The Multitasking Framework: The Effects of Increasing Workload on Acute Psychobiological Stress Reactivity

A variety of techniques exist for eliciting acute psychological stress in the laboratory; however, they vary in terms of their ease of use, reliability to elicit consistent responses and the extent to which they represent the stressors encountered in everyday life. There is, therefore, a need to develop simple laboratory techniques that reliably elicit psychobiological stress reactivity that are representative of the types of stressors encountered in everyday life. The multitasking framework is a performance‐based, cognitively demanding stressor, representative of environments where individuals are required to attend and respond to several different stimuli simultaneously with varying levels of workload. Psychological (mood and perceived workload) and physiological (heart rate and blood pressure) stress reactivity was observed in response to a 15‐min period of multitasking at different levels of workload intensity in a sample of 20 healthy participants. Multitasking stress elicited increases in heart rate and blood pressure, and increased workload intensity elicited dose–response increases in levels of perceived workload and mood. As individuals rarely attend to single tasks in real life, the multitasking framework provides an alternative technique for modelling acute stress and workload in the laboratory. Copyright © 2013 John Wiley & Sons, Ltd.     

The shape of stress: the use of frequent sampling to measure temporal variation in S‐IgA levels during acute stress

Previous studies have indicated that statistically significant increases in Secretory immunoglobulin A (S‐IgA) can be achieved in as little as 5min as a result of mental stress. However, the temporal resolution of these changes is low and therefore the rate and pattern of changes during the stress task and during subsequent recovery is unclear. A within‐subjects design was used to examine levels of S‐IgA before, during and after a short (8 min) mental stress task. S‐IgA was measured from saliva samples obtained every 2 min during the entire 30‐min session. Significant increases in S‐IgA concentration were observed as early as the task instruction period, with additional increases during the stress task itself. The data also show a rapid recovery of S‐IgA, with a return to baseline levels within 6 min. Results suggest that S‐IgA changes can occur very rapidly and that the observed increases are short‐lived. Copyright © 2007 John Wiley & Sons, Ltd.     

Effects of motivation and workload on firefighters' perceived health,stress, and performance

This study investigated the effects of autonomous and controlled motivations, and workload on perceived stress, health, and performance. Workload was also considered as a moderator of the effects of autonomous motivation on perceived health and performance and of controlled motivation on perceived stress. We conducted an empirical study using a sample of 654 firefighters. Consistent with our predictions, results showed positive effects of autonomous motivation and negative effects of workload and controlled motivation on perceived health and performance. They also revealed positive effects of controlled motivation and workload and negative effects of autonomous motivation on perceived stress. Moreover, workload moderated the relations between autonomous motivation and perceived health and performance, so that the positive relations between autonomous motivation and perceived health and performance were lower when workload was high. Finally, workload moderated the relation between controlled motivation and perceived stress so that the positive relation between controlled motivation and perceived stress was stronger when workload was high. Theoretical contributions and perspectives, as well as implications for practice, are discussed.     

Basal SIgA and cortisol levels predict stress‐related health outcomes

The present study investigates the relationship between stress and health in young adults. We predicted that academic stressor exposure would lead to an increase in self‐reported stress and health symptoms, as well as alterations in salivary secretory immunoglobulin A (SIgA) and salivary cortisol concentration. Thirty‐four healthy participants were administered stress and health inventories and tested to assess SIgA and cortisol levels during a baseline (low‐stress) session and during an examination (high‐stress) session. Self‐report stress and health scores increased between low‐ and high‐stress sessions in all participants. Cortisol level also increased between study sessions, but only in those participants who experienced an increase in perceived stress. No changes in SIgA were observed. Multiple linear regression revealed that baseline SIgA and cortisol level moderated the relationship between stressor exposure and health outcome. Participants with low basal SIgA levels and high basal cortisol levels had poorer health outcomes during the examination session than did participants with high basal SIgA levels and low basal cortisol levels. Neither cortisol reactivity, nor SIgA reactivity moderated the relationship between stressor exposure and health outcome. These findings suggest that individual differences in basal immune and endocrine activity predict stress‐related susceptibility to ill health. Copyright © 2006 John Wiley & Sons, Ltd.     

Dispositional mindfulness is associated with heart rate reactivity and recovery in response to a lab stressor

Heightened perceived stress is consistently associated with symptoms of psychopathology. Perceived stress can be reliably linked with physiological responses, such as increased heart rate. Even though dispositional mindfulness is associated with lower self‐reported stress, no studies to date have examined whether dispositional mindfulness can predict physiological responses to and recovery from stress. We recruited 142 student participants and administered a measure of dispositional mindfulness (Five Facet Mindfulness Questionnaire—Short Form/FFMQ‐SF) and a modified version of the Trier Social Stress Test (TSST). Specifically, during the TSST, we instructed participants that they were about to deliver a presentation to a panel of judges, then informed them they no longer need to deliver this presentation, all while measuring their heart rate. We found that total FFMQ‐SF and non‐reactivity subscale scores were positively and significantly correlated with heart rate reactivity to the lab stressor. Further, we found that the FFMQ‐SF facet of non‐judgment was negatively and significantly correlated with the time it took for participants' heart rates to return to and stabilize at baseline. The results of this study elucidate potential mechanisms of mindfulness in stress. Specifically, mindfulness may not necessarily make people less reactive to stressors, but may operate through top‐down processes to enhance recovery and resilience during stress.     

Abusive Supervision and Workload Demands from Supervisors: Exploring Two Types of Supervisor‐related Stressors and their Association with Strain

Our study aimed to identify two types of stressors from supervisors: abusive supervision (AS) and workload demands from supervisors (WDS). AS reflects the relationship dimension of supervisor‐related stressors, and WDS reflects the task dimension of supervisor‐related stressors. In Study 1, we attempted to distinguish between AS and WDS. The results of confirmatory factor analysis showed that AS and WDS are two distinct dimensions of supervisor‐related stressors. In Study 2, we utilized job demands–resources model and investigated whether AS and WDS can uniquely predict subordinates' emotional exhaustion (EE). We also explored whether perceived job characteristics (PJCs) have differential moderating effects on the relationships between the two dimensions of supervisor‐related stressors (AS and WDS) and EE. Consistent with our predictions, the results showed that both AS and WDS have incremental predictive effects on EE after controlling for the effect of the other. The results also revealed that PJCs weaken the WDS–EE relationship, not the AS–EE relationship. We discussed the theoretical and practical implications at the end. Copyright © 2012 John Wiley & Sons, Ltd.     

Self-perceived work-related stress and its relation to salivary IgA, cortisol and 3-methoxy-4-hydroxyphenyl glycol levels among neonatal intensive care nurses

This study investigated self‐perceived work‐related stress, along with salivary IgA (s‐IgA), cortisol and 3‐methoxy‐4‐hydroxyphenyl glycol (MHPG) in 38 neonatal intensive care unit (NICU) nurses and 26 general ward (GW) nurses. To adjust for sociodemographic characteristics, the two groups of nurses were strictly matched for age, gender (feminine), average work experience and marital status (unmarried). General fatigue and anxiety were significantly higher, and depressive mood tended to be higher, in NICU nurses compared to GW nurses, based on Cumulative Fatigue Symptoms Index scores (p < 0.05, p < 0.05, p = 0.079, respectively). s‐IgA concentrations were also inversely correlated with self‐perceived work‐related stress and were significantly lower in NICU nurses than in GW nurses (p < 0.01). There tended to be a positive association between high cortisol concentrations and the CFSI subscale of depressive mood in both NICU and GW nurses (p = 0.053). Cortisol and MHPG levels were not different between NICU and GW nurses. These work‐related stress markers, both self‐perceived (CFSI) and biological (s‐IgAand cortisol concentrations), highlight the importance of creating and sustaining healthy work environments for NICU and GW nurses. Copyright © 2011 John Wiley & Sons, Ltd.     

A comparison of changes in secretory immunoglobulin A following a stress‐inducing and stress‐reducing task

Research suggests that the immune system may be adversely affected by chronic stress. There is some evidence that relaxation‐based practices may effect an increase in immune functioning, but recent findings suggest that acute stress may lead to similar increases. Given this, we used a counterbalanced within‐subjects design to directly compare the effects of a stressful mental arithmetic task and a relaxation‐based task on secretory immunoglobulin A (S‐IgA). Thirty participants were seen in small groups of two or three where they were administered both a mental arithmetic (stress) task and a relaxing hypnosis task. Four‐minute timed saliva samples were obtained immediately following the two experimental tasks and following two baseline periods. Results demonstrated that, compared with baseline, S‐IgA concentration and secretion rate were significantly higher following both the relaxation‐based task and stress task. Additionally, our data showed that the increases were short‐lived, decreasing significantly within 8 min following the completion of each task. Our results indicate that both stress‐reducing and stress‐inducing tasks can increase S‐IgA levels, and these results are discussed with reference to the potential differential mechanisms and clinical significance of such changes. Copyright © 2008 John Wiley & Sons, Ltd.     

Sex,stress, and health: Does stress predict health symptoms differently for the two sexes?

Objectives: Previous studies have been inconsistent with regard to the extent to which stress perception, rather than stressor exposure, predicts negative health symptoms. Because sex differences have been observed in all three of these variables, in this study the possibility that sex differences also exist in the relationships between them is investigated. Methods: Self‐report inventories of perceived stress, stressor exposure, and negative health symptoms were given to 107 young‐adult participants (65 females, 42 males). Results: Sex differences were observed in the associations among perceived stress, stressor exposure, and negative health symptom rates. Specifically, while higher perceived stress and higher stressor exposure rates independently predicted higher negative health symptoms rates in females, only higher stressor exposure rates independently predicted higher negative health symptoms in males. Indeed, unexpectedly, after controlling for exposure to stressors there was a trend towards higher perceived stress predicting lower negative health symptoms in males. Conclusions: While exposure to stress was a significant negative predictor of health for both sexes, perception of stress was predictive only for females. One implication of this finding is that different psychological models are needed to predict health symptoms in the two sexes. Copyright © 2005 John Wiley & Sons, Ltd.     

Psychophysiological response to acute‐high‐stress combat situations in professional soldiers

The study of psychophysiological responses of soldiers in combat situations remains a challenge, especially in melee combat—a close proximity unarmed fight—defined by high unpredictability. Gaining knowledge about psychophysiological changes in high‐stress situations is required to optimise training. This study aimed to analyse modifications in autonomic modulation, cortical arousal, heart rate, muscle strength, blood lactate concentration, and rating of perceived exertion of veteran soldiers in a melee combat simulation. Twenty veteran soldiers were analysed before and after a melee combat simulation in accordance with realistic situations that occur in actual operations areas. The simulation consisted of actions performed by a binomial unit in a security and protection mission in an operations area. The melee combat caused an increase in sympathetic modulation, blood lactate concentration, heart rate, muscle strength, a decreased tendency in cortical arousal, and a lower rating of perceived exertion than the organic response measured. An intense fight–flight response was observed in soldiers by the limbic system activation, causing a misinterpretation of perceived exertion. Finally, implications for the design of simulation environments for tactics training in high‐stress professions are discussed.     

Autonomic response to stress in interstitial cystitis

PURPOSE: Previous studies have documented elevations in indices of sympathetic activity in cats and humans with interstitial cystitis (IC). To examine potential autonomic dysregulation in IC we examined the effects of a laboratory mental stress challenge on blood pressure and heart rate (HR) in patients with IC and healthy controls. MATERIALS AND METHODS: A total of 14 female patients with IC and 14 age matched controls participated in a laboratory session, including a 25-minute mental stress challenge. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were measured at intervals before, during and following the stressor. The level of chronic stress, symptom severity and pain at voiding were assessed. RESULTS: Mean age was 49 years (range 32 to 66). The resting HR of patients with IC (82.02 bpm) was significantly higher than that of controls (63.31 bpm, p = 0.0001). There was also suggested evidence of elevated resting DBP in patients with IC (p = 0.07) but no significant difference in mean resting SBP. Autonomic arousal elicited by the laboratory stressor did not differ between the groups and subjects in each group perceived the task as equally stressful. Patients with IC had significantly elevated HR at each time point compared with controls (p <0.0001) with an average mean difference +/- SD between the groups of 19.5 +/- 4.0 (main effect for group p <0.0001). Although consistent increases in SBP and DBP were observed in patients after baseline, these differences were not significant. CONCLUSIONS: Patients with IC had an increased HR at baseline and throughout a laboratory mental stress challenge compared to healthy age matched women. No differences in HR or blood pressure reactivity were observed between the 2 groups.     

Perceived control and the cold pressor test

The cold pressor test was used as a stressor in 30 subjects who were randomly assigned to either a perceived control group or a group without perceived control over the stressor. Physiological response (frontalis EMG and heart rate) was measured during exposure to the stressor. The psychological aftereffects of stress were monitored with the Stroop test, which was administered following exposure to the stressor. Perceived control resulted in higher frontalis EMG during the cold pressor test. There was no significant effect of perceived control upon heart rate. Performance on three parts of the Stroop test (word, colour and colour-word cards) was superior in the group having perceived control. Perceived control had no significant effect upon any Stroop interference scores. The pattern of results suggests that perceived control increases the amount of effort expended on a task. This increased effort results in superior performance of the Stroop test when subjects have perceived control over a stressor.     

Stress‐reduction Interventions in an Australian University: A Case Study

We examined the effects of awareness of stress‐reduction interventions on employee well‐being and work attitudes using a mixed methods design. Cross‐sectional data are presented from 247 employees who completed questionnaires in 2004 at one Australian university. Analyses indicated that employees, who reported that interventions had been undertaken, scored higher on job satisfaction, affective organizational commitment, perceived procedural justice and trust in senior management than those who were not aware of the measures, although they did not differ in psychological strain. Details of the stress‐reduction interventions implemented by the Occupational Health and Safety department at the university are also reported. Thematic analyses of the perceived causes of both decreases and increases in stress for employees showed that staff reported workload and staffing pressures as key sources of increases in stress. On the other hand, new supervisors and/or management were identified as sources of decreased stress. Areas for consideration in future efforts to develop and refine stress interventions are also discussed. Copyright © 2013 John Wiley & Sons, Ltd.     

Challenge and hindrance demands lead to employees' health and behaviours through intrinsic motivation

Based on the job demand‐resource theory, this study examined the differential relationships of two types of job demands, challenge and hindrance stressors, with three outcomes: ill health, organizational citizenship behaviour, and work engagement. These relationships were mediated by two personal resources: psychological empowerment and organization‐based self‐esteem (OBSE). Data were collected at two separate points, 2 weeks apart. With 336 full‐time U.S. employees, results from path analysis indicated that the challenge stressor, workload, was positively related to psychological empowerment and OBSE, both of which were in turn positively related to good work behaviours as well as negatively related to ill health, an indication that employees experienced physical symptoms and psychological strains. In contrast, hindrance stressors (role stressors and interpersonal conflict) showed the opposite patterns of relationships with these intermediate outcomes, resulting in less empowerment and OBSE. Overall, findings suggested that psychological empowerment and OBSE were important intrinsic motivational mechanisms through which some stressors (especially hindrance demands) can promote employees' favourable work behaviours as well as alleviate the negative health outcomes.     

The influence of mindfulness and social support on stress reactivity during pregnancy

Exaggerated stress reactivity can lead to negative health outcomes, which can be especially harmful during important periods of development such as pregnancy. Therefore, studies are needed to examine potential protective factors associated with lower perceived stress reactivity and lower cortisol awakening response (CAR) during pregnancy. The current cross‐sectional study examined whether low‐income women (n = 152) with higher mindfulness (attentiveness and awareness of the present moment) and more perceived social support had lower levels of perceived stress reactivity and a lower CAR during pregnancy. Women completed self‐report measures of mindfulness (Mindful Attention Awareness Scale), social support (Medical Outcomes Study‐Social Support Scale), and perceived stress reactivity (Perceived Stress Reactivity Scale) during their first trimester of pregnancy and collected saliva using the passive drool procedure at home (at awakening and at 30 min after awakening). Results showed that women with greater mindfulness and greater perceived social support had significantly lower perceived stress reactivity, but not a lower CAR. These results provide preliminary support for mindfulness and social support as potential protective factors of perceived stress reactivity and have implications for experimental studies aimed at improving pregnant women's mindfulness and social support for reducing their stress reactivity and potentially improving health outcomes.     

A unique approach to quantifying the changing workload and case mix in laparoscopic colorectal surgery

Aim Laparoscopic colorectal surgery includes a range of operations with differing technical difficulty, and traditional parameters, such as conversion and complication rates, may not be sensitive enough to assess the complexity of these procedures. This study aims to define a reproducible and reliable tool for quantifying the total workload and the complexity of the case mix. Method This is a review of a single surgeon’s 10‐year experience. The intermediate equivalent value scoring system was used to code complexity of cases. To assess changes in the workload and case mix, the period has been divided into five phases. Results Three hundred and forty‐nine laparoscopic operations were performed, of which there were 264 (75.6%) resections. The overall conversion rate was 17.8%, with progressive improvement over the phases. Complex major operation (CMO), as defined in the British United Provident Association (BUPA) schedule of procedures, accounted for 35% of the workload. In spite of similar numbers of cases in each phase, there was a steady increase in the workload score, correlating with the increasing complexity of the case mix. There was no significant difference in the conversion and complications rates between CMO and non‐CMO. The paradoxical increase in the mean operating time with increasing experience corresponded to the progressive increase in the workload score, reflecting the increasing complexity of the case mix. Conclusion This article establishes a reliable and reproducible tool for quantifying the total laparoscopic colorectal workload of an individual surgeon or of an entire department, while at the same time providing a measure of the complexity of the case mix.     

Is there a causal relationship of anxiety,stress or cardiovascular reactivity to hypertension?

Cardiovascular responses constantly occur in the waking state, whether or not associated with perceived stress, and any type of emotional arousal similarly raises the blood pressure. Differences during all types of emotions are largely quantitative, and there does not appear to be any specificity of sympathoadrenal response to emotional stress. These responses may be physiological and homeostatic, rather than psychologically reactive and do not provide evidence to support causal roles for anxiety, stress and cardiovascular reactivity in the pathogenesis of sustained hypertension.     

Well‐being Under chronic stress: is morningness an advantage?

This study investigated whether morningness was associated with better quality of life in individuals experiencing chronic stress. Thirty‐one informal primary carers and 35 non‐carers completed self‐report measures of time‐of‐day preference, stress and well‐being. The data were collected as part of a broader study of circadian rhythmicity under conditions of prolonged stress. There was a significant interaction between diurnal preference and caregiving, with morningness associated with better well‐being outcomes in those providing long‐term home care. It appears that chronic arousal, but not perceived stress, plays a role in this morningness–carer interaction, with lower arousal levels also evident in carers with a greater preference for morningness. These results point to a possible role for circadian influences in the relationship between stress and subjective well‐being. Copyright © 2010 John Wiley & Sons, Ltd.     

Exposure to Discrimination and Heart Rate Variability Reactivity to Acute Stress among Women with Diabetes

Exposure to racial discrimination has been linked to physiological reactivity. This study investigated self‐reported exposure to racial discrimination and parasympathetic [high‐frequency heart rate variability (HF‐HRV)] and sympathetic (norepinephrine and cortisol) activity at baseline and then again after acute laboratory stress. Lifetime exposure to racial discrimination was measured with the Schedule of Racist Events scale. Thirty‐two women (16 Black and 16 White) with type 2 diabetes performed a public speaking stressor. Beat‐to‐beat intervals were recorded on electrocardiograph recorders, and HF‐HRV was calculated using spectral analysis and natural log transformed. Norepinephrine and cortisol were measured in blood. Higher discrimination predicted lower stressor HF‐HRV, even after controlling for baseline HF‐HRV. When race, age, A1c and baseline systolic blood pressure were also controlled, racial discrimination remained a significant independent predictor of stressor HF‐HRV. There was no association between lifetime discrimination and sympathetic markers. In conclusion, preliminary data suggest that among women with type 2 diabetes mellitus (T2DM), exposure to racial discrimination is adversely associated with parasympathetic, but not sympathetic, reactivity. Copyright © 2013 John Wiley & Sons, Ltd.     

Separation recall: psychophysiological response‐patterns in an attachment‐related short‐term stressor

Attachment theory is a conceptual framework for emotional‐motivational behaviour and stress regulation in social relationships. However, few experimental studies have investigated attachment‐related autonomic stress responses in adults. In a sample of 50 healthy subjects, we investigated autonomic cardiovascular reactions and subjective stress‐load to a newly developed, attachment‐related short‐term stressor (separation recall, SR). The overall magnitude of the cardiovascular response to SR was comparable to the well established mental arithmetic (MA) stress test. However, the SR induced higher levels of sadness and impaired diastolic blood pressure recovery, whereas MA was associated with higher levels of anger and greater heart rate increase. Recovery scores to the attachment‐stressor but not the mental arithmetic were related to attachment avoidance as measured by self‐report, especially when taking into account the content of the reported episodes of the SR. In sum, our newly developed attachment‐related short‐term stressor has proven good performance in a first study. Copyright © 2010 John Wiley & Sons, Ltd.