Self report assessment of stress perception and emotional strain in female medical students during their final exam.

<p>Graphs (a)-(f) show self-report data assessed at the following points in time (T): baseline, twelve weeks prior to the exam and before the learning period started (1); within the first and second week after the written part of the exam and before test results were released (2); and twelve weeks after the completion of the exam (3). Graph (g) shows cortisol measurements in saliva samples taken on the day prior to T2. Samples were processed to assess diurnal cortisol secretion as described below in the Materials and Methods section. (a)-(g): N = 18 in exam group, N = 15 in comparison group. Mean values and SEM are shown. Mann Whitney U tests were used to examine differences between group means at distinct points in time, Kruskal-Wallis tests with post-hoc Dunn's tests corrected for multiple comparisons to examine differences between different points in time within one group. P-values < 0.1 –one asterix in brackets, <0.05 –one asterix, < 0.01—two asterix, < 0.001—three asterix.</p

Assessment of immune mediators in female medical students during their final exam.

<p>(a)-(e): N = 18 in exam group, N = 15 in comparison group. Mann Whitney U tests were used to examine differences between group means at distinct points in time, Kruskal-Wallis tests with post-hoc Dunn's tests corrected for multiple comparisons to examine differences between different points in time within one group. Mean values and SEM are shown. P-values < 0.1 –one asterix in brackets, <0.05 –one asterix, < 0.01—two asterix.</p

Assessment of stress perception and acquisition of samples to assess biological outcomes in exam versus comparison students.

<p>Note that T2 took place within the first two weeks after the written and before the oral part of the exam. A salivary cortisol profile was obtained the day prior to T2 to confirm altered cortisol diurnal profile in the exam group. In addition to assessing subacute stress perception, participants were assessed for mental health, other parameters of psychological strain and coping/resources, to ensure good health and resourcefulness. Abbreviations: <b>COPE</b>—coping strategies, <b>DHUS</b>—Daily Hassles and Uplifts Scales (Kanner et al., 1981), <b>HADS</b>—Hospital Anxiety and Depression Scale, <b>IES</b>—Impact of Event Scale, <b>PSQ</b>—Perceived Stress Questionnaire, <b>SOMS</b>—Screening for Somatoform Symptoms, <b>TICS</b>—Trier Inventory for the Assessment of Chronic Stress.</p

Demographic and self-report mental health baseline characteristics of study participants.

<p>Demographic and self-report mental health baseline characteristics of study participants.</p