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The final chapter compares The Villages to other retirement communities, aging in place, and aging in community. Drawing on the study’s findings and the perceptions of interviewed individuals, it highlights how The Villages’ unique characteristics – including its size, innovation culture, bubble communication, opportunities for meaningful involvement, social networks, and communal coping – generally enhance residents’ well-being. The chapter also summarizes The Villages’ weaknesses and presents key takeaways about the societal meanings of its success.
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.
Objective
The objective of this study was to examine the psychometric properties of the SAI in 294 older adults.
Methods
The SAI was evaluated on its dimensionality, reliability, and validity.
Findings
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.
Discussion
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.
This study identifies P–O (person–organization) fit as a key construct affecting employee citizenship fatigue, affective commitment, and turnover intention. We use the conservation of resources theory to explain how citizenship fatigue, the unintended by-product of organizational citizenship behavior, mediates the relationship between P–O fit and key employee outcomes. The conceptual model was tested on a sample of 206 employees from the United States, obtained through a two-phase survey. The empirical results strongly suggest that citizenship fatigue mediates the relationship between P–O fit, turnover intention, and affective commitment. While P–O fit’s positive effects are well documented in organizational behavior research, this study highlights the dark side of citizenship behaviors in predicting costly individual-level and organizational consequences. We conclude by discussing some practical and theoretical implications of our research findings, while considering the relevance of stress and fatigue given the increasingly fast-paced and pluralistic work environment.
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.
Methods
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.
Results
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.
Conclusions
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.
Aims
To systematically review the literature and meta-analyse evidence on the relationship between premenstrual symptoms and stress.
Method
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.
Results
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.
Conclusions
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.
Aims
This study aimed to explore the prevalence and correlates of PGD symptom severity among 1603 bereaved Italian adults.
Method
Self-reported data on PGD, suicidal ideation, depression, anxiety and stress were gathered. Descriptive characteristics and bereavement-related information were also collected.
Results
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.
Conclusions
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.
Words in Tagalog/Filipino can be either penult-prominent or ultima-prominent. Scholars have been divided on whether the language has stress, or only phonemic vowel length in penults and default phrase-final prominence. Using a corpus of Original Pilipino Music, we find that both prominent penults and prominent ultimas are set to longer notes and stronger beats, even in phrase-medial position. We further find that among pre-tonic syllables, those that would plausibly attract secondary stress are mostly set to longer notes and stronger beats. Text-setting does not faithfully reflect differences in phonetic cues between the two types of prominence, nor is it sensitive to presumed phonetic differences between high and low vowels. We conclude that songwriters’ text-setting decisions reflect phonological stress in Filipino, and that both penult-prominent and ultima-prominent words bear stress.
Chapter 5 presents the facts concerning phonological convergence among the Balkan languages, focusing on shared processes affecting consonants and vowels, on prosodic units (including clitic behavior), on morphophonemic alternations, and on expressive uses of sounds. The vast majority of phonological Balkanisms are highly localized in nature, leading to the conclusion that we see here not Balkan phonology but rather Balkan phonologies. Despite the general inattentiveness on the part of scholars to phonology in the Balkan sprachbund, it is demonstrated here that there is robust convergence in this domain of grammar, albeit at local levels.
Accounts of prosody in understudied languages are often impressionistic, potentially leading to conflicting accounts due to different researchers being drawn to different acoustic cues. The debate surrounding the location of primary stress in Plains Cree is such a case. One widely adopted claim states that stress is realized on the antepenult, whereas others argue for a penultimate accent. The present study investigates the phonetic properties of stress (duration, F0, intensity, vowel quality) in multisyllabic words and in phrases to understand the patterns that have led to the current debate. We find that there are cues supporting both previous claims: a high F0 on the antepenultimate syllable compatible with “antepenultimate stress” and a falling F0 on the penultimate syllable compatible with “penultimate accent.” Based on the acoustic evidence, we suggest that Plains Cree is a pitch-accent system, with a predictable penultimate HL word-level pitch-accent. Tonal patterns in other syllables are the result of prosodic boundaries, phonetic interpolation, or tonal spreading.
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.
Design:
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.
Setting:
Online survey.
Participants:
1630 U.S. young adults.
Results:
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.
Conclusion:
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.
Describe different types of memory and how they develop; explain how early experiences are remembered and why they are forgotten; understand why a limited memory can be beneficial for learning.
Describe the mix of emotions and attitudes adolescents have towards themselves and their lives; understand the factors that cause unhappiness as well as those that promote well-being and buffer against adversity; evaluate the emotional opportunities and risks of adolescence.
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.
Aims
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.
Method
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.
Results
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.
Conclusions
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.
Methods
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.
Results
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).
Conclusions
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.
Aims
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.
Method
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.
Results
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.
Conclusions
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.
The chapter introduces in a unified manner all ferroic materials including the three main ferroic systems, namely ferromagnetic, ferroelectric and ferroelastic, in addition to the case of materials that can display ferrotoroidic order. General physical aspects of magnetism, electricity and elasticity are used in order to introduce the order parameters that conveniently describe all these classes of ferroic phase transitions. It is shown that while the order parameter has a vectorial nature for ferromagnetic (axial vector), ferroelectric (polar vector) and magnetic ferrotoroidal (axial vector) systems, it is a rank-2 polar tensor in ferroelastic materials. The resulting physical differences arising from the different nature of the order parameter are then analysed in detail. Next, it is shown how to construct a convenient Ginszburg–Landau free energy functional in terms of these order parameters and their coupling for the different ferroic systems besides how to obtain the corresponding phase diagrams and microstructural features.
Acknowledging the impact of chronic kidney disease on caregivers’ quality of life (QoL) and psychological well-being has become a global priority, highlighting the need for supportive interventions specifically aimed at caregivers.
Aims
This study aimed to assess the prevalence of stress, anxiety and depression among family caregivers of Omani patients undergoing haemodialysis and to explore its association with QoL.
Method
The study employed a cross-sectional design. A sample of 326 participants completed the study’s surveys, including the Depression Anxiety Stress Scale, WHOQOL-BREF scale and a demographic scale.
Results
The survey indicated that 68.4% of the participant caregivers experienced varying degrees of depression. In addition, 48.4% of caregivers reported experiencing stress levels ranging from mild to extremely severe. For anxiety, 65.6% (n = 214) of caregivers noted varying levels, from mild to extremely severe anxiety. Significant negative associations were found among caregiver age, number of chronic illnesses, number of medications, daily hours spent on caregiving, physical health, stress, anxiety and depression, on the one hand, and the physical domain of QoL, on the other hand. Regarding the psychological domain of QoL, significant negative associations were observed with daily caregiving hours, physical health, stress, anxiety and depression.
Conclusion
This study highlights the significant psychological burden faced by caregivers of patients undergoing haemodialysis. Systematic screening and practical interventions, such as support groups and mental health programmes, are essential to improve caregiver well-being. Future research should explore the effectiveness of these interventions and the long-term impact of caregiving.
Although adverse childhood experiences (ACEs) are commonly associated with depressive symptoms in adulthood, studies frequently collapse ACEs into a single unitary index, making it difficult to identify specific targets for intervention and prevention. Furthermore, studies rarely explore sex differences in this area despite males and females often differing in the experiences of ACEs, depressive symptoms, and inflammatory activity. To address these issues, we used data from the National Longitudinal Study of Adolescent to Adult Health to model the effects of 10 different ACEs on C-reactive protein (CRP) and depressive symptoms in adulthood. Path modeling was used to measure the effects of ACEs on CRP and depressive symptoms conjointly while also assigning covariances among ACEs to assess their interrelations. Sex-by-ACE interaction terms and sex-disaggregated models were used to test for potential differences. Emotional abuse and parental incarceration were consistently related to both CRP and depressive symptoms for males and females. Childhood maltreatment was associated with depressive symptoms for females, whereas sexual abuse was associated with inflammation for males. Several covariances among ACEs were identified, indicating potential networks through which ACEs are indirectly associated with CRP and depressive symptoms. These data demonstrate that ACEs have differing direct effects on CRP and depressive symptoms – and that they differ with respect to how they cluster – for males versus females. These differences should be considered in theory and clinical workflows aiming to understand, treat, and prevent the long-term impacts of ACEs on depressive symptoms and inflammation-related health conditions in adulthood.
Syllable integrity, the idea that the content of syllables may not be metrified separately, is often taken to be an inviolable constraint of grammar. This has been challenged in recent work, though the data are often subject to competing analyses. This article claims that syllable integrity is readily violable in Naasioi. Evidence from stress, the minimal word and metrically sensitive allomorphy supports an analysis of the metrical system operating on bimoraic feet, and in which long vowels can be metrified separately. Despite this, there is also evidence, in the form of vowel shortening and truncation, to indicate that long vowels constitute a single syllable. The net result is a stress system which systematically ignores syllables, a state of affairs which allows for syllable integrity violations to arise.