A guided, internet-based stress management intervention for university students with high levels of stress:Feasibility and acceptability study

BackgroundTransitioning to adulthood and challenges in university life can result in increased stress levels among university students. Chronic and severe stress is associated with deleterious psychological and physiological effects. Digital interventions could succeed in approaching and helping university students who might be at risk; however, the experiences of students with internet-based stress management interventions are insufficiently understood.ObjectiveThis study aims to explore the feasibility; acceptability; and changes in perceived stress, depressive symptoms, and quality of life from baseline to posttest assessment of a 5-session, internet-based stress management intervention guided by an e-coach, developed for university students experiencing high levels of stress.MethodsA single-arm study was conducted. Students were recruited from different channels, mainly from a web survey. Students were eligible if they (1) scored ≥20 on the Perceived Stress Scale-10, (2) were aged ≥18 years, and (3) were studying at one of the participating universities. Feasibility and acceptability of the intervention were investigated using several indications, including satisfaction (Client Satisfaction Questionnaire-8) and usability (System Usability Scale-10). We also investigated the indicators of intervention adherence using use metrics (eg, the number of completed sessions). Our secondary goal was to explore the changes in perceived stress (Perceived Stress Scale-10), depressive symptoms (Patient Health Questionnaire-9), and quality of life (EQ-5D-5L scale) from baseline to posttest assessment. In addition, we conducted semistructured interviews with intervention completers and noncompleters to understand user experiences in depth. For all primary outcomes, descriptive statistics were calculated. Changes from baseline to posttest assessment were examined using 2-tailed paired sample t tests or the Wilcoxon signed rank test. Qualitative data were analyzed using thematic analysis.ResultsOf 436 eligible students, 307 (70.4%) students started using the intervention. Overall, 25.7% (79/307) completed the core sessions (ie, sessions 1-3) and posttest assessment. A substantial proportion of the students (228/307, 74.3%) did not complete the core sessions or the posttest assessment. Students who completed the core sessions reported high satisfaction (mean 25.78, SD 3.30) and high usability of the intervention (mean 86.01, SD 10.25). Moreover, this group showed large reductions in perceived stress (Cohen d=0.80) and moderate improvements in depression score (Cohen d=0.47) and quality of life (Cohen d=-0.35) from baseline to posttest assessment. Qualitative findings highlight that several personal and intervention-related factors play a role in user experience.ConclusionsThe internet-based stress management intervention seems to be feasible, acceptable, and possibly effective for some university students with elevated stress levels. However, given the high dropout rate and qualitative findings, several adjustments in the content and features of the intervention are needed to maximize the user experience and the impact of the intervention.Trial Registration: Netherlands Trial Register 8686; https://onderzoekmetmensen.nl/nl/trial/20889.International Registered Report Identifier (IRRID): RR2-10.1016/j.invent.2021.100369.</p

A tangled start:The link between childhood maltreatment, psychopathology, and relationships in adulthood

Background: Adults with a history of childhood maltreatment are more likely to experience distrust, feel distant from others, and develop an insecure attachment style which may also affect relationship quality. Furthermore, childhood maltreatment has been linked to several mental health problems; including, depression, anxiety, and alcohol dependance severity, that are also known to relationship quality. Objective: The current study was designed to investigate to what extent childhood maltreatment is associated with adult insecure attachment and intimate relationships and whether this association is mediated by psychopathology. Participants and Method: In a study comprised of 2035 adults aged 18-65, we investigated whether childhood maltreatment was associated with insecure adult attachment styles and the quality of intimate relationships and whether this was mediated by depression, anxiety, and alcohol dependence severity (based on repeated assessments of the Inventory of Depressive Symptomatology-Self Report, Beck Anxiety Index, and Alcohol Use Disorders Identification Test respectively). Results: The path model showed an acceptable fit, RMSEA = 0.05, and suggested full mediation of the association of childhood maltreatment with quality of intimate relationships by depression severity and a) anxious attachment (13 = -4.0 * 10-2; 95% CI = -5.5 * 10-2, -2.7 * 10-2) and b) avoidant attachment (13 = -7.2 * 10-2; 95% CI = -9.6 * 10-2, -4.9 * 10-2). Anxiety and alcohol dependence severity were not significant mediators. Conclusions: Childhood maltreatment is associated with a lower quality of intimate relationships, which is fully mediated by depression severity and insecure attachment styles.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Prediction of Mental Health Services Use One Year After Regular Referral to Specialized Care Versus Referral to Stepped Collaborative Care

FSW - Self-regulation models for health behavior and psychopathology - ou

Collaborative mental health care versus care as usual in a primary care setting: A randomized controlled trial.

De samenhang tussen somatische en psychische (dys)functie

Cognitive-behavioural intervention for self-harm: randomised controlled trial.

FSW - Self-regulation models for health behavior and Psychopathology - Ou

Self-reported personality traits in forensic populations: a meta-analysis

FSW - Self-regulation models for health behavior and psychopathology - ou

The endorsement of dysfunctional attitudes is associated with an impaired retrieval of specific autobiographical memories in response to matching cues

Two studies investigated a hypothesis of Dalgleish et al. (2003) that overgeneral memory may arise from matching between task cues and dysfunctional attitudes or schemas. In the first study, 111 euthymic patients with at least two previous major depressive episodes completed the Dysfunctional Attitude Scale: Form A (DAS-A) and the Autobiographical Memory Test (AMT). In the second study, 82 patients with a borderline personality disorder completed the Young Schema Questionnaire (YSQ) and the same version of the AMT. In both studies, patients retrieved less specific autobiographical memories in response to cue words that matched highly endorsed attitudes or schemas. These results suggest that an impaired retrieval of specific memories may be the result of certain cues activating generic, higher-order mental representations

Prevalence of anxiety disorders and subthreshold anxiety throughout later life: systematic review and meta-analysis

This systematic review and meta-analysis compared prevalence rates for subthreshold anxiety and anxiety disorders in adults aged 55 degrees and examined if these rates were associated with age. A systematic search and screening procedure resulted in 46 included articles. First, prevalence rates for subthreshold anxiety and anxiety disorders were statistically compared. Subthreshold panic, generalized anxiety and specific phobia were significantly more prevalent than the corresponding clinical disorders. In general, subthreshold anxiety appeared to be at least similarly prevalent to anxiety disorders, although firm conclusions are precluded due to the small number of samples that could be included in the analyses and the large heterogeneity between the reported prevalence rates. Second, using subgroup analyses, pooled prevalence rates for four age groups of older adults (55-64, 65-74, 75-84, 85 degrees) were compared. For specific phobia, the 75-84 and 85 degrees groups had significantly lower prevalence rates than the 55-64 and 65-74 groups. Posttraumatic stress disorder was significantly more prevalent in the 55-64 group than in the other age groups, and lowest in the 85 degrees group. No other significant differences between age groups were found. The association between later life subthreshold anxiety and age could not be examined due to a lack of reported information. The main limitation of this study is the small number of samples in the analyses, which limits their power and generalizability.Stress and Psychopatholog

Septic Thrombophlebitis of the Right Ovarian Vein

Background: A 26-year-old woman presented at the emergency department with a painful abdomen and fever up to 39°C, despite antibiotics. She had given prematurely birth by caesarian section to a twin 8 days earlier. On clinical examination she had a diffuse painful and tender abdomen, especially on the right side and suprapubic region. Laboratory findings showed an increased c-reactive protein of 24 mg/dL (normal < 0,3) and increased white blood cell count of 13 Å~ 10E9/L (normal 4,3-10 Å~ 10E9/L). There was also a decreased hemoglobin level of 8,4 g/dL (normal 12-15 g/dL). An ultrasonography was performed by the gynecologist and revealed a large heterogeneous fluid collection anteriorly of the uterus