. The CG showed decreased depression symptoms (P = 0.011) and improved sleep quality (P = 0.012). There were no significant group differences in quality-of-life outcomes (P > 0.05), though REG showed greater improvement in depression and perceived stress scores (P < 0.05).

Relaxation-based exercises can improve sleep quality in individuals experiencing post-earthquake stress, and reduce depression, anxiety, and perceived stress. This approach can be used as a novel rehabilitation model in preventive mental health for the community.

Extreme events (e.g. floods and disease outbreaks) can overwhelm healthcare workers (HCWs) and healthcare systems. During the COVID-19 pandemic, high levels of distress and mental ill health were reported by HCWs.

To examine and synthesise research findings reported in the qualitative literature regarding the stressors, and their psychosocial impacts, faced by HCWs in the UK during the COVID-19 pandemic, and to provide lessons for future support.

Qualitative articles were identified in EMBASE and OVID (preregistered on PROSPERO: CRD42022304235). Studies were required to have been published between January 2021 and January 2022 and to have examined the impact of COVID-19 on UK HCWs. We included 27 articles that represented the experiences of 2640 HCWs, assessed their quality using National Institute for Health and Care Excellence criteria and integrated their findings using thematic synthesis.

Several secondary stressors were identified, including lack of personal protective equipment, ineffective leadership and communication, high workloads and problems stemming from uncertainty and a lack of knowledge. Stressors were related to adverse psychosocial outcomes including worry, fatigue, lack of confidence in oneself and senior managers, impacts on teamwork and feeling unappreciated or that one’s needs are not recognised.

Our thematic synthesis moves beyond simply mapping stressors faced by HCWs by considering their antecedents, origins and psychosocial impacts. Utilising a theoretical framework that points towards systemic deficiencies, we argue that secondary stressors can be modified to remove their negative effects. Consequently, workforce planning should shift from focusing on individual change towards amending psychosocial environments in which HCWs work.