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Research Article

Anxiety, Affect, Self-Esteem, and Stress: Mediation and Moderation Effects on Depression

Affiliations Department of Psychology, University of Gothenburg, Gothenburg, Sweden, Network for Empowerment and Well-Being, University of Gothenburg, Gothenburg, Sweden

Affiliation Network for Empowerment and Well-Being, University of Gothenburg, Gothenburg, Sweden

Affiliations Department of Psychology, University of Gothenburg, Gothenburg, Sweden, Network for Empowerment and Well-Being, University of Gothenburg, Gothenburg, Sweden, Department of Psychology, Education and Sport Science, Linneaus University, Kalmar, Sweden

* E-mail: [email protected]

Affiliations Network for Empowerment and Well-Being, University of Gothenburg, Gothenburg, Sweden, Center for Ethics, Law, and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

• Ali Al Nima, 
• Patricia Rosenberg, 
• Trevor Archer, 
• Danilo Garcia

• Published: September 9, 2013
• https://doi.org/10.1371/journal.pone.0073265
• Reader Comments

23 Sep 2013: Nima AA, Rosenberg P, Archer T, Garcia D (2013) Correction: Anxiety, Affect, Self-Esteem, and Stress: Mediation and Moderation Effects on Depression. PLOS ONE 8(9): 10.1371/annotation/49e2c5c8-e8a8-4011-80fc-02c6724b2acc. https://doi.org/10.1371/annotation/49e2c5c8-e8a8-4011-80fc-02c6724b2acc View correction

Mediation analysis investigates whether a variable (i.e., mediator) changes in regard to an independent variable, in turn, affecting a dependent variable. Moderation analysis, on the other hand, investigates whether the statistical interaction between independent variables predict a dependent variable. Although this difference between these two types of analysis is explicit in current literature, there is still confusion with regard to the mediating and moderating effects of different variables on depression. The purpose of this study was to assess the mediating and moderating effects of anxiety, stress, positive affect, and negative affect on depression.

Two hundred and two university students (males  = 93, females  = 113) completed questionnaires assessing anxiety, stress, self-esteem, positive and negative affect, and depression. Mediation and moderation analyses were conducted using techniques based on standard multiple regression and hierarchical regression analyses.

Main Findings

The results indicated that (i) anxiety partially mediated the effects of both stress and self-esteem upon depression, (ii) that stress partially mediated the effects of anxiety and positive affect upon depression, (iii) that stress completely mediated the effects of self-esteem on depression, and (iv) that there was a significant interaction between stress and negative affect, and between positive affect and negative affect upon depression.

The study highlights different research questions that can be investigated depending on whether researchers decide to use the same variables as mediators and/or moderators.

Citation: Nima AA, Rosenberg P, Archer T, Garcia D (2013) Anxiety, Affect, Self-Esteem, and Stress: Mediation and Moderation Effects on Depression. PLoS ONE 8(9): e73265. https://doi.org/10.1371/journal.pone.0073265

Editor: Ben J. Harrison, The University of Melbourne, Australia

Received: February 21, 2013; Accepted: July 22, 2013; Published: September 9, 2013

Copyright: © 2013 Nima et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: The authors have no support or funding to report.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Mediation refers to the covariance relationships among three variables: an independent variable (1), an assumed mediating variable (2), and a dependent variable (3). Mediation analysis investigates whether the mediating variable accounts for a significant amount of the shared variance between the independent and the dependent variables–the mediator changes in regard to the independent variable, in turn, affecting the dependent one [1] , [2] . On the other hand, moderation refers to the examination of the statistical interaction between independent variables in predicting a dependent variable [1] , [3] . In contrast to the mediator, the moderator is not expected to be correlated with both the independent and the dependent variable–Baron and Kenny [1] actually recommend that it is best if the moderator is not correlated with the independent variable and if the moderator is relatively stable, like a demographic variable (e.g., gender, socio-economic status) or a personality trait (e.g., affectivity).

Although both types of analysis lead to different conclusions [3] and the distinction between statistical procedures is part of the current literature [2] , there is still confusion about the use of moderation and mediation analyses using data pertaining to the prediction of depression. There are, for example, contradictions among studies that investigate mediating and moderating effects of anxiety, stress, self-esteem, and affect on depression. Depression, anxiety and stress are suggested to influence individuals' social relations and activities, work, and studies, as well as compromising decision-making and coping strategies [4] , [5] , [6] . Successfully coping with anxiety, depressiveness, and stressful situations may contribute to high levels of self-esteem and self-confidence, in addition increasing well-being, and psychological and physical health [6] . Thus, it is important to disentangle how these variables are related to each other. However, while some researchers perform mediation analysis with some of the variables mentioned here, other researchers conduct moderation analysis with the same variables. Seldom are both moderation and mediation performed on the same dataset. Before disentangling mediation and moderation effects on depression in the current literature, we briefly present the methodology behind the analysis performed in this study.

Mediation and moderation

Baron and Kenny [1] postulated several criteria for the analysis of a mediating effect: a significant correlation between the independent and the dependent variable, the independent variable must be significantly associated with the mediator, the mediator predicts the dependent variable even when the independent variable is controlled for, and the correlation between the independent and the dependent variable must be eliminated or reduced when the mediator is controlled for. All the criteria is then tested using the Sobel test which shows whether indirect effects are significant or not [1] , [7] . A complete mediating effect occurs when the correlation between the independent and the dependent variable are eliminated when the mediator is controlled for [8] . Analyses of mediation can, for example, help researchers to move beyond answering if high levels of stress lead to high levels of depression. With mediation analysis researchers might instead answer how stress is related to depression.

In contrast to mediation, moderation investigates the unique conditions under which two variables are related [3] . The third variable here, the moderator, is not an intermediate variable in the causal sequence from the independent to the dependent variable. For the analysis of moderation effects, the relation between the independent and dependent variable must be different at different levels of the moderator [3] . Moderators are included in the statistical analysis as an interaction term [1] . When analyzing moderating effects the variables should first be centered (i.e., calculating the mean to become 0 and the standard deviation to become 1) in order to avoid problems with multi-colinearity [8] . Moderating effects can be calculated using multiple hierarchical linear regressions whereby main effects are presented in the first step and interactions in the second step [1] . Analysis of moderation, for example, helps researchers to answer when or under which conditions stress is related to depression.

Mediation and moderation effects on depression

Cognitive vulnerability models suggest that maladaptive self-schema mirroring helplessness and low self-esteem explain the development and maintenance of depression (for a review see [9] ). These cognitive vulnerability factors become activated by negative life events or negative moods [10] and are suggested to interact with environmental stressors to increase risk for depression and other emotional disorders [11] , [10] . In this line of thinking, the experience of stress, low self-esteem, and negative emotions can cause depression, but also be used to explain how (i.e., mediation) and under which conditions (i.e., moderation) specific variables influence depression.

Using mediational analyses to investigate how cognitive therapy intervations reduced depression, researchers have showed that the intervention reduced anxiety, which in turn was responsible for 91% of the reduction in depression [12] . In the same study, reductions in depression, by the intervention, accounted only for 6% of the reduction in anxiety. Thus, anxiety seems to affect depression more than depression affects anxiety and, together with stress, is both a cause of and a powerful mediator influencing depression (See also [13] ). Indeed, there are positive relationships between depression, anxiety and stress in different cultures [14] . Moreover, while some studies show that stress (independent variable) increases anxiety (mediator), which in turn increased depression (dependent variable) [14] , other studies show that stress (moderator) interacts with maladaptive self-schemata (dependent variable) to increase depression (independent variable) [15] , [16] .

The present study

In order to illustrate how mediation and moderation can be used to address different research questions we first focus our attention to anxiety and stress as mediators of different variables that earlier have been shown to be related to depression. Secondly, we use all variables to find which of these variables moderate the effects on depression.

The specific aims of the present study were:

• To investigate if anxiety mediated the effect of stress, self-esteem, and affect on depression.
• To investigate if stress mediated the effects of anxiety, self-esteem, and affect on depression.
• To examine moderation effects between anxiety, stress, self-esteem, and affect on depression.

Ethics statement

This research protocol was approved by the Ethics Committee of the University of Gothenburg and written informed consent was obtained from all the study participants.

Participants

The present study was based upon a sample of 206 participants (males  = 93, females  = 113). All the participants were first year students in different disciplines at two universities in South Sweden. The mean age for the male students was 25.93 years ( SD  = 6.66), and 25.30 years ( SD  = 5.83) for the female students.

In total, 206 questionnaires were distributed to the students. Together 202 questionnaires were responded to leaving a total dropout of 1.94%. This dropout concerned three sections that the participants chose not to respond to at all, and one section that was completed incorrectly. None of these four questionnaires was included in the analyses.

Instruments

Hospital anxiety and depression scale [17] ..

The Swedish translation of this instrument [18] was used to measure anxiety and depression. The instrument consists of 14 statements (7 of which measure depression and 7 measure anxiety) to which participants are asked to respond grade of agreement on a Likert scale (0 to 3). The utility, reliability and validity of the instrument has been shown in multiple studies (e.g., [19] ).

Perceived Stress Scale [20] .

The Swedish version [21] of this instrument was used to measures individuals' experience of stress. The instrument consist of 14 statements to which participants rate on a Likert scale (0 =  never , 4 =  very often ). High values indicate that the individual expresses a high degree of stress.

Rosenberg's Self-Esteem Scale [22] .

The Rosenberg's Self-Esteem Scale (Swedish version by Lindwall [23] ) consists of 10 statements focusing on general feelings toward the self. Participants are asked to report grade of agreement in a four-point Likert scale (1 =  agree not at all, 4 =  agree completely ). This is the most widely used instrument for estimation of self-esteem with high levels of reliability and validity (e.g., [24] , [25] ).

Positive Affect and Negative Affect Schedule [26] .

This is a widely applied instrument for measuring individuals' self-reported mood and feelings. The Swedish version has been used among participants of different ages and occupations (e.g., [27] , [28] , [29] ). The instrument consists of 20 adjectives, 10 positive affect (e.g., proud, strong) and 10 negative affect (e.g., afraid, irritable). The adjectives are rated on a five-point Likert scale (1 =  not at all , 5 =  very much ). The instrument is a reliable, valid, and effective self-report instrument for estimating these two important and independent aspects of mood [26] .

Questionnaires were distributed to the participants on several different locations within the university, including the library and lecture halls. Participants were asked to complete the questionnaire after being informed about the purpose and duration (10–15 minutes) of the study. Participants were also ensured complete anonymity and informed that they could end their participation whenever they liked.

Correlational analysis

Depression showed positive, significant relationships with anxiety, stress and negative affect. Table 1 presents the correlation coefficients, mean values and standard deviations ( sd ), as well as Cronbach ' s α for all the variables in the study.

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https://doi.org/10.1371/journal.pone.0073265.t001

Mediation analysis

Regression analyses were performed in order to investigate if anxiety mediated the effect of stress, self-esteem, and affect on depression (aim 1). The first regression showed that stress ( B  = .03, 95% CI [.02,.05], β = .36, t  = 4.32, p <.001), self-esteem ( B  = −.03, 95% CI [−.05, −.01], β = −.24, t  = −3.20, p <.001), and positive affect ( B  = −.02, 95% CI [−.05, −.01], β = −.19, t  = −2.93, p  = .004) had each an unique effect on depression. Surprisingly, negative affect did not predict depression ( p  = 0.77) and was therefore removed from the mediation model, thus not included in further analysis.

The second regression tested whether stress, self-esteem and positive affect uniquely predicted the mediator (i.e., anxiety). Stress was found to be positively associated ( B  = .21, 95% CI [.15,.27], β = .47, t  = 7.35, p <.001), whereas self-esteem was negatively associated ( B  = −.29, 95% CI [−.38, −.21], β = −.42, t  = −6.48, p <.001) to anxiety. Positive affect, however, was not associated to anxiety ( p  = .50) and was therefore removed from further analysis.

A hierarchical regression analysis using depression as the outcome variable was performed using stress and self-esteem as predictors in the first step, and anxiety as predictor in the second step. This analysis allows the examination of whether stress and self-esteem predict depression and if this relation is weaken in the presence of anxiety as the mediator. The result indicated that, in the first step, both stress ( B  = .04, 95% CI [.03,.05], β = .45, t  = 6.43, p <.001) and self-esteem ( B  = .04, 95% CI [.03,.05], β = .45, t  = 6.43, p <.001) predicted depression. When anxiety (i.e., the mediator) was controlled for predictability was reduced somewhat but was still significant for stress ( B  = .03, 95% CI [.02,.04], β = .33, t  = 4.29, p <.001) and for self-esteem ( B  = −.03, 95% CI [−.05, −.01], β = −.20, t  = −2.62, p  = .009). Anxiety, as a mediator, predicted depression even when both stress and self-esteem were controlled for ( B  = .05, 95% CI [.02,.08], β = .26, t  = 3.17, p  = .002). Anxiety improved the prediction of depression over-and-above the independent variables (i.e., stress and self-esteem) (Δ R 2  = .03, F (1, 198) = 10.06, p  = .002). See Table 2 for the details.

https://doi.org/10.1371/journal.pone.0073265.t002

A Sobel test was conducted to test the mediating criteria and to assess whether indirect effects were significant or not. The result showed that the complete pathway from stress (independent variable) to anxiety (mediator) to depression (dependent variable) was significant ( z  = 2.89, p  = .003). The complete pathway from self-esteem (independent variable) to anxiety (mediator) to depression (dependent variable) was also significant ( z  = 2.82, p  = .004). Thus, indicating that anxiety partially mediates the effects of both stress and self-esteem on depression. This result may indicate also that both stress and self-esteem contribute directly to explain the variation in depression and indirectly via experienced level of anxiety (see Figure 1 ).

Changes in Beta weights when the mediator is present are highlighted in red.

https://doi.org/10.1371/journal.pone.0073265.g001

For the second aim, regression analyses were performed in order to test if stress mediated the effect of anxiety, self-esteem, and affect on depression. The first regression showed that anxiety ( B  = .07, 95% CI [.04,.10], β = .37, t  = 4.57, p <.001), self-esteem ( B  = −.02, 95% CI [−.05, −.01], β = −.18, t  = −2.23, p  = .03), and positive affect ( B  = −.03, 95% CI [−.04, −.02], β = −.27, t  = −4.35, p <.001) predicted depression independently of each other. Negative affect did not predict depression ( p  = 0.74) and was therefore removed from further analysis.

The second regression investigated if anxiety, self-esteem and positive affect uniquely predicted the mediator (i.e., stress). Stress was positively associated to anxiety ( B  = 1.01, 95% CI [.75, 1.30], β = .46, t  = 7.35, p <.001), negatively associated to self-esteem ( B  = −.30, 95% CI [−.50, −.01], β = −.19, t  = −2.90, p  = .004), and a negatively associated to positive affect ( B  = −.33, 95% CI [−.46, −.20], β = −.27, t  = −5.02, p <.001).

A hierarchical regression analysis using depression as the outcome and anxiety, self-esteem, and positive affect as the predictors in the first step, and stress as the predictor in the second step, allowed the examination of whether anxiety, self-esteem and positive affect predicted depression and if this association would weaken when stress (i.e., the mediator) was present. In the first step of the regression anxiety ( B  = .07, 95% CI [.05,.10], β = .38, t  = 5.31, p  = .02), self-esteem ( B  = −.03, 95% CI [−.05, −.01], β = −.18, t  = −2.41, p  = .02), and positive affect ( B  = −.03, 95% CI [−.04, −.02], β = −.27, t  = −4.36, p <.001) significantly explained depression. When stress (i.e., the mediator) was controlled for, predictability was reduced somewhat but was still significant for anxiety ( B  = .05, 95% CI [.02,.08], β = .05, t  = 4.29, p <.001) and for positive affect ( B  = −.02, 95% CI [−.04, −.01], β = −.20, t  = −3.16, p  = .002), whereas self-esteem did not reach significance ( p < = .08). In the second step, the mediator (i.e., stress) predicted depression even when anxiety, self-esteem, and positive affect were controlled for ( B  = .02, 95% CI [.08,.04], β = .25, t  = 3.07, p  = .002). Stress improved the prediction of depression over-and-above the independent variables (i.e., anxiety, self-esteem and positive affect) (Δ R 2  = .02, F (1, 197)  = 9.40, p  = .002). See Table 3 for the details.

https://doi.org/10.1371/journal.pone.0073265.t003

Furthermore, the Sobel test indicated that the complete pathways from the independent variables (anxiety: z  = 2.81, p  = .004; self-esteem: z  =  2.05, p  = .04; positive affect: z  = 2.58, p <.01) to the mediator (i.e., stress), to the outcome (i.e., depression) were significant. These specific results might be explained on the basis that stress partially mediated the effects of both anxiety and positive affect on depression while stress completely mediated the effects of self-esteem on depression. In other words, anxiety and positive affect contributed directly to explain the variation in depression and indirectly via the experienced level of stress. Self-esteem contributed only indirectly via the experienced level of stress to explain the variation in depression. In other words, stress effects on depression originate from “its own power” and explained more of the variation in depression than self-esteem (see Figure 2 ).

https://doi.org/10.1371/journal.pone.0073265.g002

Moderation analysis

Multiple linear regression analyses were used in order to examine moderation effects between anxiety, stress, self-esteem and affect on depression. The analysis indicated that about 52% of the variation in the dependent variable (i.e., depression) could be explained by the main effects and the interaction effects ( R 2  = .55, adjusted R 2  = .51, F (55, 186)  = 14.87, p <.001). When the variables (dependent and independent) were standardized, both the standardized regression coefficients beta (β) and the unstandardized regression coefficients beta (B) became the same value with regard to the main effects. Three of the main effects were significant and contributed uniquely to high levels of depression: anxiety ( B  = .26, t  = 3.12, p  = .002), stress ( B  = .25, t  = 2.86, p  = .005), and self-esteem ( B  = −.17, t  = −2.17, p  = .03). The main effect of positive affect was also significant and contributed to low levels of depression ( B  = −.16, t  = −2.027, p  = .02) (see Figure 3 ). Furthermore, the results indicated that two moderator effects were significant. These were the interaction between stress and negative affect ( B  = −.28, β = −.39, t  = −2.36, p  = .02) (see Figure 4 ) and the interaction between positive affect and negative affect ( B  = −.21, β = −.29, t  = −2.30, p  = .02) ( Figure 5 ).

https://doi.org/10.1371/journal.pone.0073265.g003

Low stress and low negative affect leads to lower levels of depression compared to high stress and high negative affect.

https://doi.org/10.1371/journal.pone.0073265.g004

High positive affect and low negative affect lead to lower levels of depression compared to low positive affect and high negative affect.

https://doi.org/10.1371/journal.pone.0073265.g005

The results in the present study show that (i) anxiety partially mediated the effects of both stress and self-esteem on depression, (ii) that stress partially mediated the effects of anxiety and positive affect on depression, (iii) that stress completely mediated the effects of self-esteem on depression, and (iv) that there was a significant interaction between stress and negative affect, and positive affect and negative affect on depression.

Mediating effects

The study suggests that anxiety contributes directly to explaining the variance in depression while stress and self-esteem might contribute directly to explaining the variance in depression and indirectly by increasing feelings of anxiety. Indeed, individuals who experience stress over a long period of time are susceptible to increased anxiety and depression [30] , [31] and previous research shows that high self-esteem seems to buffer against anxiety and depression [32] , [33] . The study also showed that stress partially mediated the effects of both anxiety and positive affect on depression and that stress completely mediated the effects of self-esteem on depression. Anxiety and positive affect contributed directly to explain the variation in depression and indirectly to the experienced level of stress. Self-esteem contributed only indirectly via the experienced level of stress to explain the variation in depression, i.e. stress affects depression on the basis of ‘its own power’ and explains much more of the variation in depressive experiences than self-esteem. In general, individuals who experience low anxiety and frequently experience positive affect seem to experience low stress, which might reduce their levels of depression. Academic stress, for instance, may increase the risk for experiencing depression among students [34] . Although self-esteem did not emerged as an important variable here, under circumstances in which difficulties in life become chronic, some researchers suggest that low self-esteem facilitates the experience of stress [35] .

Moderator effects/interaction effects

The present study showed that the interaction between stress and negative affect and between positive and negative affect influenced self-reported depression symptoms. Moderation effects between stress and negative affect imply that the students experiencing low levels of stress and low negative affect reported lower levels of depression than those who experience high levels of stress and high negative affect. This result confirms earlier findings that underline the strong positive association between negative affect and both stress and depression [36] , [37] . Nevertheless, negative affect by itself did not predicted depression. In this regard, it is important to point out that the absence of positive emotions is a better predictor of morbidity than the presence of negative emotions [38] , [39] . A modification to this statement, as illustrated by the results discussed next, could be that the presence of negative emotions in conjunction with the absence of positive emotions increases morbidity.

The moderating effects between positive and negative affect on the experience of depression imply that the students experiencing high levels of positive affect and low levels of negative affect reported lower levels of depression than those who experience low levels of positive affect and high levels of negative affect. This result fits previous observations indicating that different combinations of these affect dimensions are related to different measures of physical and mental health and well-being, such as, blood pressure, depression, quality of sleep, anxiety, life satisfaction, psychological well-being, and self-regulation [40] – [51] .

Limitations

The result indicated a relatively low mean value for depression ( M  = 3.69), perhaps because the studied population was university students. These might limit the generalization power of the results and might also explain why negative affect, commonly associated to depression, was not related to depression in the present study. Moreover, there is a potential influence of single source/single method variance on the findings, especially given the high correlation between all the variables under examination.

Conclusions

The present study highlights different results that could be arrived depending on whether researchers decide to use variables as mediators or moderators. For example, when using meditational analyses, anxiety and stress seem to be important factors that explain how the different variables used here influence depression–increases in anxiety and stress by any other factor seem to lead to increases in depression. In contrast, when moderation analyses were used, the interaction of stress and affect predicted depression and the interaction of both affectivity dimensions (i.e., positive and negative affect) also predicted depression–stress might increase depression under the condition that the individual is high in negative affectivity, in turn, negative affectivity might increase depression under the condition that the individual experiences low positive affectivity.

Acknowledgments

The authors would like to thank the reviewers for their openness and suggestions, which significantly improved the article.

Author Contributions

Conceived and designed the experiments: AAN TA. Performed the experiments: AAN. Analyzed the data: AAN DG. Contributed reagents/materials/analysis tools: AAN TA DG. Wrote the paper: AAN PR TA DG.

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Psychological and biological resilience modulates the effects of stress on epigenetic aging

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Our society is experiencing more stress than ever before, leading to both negative psychiatric and physical outcomes. Chronic stress is linked to negative long-term health consequences, raising the possibility that stress is related to accelerated aging. In this study, we examine whether resilience factors affect stress-associated biological age acceleration. Recently developed “epigenetic clocks” such as GrimAge have shown utility in predicting biological age and mortality. Here, we assessed the impact of cumulative stress, stress physiology, and resilience on accelerated aging in a community sample ( N  = 444). Cumulative stress was associated with accelerated GrimAge ( P  = 0.0388) and stress-related physiologic measures of adrenal sensitivity (Cortisol/ACTH ratio) and insulin resistance (HOMA). After controlling for demographic and behavioral factors, HOMA correlated with accelerated GrimAge ( P  = 0.0186). Remarkably, psychological resilience factors of emotion regulation and self-control moderated these relationships. Emotion regulation moderated the association between stress and aging ( P  = 8.82e−4) such that with worse emotion regulation, there was greater stress-related age acceleration, while stronger emotion regulation prevented any significant effect of stress on GrimAge. Self-control moderated the relationship between stress and insulin resistance ( P  = 0.00732), with high self-control blunting this relationship. In the final model, in those with poor emotion regulation, cumulative stress continued to predict additional GrimAge Acceleration even while accounting for demographic, physiologic, and behavioral covariates. These results demonstrate that cumulative stress is associated with epigenetic aging in a healthy population, and these associations are modified by biobehavioral resilience factors.

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Introduction.

Cumulative stress can have adverse psychiatric and physical effects, increasing risk for cardiometabolic diseases, mood disorders, post-traumatic stress disorder and addiction [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. There are several potential psychological and biological mechanisms through which these effects may occur. For example, stress may reduce psychological resilience measures such as emotion regulation and self-control that are known to protect against psychiatric and physical health outcomes [ 1 , 12 , 13 , 14 ]. Notably, emotional stress exposure decreases cognitive and emotion regulation abilities [ 15 , 16 , 17 , 18 ], and this effect may be modulated by cortisol [ 15 ]. Furthermore, stress decreases self-control abilities [ 19 , 20 , 21 ] and impacts the likelihood of individuals engaging in healthy behaviors such as exercise or maintaining a healthy diet, and is associated with unhealthy behaviors such as smoking, alcohol, and drug use [ 22 , 23 , 24 , 25 ]. Recent evidence also suggests that stress effects on metabolic health may be affected by BMI-related changes in insulin resistance and other gut hormones [ 26 , 27 ]. Indeed, stress’s effects on physiology resulting in alterations in neuro-hormonal signaling pathways as well as increased inflammation are well documented [ 26 , 28 , 29 , 30 ]. Both stress and these physiologic changes may increase the risk of multiple physical and psychiatric illnesses, which in turn increase morbidity and mortality risk. This has often been described as an increased allostatic load, and notably many of these processes, such as metabolic and cardiovascular dysfunction, have been associated with human aging [ 31 ]. For example, insulin signaling might be linked to aging and aging-related diseases in humans [ 32 ], with recent data on metformin (a treatment for insulin resistance) suggesting it may be useful as an anti-aging drug [ 33 ].

There is growing evidence that cumulative stress may adversely impact health via accelerating the cellular aging process. For example, stress shortens telomere length and alters telomerase activity, and this interaction is modified by behavioral and psychological resilience factors [ 34 , 35 , 36 , 37 ]. However, recent studies have demonstrated mixed results on whether characteristics that contribute to resilience improve or worsen the impact of stress on health [ 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. These data suggest that resiliency factors may modulate the relationship between chronic stress and aging, but to our knowledge this has not been tested in a healthy community sample. While there are many aspects of resilience, including cultural/societal, environmental, and personal which can decrease the negative consequences of stressors on individuals, herein we will focus on personal-level, psychological skills, including self-control and emotion regulation.

Recently developed DNA methylation-based epigenetic “clocks” appear to provide a more accurate measure of biological age than telomere length [ 48 , 49 , 50 , 51 ]. These clocks are built from a set of DNA methylation markers that correlate with chronologic age and serve as molecular estimators of biological age in cells, tissues, and individuals [ 52 ]. Epigenetic clocks have a significantly higher predictive value than previously used measures such as telomere length for frailty, [ 53 ] mortality risk [ 54 , 55 ], hazard ratios [ 56 ], and chronologic age [ 57 ]. The development of these biological aging markers promises to not only aid in identifying individuals at higher risk for aging-related illnesses, but potentially also developing interventions to prevent accelerated aging.

Previous studies (reviewed by Palma-Gudiel et al [ 58 ]) have utilized epigenetic clocks to demonstrate associations between trauma, early life adversity, or low socioeconomic status and accelerated epigenetic aging. Studies have often been focused upon selected populations, such military veterans [ 45 ], individuals with significant trauma histories [ 59 ], or specific cohorts at higher risk [ 60 , 61 , 62 ]. Notably, these studies did not exclude, and often explicitly included, individuals with significant mental and physical illnesses, including PTSD, MDD, and other disabilities [ 59 , 63 ]. These studies also primarily utilized epigenetic clocks trained upon chronologic age. However, a recently developed epigenetic clock, GrimAge, was trained using biomarkers of mortality and indicators of health, and has superior performance in predicting health outcomes when compared with other epigenetic clocks [ 51 , 64 ].

We utilized GrimAge Acceleration (“GAA”, defined as the residual of the regression of GrimAge to chronologic age, with a positive number indicating biological age greater than chronologic age) to conduct a cross-sectional study to answer three questions. First, is cumulative stress related to epigenetic markers of biological aging in a healthy young-to-middle-aged community population? Second, if stress is associated with epigenetic aging, does stress-related physiology contribute to stress-associated biological aging? And finally, how do psychological factors that contribute to resilience modulate these relationships? Based on previous research, we hypothesized that cumulative stress will be positively associated with GrimAge Acceleration (GAA), that stress effects on GrimAge will be related to changes in the hypothalamic-pituitary-adrenal axis (HPA) and insulin sensitivity, and that strong emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS, [ 65 ]) and high self-control as measured by the Self Control Scale-Brief (SCS-B, [ 66 ]) will moderate the relationships between stress, physiology, and accelerated aging (See Fig. 1 for a model summarizing our hypotheses).

We hypothesize that stress is positively associated with accelerated biological aging, which we measure via GrimAge Acceleration (GAA), and that this relationship will be mediated by stress-related physiologic changes such as insulin and HPA signaling. We also hypothesize that strong psychological resilience factors will be protective against the negative consequences of stress on aging. Note that these relationships are predictive, not causative, as this study is cross-sectional and thus directionality of relationships cannot be conclusively examined.

Materials and methods

Cohort recruitment.

The participant cohort included 444 community adults between the ages of 18–50 in the greater New Haven, CT area who volunteered to participate in a study examining the role of stress and self-control at the Yale Stress Center as previously described [ 67 ]. Briefly, participants were recruited via advertisements online, in local newspapers, and at a community center between 2008 and 2012. Participants were excluded if they had a substance use disorder (not including nicotine) as assessed via the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (SCID-I for DSM-IVTR), were pregnant, had a chronic medical condition (e.g, hypertension, diabetes, hypothyroidism), or were unable to read English at or above the 6th grade level. Participants were also excluded if they had a concussion with loss of consciousness greater than 30 minutes, another head injury such as documented traumatic brain injury or another injury with documented lasting deficits, or were using any prescribed medications for any psychiatric or medical disorders. Breathalyzer and urine toxicology screens were conducted at each appointment to ensure the participants were drug-free. Of a total of 1000 potential participants who underwent initial screening for eligibility, epigenetic data combined with physiologic and behavioral data were available on 444, who comprised the current sample. All participants provided written and verbal informed consent to participate, and the research protocol was reviewed and approved by the Yale IRB.

Initial assessment and measurement of physiologic parameters

All eligible subjects met with a research assistant for two intake sessions to complete a physical health review with the Cornell Medical Index (CMI, [ 68 ]), structured clinical interview for diagnoses (SCID) of DSM-IVTR psychiatric illnesses, cumulative stress interview, self-report assessments and a separate morning biochemical evaluation after fasting overnight. The structured clinical interview was performed by masters’ or doctoral level clinical research staff. Fasting insulin and glucose were obtained and Cortisol was assessed at four time-points, spaced 15 min apart beginning at 7:30 AM after overnight fasting and collected while participants were in a quiet and comfortable laboratory setting at the Yale Stress Center. Participants were financially compensated for participating in the study.

Psychological measures

Cumulative stress was assessed using the Cumulative Adversity Inventory (CAI, [ 69 ]), a 140-item multifaceted interview-based assessment of life events and subjective stress through which trained interviewers asked participants about specific stressful events that occurred during their lifetime, which comprised the subscales of major life events, life trauma events and recent life events. For purposes of scoring, a “yes” to the specific stressful event occurring led to a “1” and a sum of all the “yes” endorsements comprised the subscale score for these events subscale. The final subscale of chronic stress was the participant’s own sense of feeling overwhelmed and unable to manage the events for the other subscales listed. This was rated on a “not true”, “somewhat true”, or “very true” scale, with assigned scores of 0, 1, and 2, respectively. The final score is a sum of these values for the chronic stress subscale. The CAI-total score was a sum of each of the subscale score with a higher score indicating a higher overall level of lifetime cumulative stress. The CAI has been demonstrated to have excellent overall reliability as reported in previous research [ 12 , 26 , 70 , 71 , 72 ]. In our population for this study, the alpha reliability is 0.86. It has been previously shown to predict cumulative stress related brain volume reductions and sensitized stress functional responses as well as prediction of physical, metabolic and behavioral responses [ 26 , 70 , 71 , 72 ].

Emotion regulation was assessed using the Difficulties with Emotion Regulation Scale (DERS, [ 65 ]), which is a 41-item trait-level measure that assesses across domains of lack of emotional awareness, goals, clarity, strategies, acceptance, and impulse control in managing emotions. Higher scores on the DERS correspond to lower ability to regulate emotion. Alpha reliability has been reported to be >0.90 for the total score, and ≥0.80 for the sub-scores [ 65 ]. In this population, the alpha reliability is 0.92.

Self-control was assessed using the Self-Control Survey-Brief (SCS-B, [ 66 ]), which is a 13-item scale that assesses overall self-control. A higher score on the SCS-B suggests a stronger level of self-control. There are no sub-scores provided by the SCS-B, and the overall SCS-B has been reported to have an alpha reliability >0.80 [ 66 ]. The alpha reliability in this study is 0.85.

The Cornell Medical Index (CMI) was used to assess for participants’ current health. It is a 195-question interview that captures both physical and psychological health symptoms, and has been validated as an indicator for current general health in many studies [ 68 , 73 , 74 ]. A higher score on the CMI suggests more symptoms and worse overall health. The alpha reliability of the total CMI is 0.94. The psychological subscore has an alpha reliability of 0.92, and the biological subscore has a reliability of 0.90.

Cronbach alpha reliabilities for each of the scales described above were obtained using the alpha function in the R psych package [ 75 ].

DNA methylation and epigenetic clock analysis

DNA for epigenetic analysis was collected from whole blood samples as previously described [ 67 ]. Briefly, all samples were profiled using Illumina Infinium HumanMethylation450 Beadchips, which covers 96% of CpG islands and 99% of RefSeq genes. Quality control on these data are as previously published [ 67 ]. They are described in brief below:

Probe QC : To ensure high-quality data, we set a more stringent threshold of P  < 10 –12 . Intensity values showing P  > 10 −12 were set as zero. Additionally, we removed 11,648 probes on sex chromosomes and 36,535 probes within 10 base pairs of single-nucleotide polymorphisms. Finally, a total of 47,791 probes were removed and the remaining 437,722 probes were used for further analysis.

Sample QC : Using a detection P value < 10 –12 , one sample showing a call rate < 98% was excluded from analysis. Five samples showing sex discrepancy between the methylation predicted sex and self-reported sex were also excluded from analysis.

Data processing and normalization : Data processing and normalization were performed using the recently published protocol (Lehne et al., 2015). We first perform background correction and within-array normalization to the original green/red channel intensity data using the preprocessIllumina function in the minfi R package. The processed data were transformed to M/U methylation categories. Next, we separately performed between-array-normalization with the quantile method using the normalizeBetweenArrays function in the limma R package (version 3.26.2) after dividing the data matrix into 6 independent parts: Type I M Green, Type I M Red, Type I U Red, Type I U Green, Type II Red, Type II Green. The normalized data were merged and the beta value at each CpG site was determined.

After obtaining beta values, epigenetic clock analysis was performed as described in Lu et al. using the New Methylation Age Calculator at https://dnamage.genetics.ucla.edu/new [ 51 ]. Data were normalized as per their protocol, and the advanced analysis option was used. We focus on GrimAge acceleration (GAA), which is defined as the residuals of a linear correlation of GrimAge to chronologic age. No effects of array batch on GAA were observed (Supplementary Fig. 1 ).

The analyses herein were performed without accounting for individual variations in cell types. The Houseman method was used to determine cell type proportion [ 76 ], and the inclusion of cell fractions as covariates in a linear model does not impact the primary conclusions of this paper (see Supplementary material).

Statistical analysis

Data organization and analysis were conducted using R 3.6.3 [ 77 ] and RStudio. Linear regressions were first implemented to examine univariate associations between independent and dependent variables. Multivariable linear regressions adjust for demographic (sex, race, years of education, marital status, income) and behavioral (smoking, alcohol use, and BMI) covariates unless otherwise stated. These covariates were selected due to prior work demonstrating a relationship to epigenetic aging. Chronologic age is incorporated into the model as part of the calculation of GAA (the residual of GrimAge regressed upon chronologic age). There was no significant correlation between chronologic age and GAA. Analyses of the relationship between CAI, GAA, psychological and physiologic variables were performed in both the univariate unadjusted model and the multivariate adjusted model accounting for demographic and behavioral measures, but except when the conclusions differ, statistical values in the text represent the multivariate models for simplicity. CAI, DERS, and SCS were mean-centered to address issues of collinearity (particularly regarding individual regression coefficients) when assessing for moderation.

All tests were two-tailed with alpha set at 0.05. Statistical significance in both standard linear regressions and moderation analyses were assessed from t values. R 2 reported on plots represent the simple relationship between the stated variables, while adjusted R 2 values in the text represent the model. Partial η 2 values represent the effect size for the specific variable, with a value >= 0.01 typically indicating a small effect, >= 0.06 a medium effect, and >= 0.14 a large effect [ 78 ]. Wilcoxon signed-rank test was used to compare data between sexes. Mediation analysis was performed to determine if stress impacts GAA via behavioral and physiologic factors. Simple mediation effects were calculated via R using 10,000 simulations without bootstrapping using the mediation package [ 79 ]. Mediation was considered significant if the proportion mediated was greater than 0 with an alpha of 0.05. Serial mediation was calculated via R using the Lavaan package [ 71 ], with an indirect effect defined as the product of the coefficients of the effect of stress on BMI, of BMI on HOMA, and of HOMA on GAA. Assessment of the individual variables’ attributable GrimAge acceleration as well as confidence intervals were calculated using the Emmeans package using unadjusted pairwise comparisons.

Demographics and clinical characteristics

As shown in Table 1 , study participants were healthy and without evidence of medical or psychiatric diseases. The majority were non-smokers (79.6%), social drinkers with low risky alcohol intake screening scores (72.7% of participants have Alcohol Use Disorders Identification Test (AUDIT) < 8, and 91.7% < 15), and were not obese (74.5% of participants have a BMI < 30, 89.2% < 35). Both physical and psychological symptoms assessed on the Cornell Medical Index (CMI, [ 68 ]) were low, with 86% of participants scoring below the typical screening threshold of 30.

Cumulative stress predicts accelerated biological aging as measured by GrimAge

As expected, there was a high association between individuals’ chronologic age and GrimAge (Age: t  = 51.4, P  < 2e−16, adjusted R 2  = 0.856, Fig. 2A ). This relationship is not altered by inclusion of the covariates of smoking, alcohol use, BMI, race, sex, income, and years of education (Age: t  = 49.1, P  < 2e−16, partial η 2  = 0.848; model (GrimAge ~ Age + covariates) adjusted R 2  = 0.912), and this relationship remained significant accounting for cellular fractions (Supplementary Table 1 ). Also, using a univariate linear regression, greater cumulative stress as measured by the total Cumulative Adversity Index (CAI) score significantly predicted higher GAA (CAI: t  = 4.82  P  = 2.00e−6, η 2  = 0.050, adjusted R 2  = 0.0478, Fig. 2B ). While there were significant differences in GAA based on sex ( P  = 1.33e−7), both males (CAI: P  = 3.35e−4, adjusted R 2  = 0.0586) and females (CAI: P  = 3.12e−5, adjusted R 2  = 0.0652) demonstrated similar correlations between stress and GAA. Further analysis showed these results are consistent across CAI subscales, as well as with the Childhood Trauma Questionnaire and several of its subscales (Supplementary Table 2 ).

A Chronologic age significantly predicts GrimAge ( P  < 2e−16). B Cumulative stress total as measured by the CAI (CAI-Total) significantly predicts GAA before ( P  = 2.00e−6) and after accounting for covariates. C Higher insulin resistance (as measured by HOMA) shows a significant positive correlation with GAA before ( P  = 1.11e−8) and after accounting for covariates. D The Cortisol/ACTH ratio is negatively correlated with GAA before accounting for covariates ( P  = 2.39e−6), but not afterward. P and R 2 values in the figure represent simple univariate models (Y ~ X). In the main text, models are adjusted for covariates as stated.

After accounting for the covariates of smoking, alcohol use, BMI, race, sex, income, and years of education, the relationship between GAA and CAI remains significant (CAI: t  = 2.073, P  = 0.0388, partial η 2  = 0.010; model (GAA ~ CAI-total + covariates): adjusted R 2  = 0.3869); individual covariate effects shown in Supplementary Table 3 ). When considered as potential mediators of the relationship between stress and GAA, BMI (proportion mediated = 0.288, P  = 0.0042) and smoking (proportion mediated = 0.443, P  = 0.0030), but not alcohol use (proportion mediated = 0.001, P  = 0.931), show partial mediating effects (Supplementary Table 4 ).

Consistent with the underlying assumption that GAA is related to measures of health, GAA also predicted psychological and physical health symptoms as measured by the CMI (Supplementary Fig. 2A ; total CMI: t  = 3.449, P  = 6.18e−4, adjusted R 2  = 0.024).

Stress-related physiology is associated with GrimAge acceleration

Given the known relationship between cumulative stress and physiology, we assessed the relationship between the stress-related physiologic factors of insulin resistance and HPA-axis signaling and GAA. We found that higher HOMA (a measure of insulin resistance) significantly predicted GAA (Fig. 2C , HOMA: t  = 2.362, P  = 0.0186, partial η 2  = 0.013; model (GAA ~ HOMA + Covariates): adjusted R 2  = 0.389).

We then assessed whether cortisol/ACTH ratio changes impacted GAA. Indeed, low cortisol/ACTH ratio, a measure of adrenal sensitivity, was associated with GAA in a simple univariate model, (Fig. 2D , Cort/ACTH ratio: t  = −4.78, P  = 2.39e−6, η 2  = 0.049, adjusted R 2  = 0.0470), though this becomes non-significant when accounting for covariates (Cort/ACTH ratio: t  = −0.721, P  = 0.471, partial η 2  = 0.001; model (GAA ~ Cort/ACTH + Covariates): adjusted R 2  = 0.3816). We also find a significant association between stress and Cortisol/ACTH ratio (Supplementary Fig. 2B , CAI: t  = −2.146  P  = 0.0324; model (Cort/ACTH ratio ~ CAI + covariates): adjusted R 2  = 0.2197).

Emotion regulation moderates the relationship between stress and GrimAge acceleration directly

We then asked whether the relationship between cumulative stress and epigenetic aging was modulated by characteristics that contribute to an individual’s psychological resilience. We hypothesized that strong emotion regulation abilities would be protective against stress-related accelerated aging. We found that emotion regulation as assessed by the Difficulties in Emotion Regulation Scale (DERS, [ 65 ]) significantly moderated the relationship between GAA and CAI (Fig. 3A , CAI:DERS: F  = 11.22, P  = 8.82e−4, partial η 2  = 0.025; model (GAA ~ CAI X DERS + covariates): adjusted R 2  = 0.4004), such that poor emotion regulation significantly increased the effects of CAI on GAA. There was not a significant difference between males and females in emotion regulation ( P  = 0.0949).

A Individuals with stronger emotion regulation (as measured by lower DERS scores) suffer less GAA at high stress than individuals with poor emotion regulation before (GAA ~ CAI X DERS P  = 9.51e−5; GAA ~ CAI X DERS + Covariates: P  = 8.82e−4) and after accounting for covariates. For panel A, “good” represents the slope at the 25th percentile of DERS, “fair” at the 50th percentile, and “poor” the 75th percentile. B Better self-control (as measured by higher B-SCS scores) is protective against the effects of stress on GAA before accounting for covariates (GAA ~ CAI X SCS P  = 0.00226; GAA ~ CAI X SCS + Covariates: P  = 0.130), but not after including them in the model. C Stronger self-control moderates the relationship between stress and insulin resistance before (HOMA ~ CAI X SCS P  = 0.0115; HOMA ~ CAI X SCS + Covariates P  = 0.00732) and after accounting for covariates. For panels (B) and (C), “good” represents the slope at the 75th percentile of B-SCS, “fair” at the 50th percentile, and “poor” the 25th percentile.

Self-control moderates the association between stress and insulin resistance, which is associated with GrimAge acceleration

We next assessed whether psychological resilience in the form of self-control (as measured via the SCS-B, [ 66 ]) alters the association between cumulative stress and GAA. We found higher self-control is protective against the effects of stress on GAA before accounting for covariates, but the interaction became non-significant when covariates were accounted for (Fig. 3B , CAI:SCS: F  = 2.303, P  = 0.130, partial η 2  = 0.005; model (GAA ~ CAI X SCS + Covariates: adjusted R 2  = 0.3874).

Given the potential interplay between self-control, insulin resistance, and stress, we next asked whether self-control moderated the relationship between stress and HOMA. We observed that, even when covariates are accounted for, self-control moderates the positive relationship between stress and HOMA, with stronger self-control blunting their relationship (Fig. 3C , CAI:SCS: F = 7.263, P  = 0.00732, partial η 2  = 0.017; model (HOMA ~ CAI X SCS + Covariates: adjusted R 2  = 0.2871). Notably, self-control does not moderate the relationship between CAI and BMI (CAI:SCS: F  = 0.679, P  = 0.41). Self-control did not significantly differ between males and females ( P  = 0.0550).

Exploratory mediation analyses suggest stress influences GrimAge via BMI and HOMA

While our ability to draw causative inferences are limited by the cross-sectional nature of our data, we used mediation analyses to explore potential relationships between weight, insulin resistance, and GAA. We hypothesized that the effects of BMI on GAA may be mediated through insulin resistance. Indeed, mediation analysis suggested that a significant portion of the effect of BMI on GAA may be mediated through HOMA (Supplementary Fig. 3A , proportion mediated = 0.247, P  = 0.02). Given these findings, we next asked whether BMI and insulin resistance act sequentially to mediate the effects of stress on GAA. We identified a significant indirect effect, suggesting that stress may affect GAA through increased BMI and elevated insulin resistance (Supplementary Fig. 3B , indirect effect = 0.003; P  = 0.030), though there continues to be a significant direct effect of stress on GAA as well (direct effect = 0.034, P  = 0.009).

Cumulative stress and estimated change in GrimAge

Finally, we sought to identify the comparative contributions of our significant variables to GAA. To do this, we constructed a linear regression model using all demographic covariates (sex, race, marital status, education, income), behavioral covariates (smoking, alcohol, BMI), physiologic factors (HOMA, Cortisol/ACTH ratio), and psychological factors. In this model, we continue to see a significant interaction between stress and emotion regulation in relation to GAA (CAI:DERS t  = 3.424, P  = 0.000677, partial η 2  = 0.027; model (GAA ~ CAI-total X DERS + HOMA + Cort/ACTH ratio + SCS + Covariates): adjusted R 2  = 0.4056). Notably in this model, HOMA ( t  = 2.308, P  = 0.0215, partial η 2  = 0.012), BMI ( t  = 2.641, P  = 0.00857, partial η 2  = 0.016), and smoking ( t  = 10.47, P  < 2e−16, partial η 2  = 0.204) also demonstrate significant effects on GAA. The impact of the cortisol/ACTH ratio on GAA is not significant ( t  = −0.668, P  = 0.504, partial η 2  = 0.001), and its removal from the model does not impact any of the above conclusions.

Using this final linear model, we estimated the changes in GrimAge for each significant variable (Table 2 ) using estimated marginal means [ 80 ]. When comparing the effects of high stress (CAI-total: 75th percentile) versus low stress (CAI-total: 25th percentile) in those with poor emotion regulation (DERS: 75th percentile), stress was associated with half a year of aging independent of all other covariates and physiologic factors. However, when emotion regulation was strong (DERS: 25th percentile), stress did not independently predict GAA. Again comparing 75th versus 25th percentiles, BMI independently was related to an increase of 0.46 years of GrimAge, and HOMA for ¼ of a year. We also identified daily smoking (3.8 years), male sex (1.2 years), self-identifying as Black (1 year), and never having married (0.71 years) as covariates that significantly predicted accelerated GrimAge. When accounting for cellular fractions we see similar results regarding the relationships between stress, emotion regulation, and GAA. However, when accounting for cellular fractions, the associations between GAA and both HOMA and marital status become non-significant (Supplementary Table 5 ). Prior literature [ 51 ] suggests that GrimAge predicts the hazard ratio exponentially (HR = 1.1 GAA ). Thus, each additional year of GAA would be expected to increase the relative risk of death by approximately 10%.

In this study, we report novel findings that cumulative stress is associated with accelerated epigenetic aging in a healthy, young-to-middle-aged community sample, even after adjusting for sex, race, BMI, smoking, alcohol use, income, marital status, and education. Epigenetic aging was measured by GrimAge, a marker which has previously been associated with increased morbidity and mortality and correlates with physical and psychological health symptoms in our study. The relationship between stress and age acceleration is most prominent in those with poor emotion regulation and was related to behavioral factors such as smoking and BMI. Both stress and GAA were associated with changes in insulin resistance, which was moderated via self-control. These results suggest a relationship between stress, physiology, and accelerated aging that is moderated by emotion regulation and self-control. Overall, these findings point to multiple potentially modifiable biobehavioral targets of intervention that may reduce or prevent the deleterious effects of stress on aging and long-term health outcomes.

This study included a generally healthy, young-to-middle-aged community population, yet we still identified a significant relationship between cumulative stress and age acceleration. The population was taking no prescription medications for any medical conditions, nor were they suffering from current mental illnesses, including major depressive disorder or generalized anxiety disorder. The study includes individuals with obesity, as well as a small number of individuals with risky drinking levels as determined by the AUDIT scores. The frequency of these individuals in the sample is generally in line with those in a community population, and thus we included alcohol use and BMI as covariates to account for the impact of these variables on the results. Prior work has demonstrated that GrimAge better predicts mortality than other epigenetic clocks, and GrimAge predicts lifespan more accurately than self-reporting smoking history, demonstrating that GrimAge is a biologically meaningful and potentially clinically useful biomarker for health [ 51 , 64 ]. Our findings are consistent with recent work showing that those with significant trauma histories [ 59 , 81 ] or with diagnoses of mental illnesses, such as Bipolar disorder or MDD, may experience accelerated aging as measured by epigenetic clocks [ 57 , 81 , 82 , 83 , 84 ]. In particular, this study builds on previous findings by Zannas et al that demonstrated a relationship between trauma and epigenetic aging using the Horvath clock. However, to the best of our knowledge this is the first study to investigate the impact of cumulative stress on epigenetic aging in a healthy community sample without significant physical or mental illness. Also it is the first to our knowledge to identify factors that contribute to psychological resilience as potential modulators of such an effect. This opens the possibility that the distinction between the effects of stress on pathologic and non-pathologic samples may be along a continuum. It would be interesting to examine resilience characteristics in the population studied by Zannas et al to determine if there is a limit to the protective effects of psychological resilience. Thus, preventive interventions that decrease stress and improve resilience may be useful for maintaining long-term mental and physical health.

The relationship between stress and epigenetic aging appears to be modulated via specific psychological traits, including emotion regulation and self-control. Those with better emotion regulation and higher levels of self-control were observed to have less age acceleration even at similar levels of stress. Indeed, based on their GAA, our estimates indicate that the relationship between stress and GrimAge is as powerful as BMI, but only for those with poor emotion regulation. As these are skills that may be developed through specific psychological interventions [ 85 ], these results raise the possibility that building emotion regulation skills could result in improvements in epigenetic aging, morbidity, and mortality [ 86 ] for these populations. As this is a cross-sectional study, we are not able to address whether these relationships are causal. These novel cross-sectional findings provide support for potential future research that may assess whether such an intervention could positively impact epigenetic aging and other indices of long-term health outcomes. Other studies could also examine different aspects of resilience, such as cultural or environmental factors that contribute to resilience to determine if they also are protective against the effects of stress on epigenetic age acceleration. Future studies could also explore other physiologic mechanisms through which psychological resilience may influence epigenetic aging. Based on prior work, inflammation could be particularly important for this relationship. In particular, prior studies have found C-reactive protein [ 87 ] and IL-6 [ 88 ] to be related to emotion regulation and measures of health. The work by Gianaros et al suggests that neurologic activity of the dorsal anterior cingulate cortex may be involved as well.

The relationship between cumulative stress, epigenetic aging, and insulin resistance is of particular note given the prominence of insulin signaling in aging-related pathways [ 89 , 90 ], as well as current trials investigating metformin as a potential anti-aging drug [ 33 ]. In association with this body of work, our study suggests insulin resistance as at least one factor through which stress is associated with accelerated aging, even in a healthy population not suffering from diabetes. As this study is limited by its cross-sectional nature, any causal hypotheses regarding interactions between stress, BMI, insulin resistance, and aging will require longitudinal data to draw specific inferences beyond correlative relationships. Longitudinal studies would also enable prospective assessments of stress, which may be less subject to recall bias based on their current context. This study also identifies the cortisol/ACTH ratio as a potential point of connection between stress and epigenetic aging. However, this measure is somewhat limited in that it reflects an acute measure of the HPA axis, and this relationship becomes non-significant with the inclusion of our covariates. Future studies could utilize other, longer-term measures of HPA axis function such as hair cortisol to better characterize the relationship between stress, epigenetic aging, and the HPA axis.

Nonetheless, this study is the first to identify a clear relationship between cumulative stress and GrimAge acceleration in a healthy population, which suggests stress may play a role in accelerated aging even prior to the onset of chronic diseases. Notably, this relationship was strongly moderated by resilience factors, including self-control and emotion regulation. We also identified smoking, BMI, insulin signaling, and potentially HPA signaling as mediators of this response. However, even when accounting for all these factors as well as demographic covariates such as race, cumulative stress continues to demonstrate a significant impact on GAA, suggesting other mechanisms relating stress to aging not identified herein are also present.

Code availability

R scripts utilized for data analysis are available by contacting the authors directly.

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Acknowledgements

The authors would like to acknowledge the Yale Center of Genome Analysis for DNA methylation profiling. Funding for this study is from NIH Common Fund UL1-DE019586 (R.S.), PL1-DA24859 (R.S.), R01-AA013892 (R.S.), NIH R01DA047063 (K.X.), NIH T32MH019961 (Z.M.H.), NIH R25MH071584 (Z.M.H.). These data were presented at the SOBP virtual conference in April 2021 as a poster.

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Harvanek, Z.M., Fogelman, N., Xu, K. et al. Psychological and biological resilience modulates the effects of stress on epigenetic aging. Transl Psychiatry 11 , 601 (2021). https://doi.org/10.1038/s41398-021-01735-7

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• Research Article
• Open access
• Published: 06 April 2021

Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19

• Szabolcs Garbóczy 1 , 2 ,
• Anita Szemán-Nagy 3 ,
• Mohamed S. Ahmad 4 ,
• Szilvia Harsányi 1 ,
• Dorottya Ocsenás 5 , 6 ,
• Viktor Rekenyi 4 ,
• Ala’a B. Al-Tammemi 1 , 7 &
• László Róbert Kolozsvári   ORCID: orcid.org/0000-0001-9426-0898 1 , 7  

BMC Psychology volume  9 , Article number:  53 ( 2021 ) Cite this article

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In the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic.

A cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI).

A total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group.

The elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated.

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Introduction

On March 4, 2020, the first cases of coronavirus disease were declared in Hungary. One week later, the World Health Organization (WHO) declared COVID-19 as a global pandemic [ 1 ]. The Hungarian government ordered a ban on outdoor public events with more than 500 people and indoor events with more than 100 participants to reduce contact between people [ 2 ]. On March 27, the government imposed a nationwide lockdown for two weeks effective from March 28, to mitigate the spread of the pandemic. Except for food stores, drug stores, pharmacies, and petrol stations, all other shops and educational institutions remained closed. On April 16, a week-long extension was further announced [ 3 ].

The COVID-19 pandemic with its high morbidity and mortality has already afflicted the psychological and physical wellbeing of humans worldwide [ 4 , 5 , 6 , 7 , 8 , 9 ]. During major life events, people may have to deal with more stress. Stress can negatively affect the population’s well-being or function when they construe the situation as stressful and they cannot handle the environmental stimuli [ 10 ]. Various inter-related and inter-linked concepts are present in such situations including stress, anxiety, and coping. According to the literature, perceived stress can lead to higher levels of anxiety and lower levels of health-related quality of life [ 11 ]. Another study found significant and consistent associations between coping strategies and the dimensions of health anxiety [ 12 ].

Health anxiety is one of the most common types of anxiety and it describes how people think and behave toward their health and how they perceive any health-related concerns or threats. Health anxiety is increasingly conceptualized as existing on a spectrum [ 13 , 14 ], and as an adaptive signal that helps to develop survival-oriented behaviors. It also occurs in almost everyone’s life to a certain degree and can be rather deleterious when it is excessive [ 13 , 14 ]. Illness anxiety or hypochondriasis is on the high end of the spectrum and it affects someone’s life when it interferes with daily life by making people misinterpret the somatic sensations, leading them to think that they have an underlying condition [ 14 ].

According to the American Psychiatric Association—Diagnostic and Statistical Manual of Mental Disorders (fifth edition), Illness anxiety disorder is described as a preoccupation with acquiring or having a serious illness, and it reflects the high spectrum of health anxiety [ 15 ]. Somatic symptoms are not present or if they are, then only mild in intensity. The preoccupation is disproportionate or excessive if there is a high risk of developing a medical condition (e.g., family history) or the patient has another medical condition. Excessive health-related behaviors can be observed (e.g., checking body for signs of illness) and individuals can show maladaptive avoidance as well by avoiding hospitals and doctor appointments [ 15 ].

Health anxiety is indeed an important topic as both its increase and decrease can progress to problems [ 14 ]. Looking at health anxiety as a wide spectrum, it can be high or low [ 16 ]. While people with a higher degree of worry and checking behaviors may cause some burden on healthcare facilities by visiting them too many times (e.g., frequent unnecessary visits), other individuals may not seek medical help at healthcare units to avoid catching up infections for instance. A lower degree of health anxiety can lead to low compliance with imposed regulations made to control a pandemic [ 17 ].

The COVID-19 pandemic as a major event in almost everyone’s life has posed a great impact on the population’s perceived stress level. Several studies about the relation between coping and response to epidemics in recent and previous outbreaks found higher perceived stress levels among people [ 18 , 19 , 20 , 21 ]. Being a woman, low income, and living with other people all were associated with higher stress levels [ 18 ]. Protective factors like being emotionally more stable, having self-control, adaptive coping strategies, and internal locus of control were also addressed [ 19 , 20 ]. The findings indicated that the COVID-19 crisis is perceived as a stressful event. The perceived stress was higher amongst people than it was in situations with no emergency. Nervousness, stress, and loss of control of one’s life are the factors that are most connected to perceived stress levels which leads to the suggestion that unpredictability and uncontrollability take an important part in perceived stress during a crisis [ 19 , 20 ].

Moreover, certain coping styles (e.g., having a positive attitude) were associated with less psychological distress experiences but avoidance strategies were more likely to cause higher levels of stress [ 21 ]. According to Lazarus (1999), individuals differ in their perception of stress if the stress response is viewed as the interaction between the environment and humans [ 22 ]. An Individual can experience two kinds of evaluation processes, one to appraise the external stressors and personal stake, and the other one to appraise personal resources that can be used to cope with stressors [ 22 , 23 ]. If there is an imbalance between these two evaluation processes, then stress occurs, because the personal resources are not enough to cope with the stressor’s demands [ 23 ].

During stressful life events, it is important to pay attention to the increasing levels of health anxiety and to the kind of coping mechanisms that are potential factors to mitigate the effects of high anxiety. The transactional model of stress by Lazarus and Folkman (1987) provides an insight into these kinds of factors [ 24 ]. Lazarus and Folkman theorized two types of coping responses: emotion-focused coping, and problem-focused coping. Emotion-focused coping strategies (e.g., distancing, acceptance of responsibility, positive reappraisal) might be used when the source of stress is not embedded in the person’s control and these strategies aim to manage the individual’s emotional response to a threat. Also, emotion-focused coping strategies are directed at managing emotional distress [ 24 ]. On the other hand, problem-focused coping strategies (e.g., confrontive coping, seeking social support, planful problem-solving) help an individual to be able to endure and/or minimize the threat, targeting the causes of stress in practical ways [ 24 ]. It was also addressed that emotion-focused coping mechanisms were used more in situations appraised as requiring acceptance, whereas problem-focused forms of coping were used more in encounters assessed as changeable [ 24 ].

A recent study in Hunan province in China found that the most effective factor in coping with stress among medical staff was the knowledge of their family’s well-being [ 25 ]. Although there have been several studies about the mental health of hospital workers during the COVID-19 pandemic or other epidemics (e.g., SARS, MERS) [ 26 , 27 , 28 , 29 ], only a few studies from recent literature assessed the general population’s coping strategies. According to Gerhold (2020) [ 30 ], older people perceived a lower risk of COVID-19 than younger people. Also, women have expressed more worries about the disease than men did. Coping strategies were highly problem-focused and most of the participants reported that they listen to professionals’ advice and tried to remain calm [ 30 ]. In the same study, most responders perceived the COVID-19 pandemic as a global catastrophe that will severely affect a lot of people. On the other hand, they perceived the pandemic as a controllable risk that can be reduced. Dealing with macrosocial stressors takes faith in politics and in those people, who work with COVID-19 on the frontline.

Mental disorders are found prevalent among college students and their onset occurs mostly before entry to college [ 31 ]. The diagnosis and timely interventions at an early stage of illness are essential to improve psychosocial functioning and treatment outcomes [ 31 ]. According to research that was conducted at the University of Debrecen in Hungary a few years ago, the students were found to have high levels of stress and the rate of the participants with impacted mental health was alarming [ 32 ]. With an unprecedented stressful event like the COVID-19 crisis, changes to the mental health status of people, including students, are expected.

Aims of the study

In our present study, we aimed at assessing the levels of health anxiety, perceived stress, and coping styles among university students amidst the COVID-19 lockdown in Hungary, using three validated assessment tools for each domain.

Methods and materials

Study design and setting.

This study utilized a cross-sectional design, using online self-administered questionnaires that were created and designed in Google Forms® (A web-based survey tool). Data collection was carried out in the period April 30, 2020, and May 15, 2020, which represents one of the most stressful periods during the early stage of the COVID-19 pandemic in Hungary when the official curfew/lockdown was declared along with the closure of dormitories and shifting to online remote teaching. The first cases of COVID-19 were declared in Hungary on March 4, 2020. On April 30, 2020, there were 2775 confirmed cases, 312 deaths, and 581 recoveries. As of May 15, 2020, the number of confirmed cases, deaths, and recovered persons was 3417, 442, and 1287, respectively.

Our study was conducted at the University of Debrecen, which is one of the largest higher education institutions in Hungary. The University is located in the city of Debrecen, the second-largest city in Hungary. Debrecen city is considered the educational and cultural hub of Eastern Hungary. As of October 2019, around 28,593 students were enrolled in various study programs at the University of Debrecen, of whom, 6,297 were international students [ 33 ]. The university offers various degree courses in Hungarian and English languages.

Study participants and sampling

The target population of our study was students at the University of Debrecen. Students were approached through social media platforms (e.g., Facebook®) and the official student administration system at the University of Debrecen (Neptun). The invitation link to our survey was sent to students on the web-based platforms described earlier. By using the Neptun system, we theoretically assumed that our survey questionnaire has reached all students at the University. The students who were interested and willing to participate in the study could fill out our questionnaire anonymously during the determined study period; thus, employing a convenience sampling approach. All students at the University of Debrecen whose age was 18 years or older and who were in Hungary during the outbreak had the eligibility to participate in our study whether undergraduates or postgraduates.

Study instruments

In our present study, the survey has solicited information about the sociodemographic profile of participants including age (in years), gender (female vs male), study program (health-related vs non-health related), and whether the student stayed in Hungary or traveled abroad during the period of conducting our survey in the outbreak. Our survey has also adopted three international scales to collect data about health anxiety, coping styles, and perceived stress during the pandemic crisis. As the language of instruction for international students at the University of Debrecen is English, and English fluency is one of the criteria for international students’ admission at the University of Debrecen, the international students were asked to fill out the English version of the survey and the scales. On the other hand, the Hungarian students were asked to fill out the Hungarian version of the survey and the validated Hungarian scales. Also, we provided contact information for psychological support when needed. Students who felt that they needed some help and psychological counseling could use the contact information of our peer supporters. Four International students have used this opportunity and were referred to a higher level of care. The original scales and their validated Hungarian versions are described in the following sections.

Perceived Stress Scale (PSS)

The Perceived Stress Scale (PSS) measures the level of stress in the general population who have at least completed a junior high school [ 34 ]. In the PSS, the respondents had to report how often certain things occurred like nervousness; loss of control; feeling of upset; piling up difficulties that cannot be handled; or on the contrary how often the students felt they were able to handle situations; and were on top of things. For the International students, we used the 10-item PSS (English version). The statements’ responses were scored on a 5-point Likert scale (from 0 = never to 4 = very often) as per the scale’s guide. Also, in the 10-item PSS, four positive items were reversely scored (e.g. felt confident about someone’s ability to handle personal problems) [ 34 ]. The PSS has satisfactory psychometric properties with a Cronbach’s alpha of 0.78, and this English version was used for international students in our study.

For the Hungarian students, we used the Hungarian version of the PSS, which has 14 statements that cover the same aspects of stress described earlier. In this version of the PSS, the responses were evaluated on a 5-point Likert scale (0–4) to mark how typical a particular behavior was for a respondent in the last month [ 35 ]. The Hungarian version of the PSS was psychometrically validated in 2006. In the validation study, the Hungarian 14-item PSS has shown satisfactory internal consistency with a Cronbach’s alpha of 0.88 [ 35 ].

Ways of Coping Questionnaire (WCQ)

The second scale we used was the 26-Item Ways of Coping Questionnaire (WCQ) which was developed by Sørlie and Sexton [ 36 ]. For the international students, we used the validated English version of the 26-Item WCQ that distinguished five different factors, including Wishful thinking (hoped for a miracle, day-dreamed for a better time), Goal-oriented (tried to analyze the problem, concentrated on what to do), Seeking support (talked to someone, got professional help), Thinking it over (drew on past experiences, realized other solutions), and Avoidance (refused to think about it, minimized seriousness of it). The WCQ examined how often the respondents used certain coping mechanisms, eg: hoped for a miracle, fantasized, prepared for the worst, analyzed the problem, talked to someone, or on the opposite did not talk to anyone, drew conclusions from past things, came up with several solutions for a problem or contained their feelings. As per the 26-item WCQ, responses were scored on a 4-point Likert scale (from 0 = “does not apply and/or not used” to 3 = “used a great deal”). This scale has satisfactory psychometric properties with Cronbach's alpha for the factors ranged from 0.74 to 0.81[ 36 ].

For the Hungarian students, we used the Hungarian 16-Item WCQ, which was validated in 2008 [ 37 ]. In the Hungarian WCQ, four dimensions were identified, which were cognitive restructuring/adaptation (every cloud has a silver lining), Stress reduction (by eating; drinking; smoking), Problem analysis (I tried to analyze the problem), and Helplessness/Passive coping (I prayed; used drugs) [ 37 ]. The Cronbach’s alpha values for the Hungarian WCQ’s dimensions were in the range of 0.30–0.74 [ 37 ].

Short Health Anxiety Inventory (SHAI)

The third scale adopted was the 18-Items Short Health Anxiety Inventory (SHAI). Overall, the SHAI has two subscales. The first subscale comprised of 14 items that examined to what degree the respondents were worried about their health in the past six months; how often they noticed physical pain/ache or sensations; how worried they were about a serious illness; how much they felt at risk for a serious illness; how much attention was drawn to bodily sensations; what their environment said, how much they deal with their health. The second subscale of SHAI comprised of 4 items (negative consequences if the illness occurs) that enquired how the respondents would feel if they were diagnosed with a serious illness, whether they would be able to enjoy things; would they trust modern medicine to heal them; how many aspects of their life it would affect; how much they could preserve their dignity despite the illness [ 38 ]. One of four possible statements (scored from 0 to 3) must be chosen. Alberts et al. (2013) [ 39 ] found the mean SHAI value to be 12.41 (± 6.81) in a non-clinical sample. The original 18-item SHAI has Cronbach’s alpha values in the range of 0.74–0.96 [ 39 ]. For the Hungarian students, the Hungarian version of the SHAI was used. The Hungarian version of SHAI was validated in 2011 [ 40 ]. The scoring differs from the English version in that the four statements were scored from 1 to 4, but the statements themselves were the same. In the Hungarian validation study, it was found that the SHAI mean score in a non-clinical sample (university students) was 33.02 points (± 6.28) and the Cronbach's alpha of the test was 0.83 [ 40 ].

Data analyses

Data were extracted from Google Forms® as an Excel sheet for quality check and coding then we used SPSS® (v.25) and RStudio statistical software packages to analyze the data. Descriptive and summary statistics were presented as appropriate. To assess the difference between groups/categories of anxiety, stress, and coping styles, we used the non-parametric Kruskal–Wallis test, since the variables did not have a normal distribution and for post hoc tests, we used the Mann–Whitney test. Also, we used Spearman’s rank correlation to assess the relationship between health anxiety and perceived stress within the international group and the Hungarian group. Comparison between international and domestic groups and different genders in terms of health anxiety and perceived stress levels were also conducted using the Mann–Whitney test. Binary logistic regression analysis was also employed to examine the associations between different coping styles/ strategies (treated as independent variables) and both, health anxiety level and perceived stress level (treated as outcome variables) using median splits. A p-value less than 5% was implemented for statistical significance.

Ethical considerations

Ethical permission was obtained from the Hungarian Ethical Review Committee for Research in Psychology (Reference number: 2020-45). All methods were carried out following the institutional guidelines and conforming to the ethical standards of the declaration of Helsinki. All participants were informed about the study and written informed consent was obtained before completing the survey. There were no rewards/incentives for completing the survey.

Sociodemographic characteristics of respondents

A total of 1320 students have responded to our survey. Six responses were eliminated due to incompleteness and an additional 25 responses were also excluded as the students filled out the survey from abroad (International students who were outside Hungary during the period of conducting our study). After exclusion of the described non-eligible responses (a total of 31 responses), the remaining 1289 valid responses were included in our analysis. Out of 1289 participants (100%), 73.5% were Hungarian students and around 26.5% were international students. Overall, female students have predominated the sample (n = 920, 71.4%). The median age (Interquartile range) among Hungarian students was 22 years (5) and for the international students was 22 years (4). Out of the total sample, most of the Hungarian students were enrolled in non-health-related programs (n = 690, 53.5%), while most of the international students were enrolled in health-related programs (n = 213, 16.5%). Table 1 demonstrates the sociodemographic profile of participants (Hungarian vs International).

Perceived stress, anxiety, and coping styles

For greater clarity of statistical analysis and interpretation, we created preferences regarding coping mechanisms. That is, we made the categories based on which coping factor (in the international sample) or dimension (in the Hungarian sample) the given person reached the highest scores, so it can be said that it is the person's preferred coping strategy. The four coping strategies among international students were goal-oriented, thinking it over, wishful thinking, and avoidance, while among the Hungarian students were cognitive restructuring, problem analysis, stress reduction, and passive coping.

The 26-item WCQ [ 31 ] contains a seeking support subscale which is missing from the Hungarian 16-item WCQ [ 32 ]; therefore, the seeking support subscale was excluded from our analysis. Moreover, because the PSS contained a different number of items in English and Hungarian versions (10 items vs 14 items), we looked at the average score of the answers so that we could compare international and domestic students.

In the evaluation of SHAI, the scoring of the two questionnaires are different. For the sake of comparability between the two samples, the international points were corrected to the Hungarian, adding plus one to the value of each answer. This may be the reason why we obtained higher results compared to international standards.

Among the international students, the mean score (± standard deviation) of perceived stress among male students was 2.11(± 0.86) compared to female students 2.51 (± 0.78), while the mean score (± standard deviation) of health anxiety was 34.12 (± 7.88) and 36.31 (± 7.75) among males and females, respectively. Table 2 shows more details regarding the perceived stress scores and health anxiety scores stratified by coping strategies among international students.

In the Hungarian sample, the mean score (± standard deviation) of perceived stress among male students was 2.06 (± 0.84) compared to female students 2.18 (± 0.83), while the mean score (± standard deviation) of health anxiety was 33.40 (± 7.63) and 35.05 (± 7.39) among males and females, respectively. Table 3 shows more details regarding the perceived stress scores and health anxiety scores stratified by coping strategies among Hungarian students.

Concerning coping styles among international students, the statements with the highest-ranked responses were “wished the situation would go away or somehow be finished” and “Had fantasies or wishes about how things might turn out” and both fall into the wishful thinking coping. Among the Hungarian students, the statements with the highest-ranked responses were “I tried to analyze the problem to understand better” (falls into problem analysis coping) and “I thought every cloud has a silver lining, I tried to perceive things cheerfully” (falls into cognitive restructuring coping).

On the other hand, the statements with the least-ranked responses among the international students belonged to the Avoidance coping. Among the Hungarians, it was Passive coping “I tried to take sedatives or medications” and Stress reduction “I staked everything upon a single cast, I started to do something risky” to have the lowest-ranked responses. Table 4 shows a comparison of different coping strategies among international and Hungarian students.

To test the difference between coping strategies, we used the non-parametric Kruskal–Wallis test, since the variables did not have a normal distribution. For post hoc tests, we used Mann–Whitney tests with lowered significance levels ( p  = 0.0083). Among Hungarian students, there were significant differences between the groups in stress ( χ 2 (3) = 212.01; p < 0.001) and health anxiety ( χ 2 (3) = 80.32; p  < 0.001). In the post hoc tests, there were significant differences everywhere ( p  < 0.001) except between stress reduction and passive coping ( p  = 0.089) and between problem analysis and passive coping ( p  = 0.034). Considering the health anxiety, the results were very similar. There were significant differences between all groups ( p  < 0.001), except between stress reduction and passive coping ( p  = 0.347) and between problem analysis and passive coping ( p  = 0.205). See Figs.  1 and 2 for the Hungarian students.

Perceived stress differences between coping strategies among the Hungarian students

Health anxiety differences between coping strategies among the Hungarian students

Among the international students, the results were similar. According to the Kruskal–Wallis test, there were significant differences in stress ( χ 2 (3) = 73.26; p  < 0.001) and health anxiety ( χ 2 (3) = 42.60; p  < 0.001) between various coping strategies. The post hoc tests showed that there were differences between the perceived stress level and coping strategies everywhere ( p  < 0.005) except and between avoidance and thinking it over ( p  = 0.640). Concerning health anxiety, there were significant differences between wishful thinking and goal-oriented ( p  < 0.001), between wishful thinking and avoidance ( p  = 0.001), and between goal-oriented and avoidance ( p  = 0.285). There were no significant differences between wishful thinking and thinking it over ( p  = 0.069), between goal-oriented and thinking it over ( p  = 0.069), and between avoidance and thinking it over ( p  = 0.131). See Figs.  3 and 4 .

Perceived stress differences between coping strategies among the international students

Health anxiety differences between coping strategies among the international students

The relationship between coping strategies with health anxiety and perceived stress levels among the international students

We applied logistic regression analyses for the variables to see which of the coping strategies has a significant effect on SHAI and PSS results. In the first model (model a), with the health anxiety as an outcome dummy variable (with median split; median: 35), only two coping strategies had a statistically significant relationship with health anxiety level, including wishful thinking (as a risk factor) and goal-oriented (as a protective factor).

In the second model (model b), with the perceived stress as an outcome dummy variable (with median split; median: 2.40), three coping strategies were found to have a statistically significant association with the level of perceived stress, including wishful thinking (as a risk factor), while goal-oriented and thinking it over as protective factors. See Table 5 .

The relationship between coping strategies with health anxiety and perceived stress levels among domestic students

By employing logistic regression analysis, with the health anxiety as an outcome dummy variable (with median split; median: 33.5) (model a), three coping strategies had a statistically significant relationship with health anxiety level among domestic students, including stress reduction and problem analysis (as risk factors), while cognitive restructuring (as a protective factor).

Similarly, with the perceived stress as an outcome dummy variable (with median split; median: 2.1429) (model b), three coping strategies had a statistically significant relationship with perceived stress level, including stress reduction and problem analysis (as risk factors), while cognitive restructuring (as a protective factor). See Table 6 .

Comparisons between domestic and international students

We compared health anxiety and perceived stress levels of the Hungarian and international students’ groups using the Mann–Whitney test. In the case of health anxiety, the results showed that there were significant differences between the two groups ( W  = 149,431; p  = 0.038) and international students’ levels were higher. Also, there was a significant difference in the perceived stress level between the two groups ( W  = 141,024; p  < 0.001), and the international students have increased stress levels compared to the Hungarian ones.

Comparisons between genders within students’ groups (International vs Hungarian)

Firstly, we compared the international men’s and women’s health anxiety and stress levels using the Mann–Whitney test. The results showed that the international women’s health anxiety ( W  = 11,810; p  = 0.012) and perceived stress ( W  = 10,371; p  < 0.001) levels were both significantly higher than international men’s values. However, in the Hungarian sample, women’s health anxiety was significantly higher than men’s ( W  = 69,643; p  < 0.001), but there was no significant difference in perceived stress levels among between Hungarian women and men ( W  = 75,644.5; p  = 0.064).

Relationship between health anxiety and perceived stress

We correlated the general health anxiety and perceived stress using Spearman’s rank correlation. There was a significant moderate positive relationship between the two variables ( p  < 0.001; ρ  = 0.446). Within the Hungarian students, there was a significant correlation between health anxiety and perceived stress ( p  < 0.001; ρ  = 0.433), similarly among international students as well ( p  < 0.001; ρ  = 0.465).

In our study, we found that individuals who were characterized by a preference for certain coping strategies reported significantly higher perceived stress and/or health anxiety than those who used other coping methods. These correlations can be found in both the Hungarian and international students. In the light of our results, we can say that 48.4% of the international students used wishful thinking as their preferred coping method while around 43% of the Hungarian students used primarily cognitive restructuring to overcome their problems.

Regulation of emotion refers to “the processes whereby individuals monitor, evaluate, and modify their emotions in an effort to control which emotions they have, when they have them, and how they experience and express those emotions” [ 41 ]. There is an overlap between emotion-focused coping and emotion regulation strategies, but there are also differences. The overlap between the two concepts can be noticed in the fact that emotion-focused coping strategies have an emotional regulatory role, and emotion regulation strategies may “tax the individual’s resources” as the emotion-focused coping strategies do [ 23 , 42 ]. However, in emotion-focused coping strategies, non-emotional tools can also be used to achieve non-emotional goals, while emotion regulation strategies may be used for maintaining or reinforcing positive emotions [ 42 ].

Based on the cognitive-behavioral model of health anxiety, emotion-regulating strategies can regulate the physiological, cognitive, and behavioral consequences of a fear response to some degree, even when the person encounters the conditioned stimulus again [ 12 , 43 ]. In the long run, regular use of these dysfunctional emotion control strategies may manifest as functional impairment, which may be associated with anxiety disorders. A detailed study that examined health anxiety in the view of the cognitive-behavioral model found that, regardless of the effect of depression, there are significant and consistent correlations between certain dimensions of health anxiety and dysfunctional coping and emotional regulation strategies [ 12 ].

Similar to our current study, other studies have found that health anxiety was positively correlated with maladaptive emotion regulation and negatively with adaptive emotion regulation [ 44 ], and in the case of state anxiety that emotion-focused coping strategies proved to be less effective in reducing stress, while active coping leads to a sense of subjective well-being [ 17 , 27 , 45 , 46 , 47 ]

SHAI values were found to be high in other studies during the pandemic, and the SHAI results of the international students in our study were found to be even slightly higher compared to those studies [ 44 , 48 ]. Besides, anxiety values for women were found to be higher than for men in several studies [ 44 , 48 , 49 , 50 ]. This was similar to what we found among the international students but not among the Hungarian ones. We can speculate that the ability to contact someone, the closeness of family and beloved ones, familiarity with the living environment, and maybe less online search about the coronavirus news could be factors counting towards that finding among Hungarian students. Also, most international students were enrolled in health-related study programs and his might have affected how they perceived stress/anxiety and their preferred coping strategies as well. Literature found that students of medical disciplines could have obstacles in achieving a healthy coping strategy to deal with stress and anxiety despite their profound medical knowledge compared to non-health-related students [ 51 , 52 ]. Literature also stressed the immense need for training programs to help students of medical disciplines in adopting coping skills and stress-reducing strategies [ 51 ].

The findings of our study may be a starting point for the exploration of the linkage between perceived stress, health anxiety, and coping strategies when people are not in their domestic context. People who are away from their home and friends in a relatively alien environment may tend to use coping mechanisms other than the adequate ones, which in turn can lead to increased levels of perceived stress.

Furthermore, our results seem to support the knowledge that deep-rooted health anxiety is difficult to change because it is closely related to certain coping mechanisms. It was also addressed in the literature that personality traits may have a significant influence on the coping strategy used by a person [ 53 ], revealing sophisticated and challenging links to be considered especially during training programs on effective coping and management skills. On the other hand, perceived stress which has risen significantly above the average level in the current pandemic, can be most effectively targeted by the well-formulated recommendations and advice of major international health organizations if people successfully adhere to them (e.g. physical activity; proper and adequate sleep; healthy eating; avoiding alcohol; meditation; caring for others; relationships maintenance, and using credible information resources about the pandemic, etc.) [ 1 , 54 ]. Furthermore, there may be additional positive effects of these recommendations when published in different languages or languages that are spoken by a wide range of nationalities. Besides, cognitive behavioral therapy techniques, some of which are available online during the current pandemic crisis, can further reduce anxiety. Also, if someone does not feel safe or fear prevails, there are helplines to get in touch with professionals, and this applies to the University of Debrecen in Hungary, and to a certain extent internationally.

Naturally, our study had certain limitations that should be acknowledged and considered. The temporality of events could not be assessed as we employed a cross-sectional study design, that is, we did not have information on the previous conditions of the participants which means that it is possible that some of these conditions existed in the past, while others de facto occurred with COVID-19 crisis. The survey questionnaires were completed by those who felt interested and involved, i.e., a convenience sampling technique was used, this impairs the representativeness of the sample (in terms of sociodemographic variables) and the generalizability of our results. Also, the type of recruitment (including social media) as well as the online nature of the study, probably appealed more to people with an affinity with this kind of instrument. Besides, each questionnaire represented self-reported states; thus, over-reporting or under-reporting could be present. It is also important to note that international students were answering the survey questionnaire in a language that might not have been their mother language. Nevertheless, English fluency is a prerequisite to enroll in a study program at the University of Debrecen for international students. As the options for gender were only male/female in our survey questionnaire, we might have missed the views of students who do not identify themselves according to these gender categories. Also, no data on medical history/current medical status were collected. Lastly, we had to make minor changes to the used scales in the different languages for comparability.

The COVID-19 pandemic crisis has imposed a significant burden on the physical and psychological wellbeing of humans. Crises like the current pandemic can trigger unprecedented emotional and behavioral responses among individuals to adapt or cope with the situation. The elevated perceived stress levels during major life events can be further deepened by disengagement from home and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping strategies, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety might be mitigated.

Availability of data and materials

The datasets generated and/or analyzed during the current study are not publicly available due to compliance with institutional guidelines but they are available from the corresponding author (LRK) on a reasonable request.

Abbreviations

Centers for Disease Control and Prevention

Coronavirus Disease 2019

Perceived Stress Scale

Short Health Anxiety Inventory

Middle East Respiratory Syndrome

Severe Acute Respiratory Syndrome

Ways of Coping Questionnaire

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Acknowledgments

We would like to provide our extreme thanks and appreciation to all students who participated in our study. ABA is currently supported by the Tempus Public Foundation’s scholarship at the University of Debrecen.

This research project did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Szabolcs Garbóczy, Szilvia Harsányi, Ala’a B. Al-Tammemi & László Róbert Kolozsvári

Department of Psychiatry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

Szabolcs Garbóczy

Department of Personality and Clinical Psychology, Institute of Psychology, University of Debrecen, Debrecen, Hungary

Anita Szemán-Nagy

Faculty of Medicine, University of Debrecen, Debrecen, Hungary

Mohamed S. Ahmad & Viktor Rekenyi

Department of Social and Work Psychology, Institute of Psychology, University of Debrecen, Debrecen, Hungary

Dorottya Ocsenás

Doctoral School of Human Sciences, University of Debrecen, Debrecen, Hungary

Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Móricz Zs. krt. 22, Debrecen, 4032, Hungary

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All authors SG, ASN, MSA, SH, DO, VR, ABA, and LRK have worked on the study design, text writing, revising, and editing of the manuscript. DO, SG, and VR have done data management and extraction, data analysis. Drafting and interpretation of the manuscript were made in close collaboration by all authors SG, ASN, MSA, SH, DO, VR, ABA, and LRK. All authors read and approved the final manuscript.

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Garbóczy, S., Szemán-Nagy, A., Ahmad, M.S. et al. Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19. BMC Psychol 9 , 53 (2021). https://doi.org/10.1186/s40359-021-00560-3

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• Health anxiety
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• University students

BMC Psychology

ISSN: 2050-7283

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Ten ignored questions for stress psychology research

Affiliation.

• 1 School of Psychological Cognitive Sciences, and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China.
• PMID: 35112503
• DOI: 10.1002/pchj.520

Stress psychology is an interesting and important interdisciplinary research field. In this perspective article, we briefly discuss 10 challenges related to the conceptual definition, research methodology, and translation in the field of stress that do not receive sufficient attention or are ignored entirely. Future research should attempt to integrate a comprehensive stress conceptual framework into a multidimensional comprehensive stress model, incorporating subjective and objective indicators as comprehensive measures. The popularity of machine learning, cognitive neuroscience, and gene epigenetics is a promising approach that brings innovation to the field of stress psychology. The development of wearable devices that precisely record physiological signals to assess stress responses in naturalistic situations, standardize real-life stressors, and measure baselines presents challenges to address in the future. Conducting large individualized and digital intervention studies could be crucial steps in enhancing the translation of research.

Keywords: challenging issues; conceptual definition; research methodology; stress psychology; translation.

© 2022 Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

• Research Design*
• Stress, Psychological*

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Transforming stress through awareness, education and collaboration.

Stress Research

“The difficulty in science is often not so much how to make the discovery but rather to know that one has made it.” – J.D. Bernal

2024 Stress Statistics

The 2024 results of the American Psychiatric Association’s annual mental health poll show that U.S. adults are feeling increasingly anxious. In 2024, 43% of adults say they feel more anxious than they did the previous year, up from 37% in 2023 and 32% in 2022. Adults are particularly anxious about current events (70%) — especially the economy (77%), the 2024 U.S. election (73%), and gun violence (69%).

When asked about a list of lifestyle factors potentially impacting mental health, adults most commonly say stress (53%) and sleep (40%) have the biggest impact on their mental health. Younger adults (18-34 years old) are more likely than older adults (50+) to say social connection has the biggest impact on their mental health. Despite the increasing anxiety, most adults have not sought professional mental health support. In 2024, just one in four (24%) adults say they talked with a mental health care professional in the past year. Notably, younger adults (18-34) are more than twice as likely as older adults (50+) to have done so.

“Living in a world of constant news of global and local turmoil, some anxiety is natural and expected,” said APA President Petros Levounis, M.D., M.A. “But what stands out here is that Americans are reporting more anxious feelings than in past years. This increase may be due to the unprecedented exposure that we have to everything that happens in the world around us, or to an increased awareness and reporting of anxiety. Either way, if people have these feelings, they are not alone, and they can seek help from us.”

Among adults who have used mental health care this year, more than half prefer to meet with a mental health professional in person (55%) rather than via telehealth; 30% prefer telehealth; and 15% have no preference. Also among adults who have used mental healthcare this year, more than half (59%) are worried about losing access to mental healthcare, and 39% of insured adults are worried about losing their health insurance, as a result of the election this year.

Americans perceive broad impacts of untreated mental illness: 83% of adults say it negatively impacts families and 65% say it negatively impacts the U.S. economy. Also, 71% of adults feel that children and teens have more mental health problems than they did 10 years ago. That said, more than half of adults (55%) think there is less mental health stigma than 10 years ago.

“Over the past ten years, we’ve grown more comfortable talking about mental health, and that’s absolutely key to helping us through the current crisis,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “The continued work of APA is to ensure that people can access care when they need it, especially in areas that need it badly, like child and adolescent psychiatry.”

Other issues people said they were anxious about include:

• Keeping themselves or their families safe, 68%.
• Keeping their identity safe, 63%.
• Their health, 63%.
• Paying bills or expenses, 63%.
• The opioid epidemic, 50%.
• The impact of emerging technology on day-to-day life, 46%.

In addition, 57% of adults are concerned about climate change.

This annual poll was conducted April 9 to 11, 2024, among a sample of more than 2,200 adults. This annual survey is complemented by APA’s Healthy Minds Monthly series, conducted by Morning Consult on behalf of APA. See  past Healthy Minds Monthly polls . For a copy of the results, contact us at  [email protected] .

American Psychiatric Association

The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,900 physician members specializing in the diagnosis, treatment, prevention, and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment.

Causes and Sources of Stress

Living conditions, the political climate, financial insecurity, and work issues are some stressors US adults cite as the cause of their stress. Ineffective communications increase work stress to the point of frustration that workers want to quit.  These stressors, unfortunately, are not something people can just ignore. Quitting a job would result in debt and financial instability which, in turn, would be added stressors.

• 35% of workers say their boss is a cause of their workplace stress.
• 80% of US workers experience work stress because of ineffective company communications.
• 39% of North American employees report their workload the main source of the work stress.
• 49% of 18 – 24 year olds who report high levels of stress felt comparing themselves to others is a stressor.
• 71% of US adults with private health insurance say the cost of healthcare causes them stress while 53% with public insurance say the same.
• 54% of Americans want to stay informed about the news but following the news causes them stress.
• 42% of US adults cite personal debt as a source of significant stress.
• 1 in 4 American adults say discrimination is a significant source of stress.
• Mass shootings are a significant source of stress across all races; 84% of Hispanic report this, the highest among the races.

Stress and Relationships

People under stress admit to taking out their frustration on other people. Targets for venting out include strangers and those they have personal relationships with. Men and women report different levels of how work stress affects their relationships with their spouses.

• 76% of US workers say their workplace stress has had a negative impact on their personal relationships.
• Seven in 10 adults report work stress affects their personal relationships.
• 79% of men report work stress affects their personal relationship with their spouse compared to 61% for women.
• 36% of adults reported experiencing stress caused by a friend or loved one’s long-term health condition.

Stress Management Statistics

A look at the stress management techniques employed by US adults to deal with their stress, an overwhelming majority are self-care practices. Though very helpful, it does not address the stressor at the root of the problem. Stress management programs would be beneficial not only for employees but for the company in the long run.

• 30% of Us adults eat comfort food “more than the usual” when faced with a challenging or stressful event.
• 51% of US adults engage in prayer—a routine activity—when faced with a challenge or stressful situation.
• Coping mechanisms of Gen Z and Millenials experiencing stress in the US 44% of Gen Z and 40% of Millenials sleep in while exercising counts for 14% and 20% respectively.
• 49% of US adults report enduring stressful situations as a coping behavior to handle stress.
• Less than 25% of those with depression worldwide have access to mental health treatments.

CompareCamp

American Psychological Association

Cardiac Coherence and Post-traumatic Stress Disorder in Combat Veterans

Jay P. Ginsberg, Ph.D.; Melanie E. Berry, M.S.; Donald A Powell, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010;16 (4):52-60. PDF version of the complete paper: Cardiac Coherence and PTSD in Combat Veterans

Abstract-PTSD

Background: The need for treatment of posttraumatic stress disorder (PTSD) among combat veterans returning from Afghanistan and Iraq is a growing concern. PTSD has been associated with reduced cardiac coherence (an indicator of heart rate variability [HRV]) and deficits in early-stage information processing (attention and immediate memory) in different studies. However, the co-occurrence of reduced coherence and cognition in combat veterans with PTSD has not been studied before.

Primary Study Objective: A pilot study was undertaken to assess the covariance of coherence and information processing in combat veterans. An additional study goal was an assessment of the effects of HRV biofeedback (HRVB) on coherence and information processing in these veterans.

Methods/Design: A two-group (combat veterans with and without PTSD), a pre-post study of coherence and information processing was employed with baseline psychometric covariates.

Setting: The study was conducted at a VA Medical Center outpatient mental health clinic.

Participants: Five combat veterans from Iraq or Afghanistan with PTSD and five active-duty soldiers with comparable combat exposure who were without PTSD.

Intervention: Participants met with an HRVB professional once weekly for 4 weeks and received visual feedback in HRV patterns while receiving training in resonance frequency breathing and positive emotion induction.

Primary Outcome Measures: Cardiac coherence, word list learning, commissions (false alarms) in go—no go reaction time, digits backward.

Results: Cardiac coherence was achieved in all participants, and the increase in coherence ratio was significant post-HRVB training. Significant improvements in the information processing indicators were achieved. Degree of increase in coherence was the likely mediator of cognitive improvement.

Conclusion: Cardiac coherence is an index of the strength of control of parasympathetic cardiac deceleration in an individual that has cardinal importance for the individual’s attention and affect regulation.

The Effect of a Biofeedback-based Stress Management Tool on Physician Stress: A Randomized Controlled Clinical Trial

Jane B. Lemaire, Jean E. Wallace, Adriane M. Lewin, Jill de Grood, Jeffrey P. Schaefer

Open Medicine 2011; 5(4)E154. PDF version of the complete paper: physician-stress-randomized-controlled-clinical-trial

Abstract- Biofeedback-based Stress Management

Background: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance. Biofeedback has been used to manage stress in various populations.

Objective: To determine whether a biofeedback-based stress management tool, consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device, reduces physician stress.

Design: Randomized controlled trial measuring the efficacy of a stress-reduction intervention over 28 days, with a 28-day open-label trial extension to assess effectiveness.

Setting: Urban tertiary care hospital.

Participants: Forty staff physicians (23 men and 17 women) from various medical practices (1 from primary care, 30 from a medical specialty and 9 from a surgical specialty) were recruited by means of electronic mail, regular mail and posters placed in the physicians’ lounge and throughout the hospital.

Intervention: Physicians in the intervention group were instructed to use a biofeedback-based stress management tool three times daily. Participants in both the control and intervention groups received twice-weekly support visits from the research team over 28 days, with the intervention group also receiving re-inforcement in the use of the stress management tool during these support visits. During the 28-day extension period, both the control and the intervention groups received the intervention, but without intensive support from the research team.

Main outcome measure: Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

Results: During the randomized controlled trial (days 0 to 28), the mean stress score declined significantly for the intervention group (change -14.7, standard deviation [SD] 23.8; p = 0.013) but not for the control group (change -2.2, SD 8.4; p = 0.30). The difference in mean score change between the groups was 12.5 (p = 0.048). The lower mean stress scores in the intervention group were maintained during the trial extension to day 56. The mean stress score for the control group changed significantly during the 28-day extension period (change -8.5, SD 7.6; p < 0.001).

Conclusion: A biofeedback-based stress management tool may be a simple and effective stress-reduction strategy for physicians.

Coherence Training In Children With Attention-Deficit Hyperactivity Disorder: Cognitive Functions and Behavioral Changes

Anthony Lloyd, Ph.D.; Davide Brett, B.Sc.; Ketith Wesnes, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010; 16 (4):34-42

PDF version of the complete paper: coherence-training-in-children-with-adhd

Abstract-ADHD

Attention-deficit hyperactivity disorder (ADHD) is the most prevalent behavioral diagnosis in children, with an estimated 500 000 children affected in the United Kingdom alone. The need for an appropriate and effective intervention for children with ADHD is a growing concern for educators and childcare agencies. This randomized controlled clinical trial evaluated the impact of the HeartMath self-regulation skills and coherence training program (Institute of HeartMath, Boulder Creek, California) on a population of 38 children with ADHD in academic year groups 6, 7, and 8. Learning of the skills was supported with heart rhythm coherence monitoring and feedback technology designed to facilitate self-induced shifts in cardiac coherence. The cognitive drug research system was used to assess cognitive functioning as the primary outcome measure. Secondary outcome measures assessed teacher and student reposted changes in behavior. Participants demonstrated significant improvements in various aspects of cognitive functioning such as delayed word recall, immediate word recall, word recognition, and episodic secondary memory. Significant improvements in behavior were also found. The results suggest that the intervention offers a physiologically based program to improve cognitive functioning in children with ADHD and improve behaviors that is appropriate to implement in a school environment.

Coherence and Health Care Cost – RCA Actuarial Study: A Cost-Effectiveness Cohort Study

Woody Bedell; Mariette Kaszkin-Bettag, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010;16 (4):26-31. PDF version of the complete paper: rca-actuarial-study-coherence-and-health-care

Abstract-Health and Medicine

Chronic stress is among the most costly health problems in terms of direct health costs, absenteeism, disability, and performance standards. The Reformed Church in America (RCA) identified stress among its clergy as a major cause of higher-than-average health claims and implemented HeartMath (HM) to help its participants manage stress and increase physiological resilience. The 6-week HM program Revitalize You! was selected for the intervention including the emWave Personal Stress Reliever technology.

From 2006 to 2007, completion of a health risk assessment (HRA) provided eligible clergy with the opportunity to participate in the HM program or a lifestyle management program (LSM). Outcomes for that year were assessed with the Stress and Well-being Survey. Of 313 participants who completed the survey, 149 completed the Revitalize You! The program and 164 completed the LSM. Well-being, stress management, resilience, and emotional vitality were significantly improved in the HM group as compared to the LSM group.

In an analysis of the claims costs data for 2007 and 2008, 144 pastors who had participated in the HM program were compared to 343 non-participants (control group). Adjusted medical costs were reduced by 3.8% for HM participants in comparison with an increase of 9.0% for the control group. For the adjusted pharmacy costs, an increase of 7.9% was found compared with an increase of 13.3% for the control group. Total 2008 savings as a result of the HM program are estimated at $585 per participant, yielding a return on investment of 1.95:1. These findings show that HM stress-reduction and coherence-building techniques can reduce health care costs.

View my collection, “Stress and Cardiovascular Disease” from NCBI

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Research Topics is a collection of previously published articles, features, and news stories. They are meant to serve as an information clearinghouse and represent some of APS’s most requested and publicly relevant subjects. Note: this content may reflect the accepted style and terminology of the date the articles were first published.

Trending Topics

Disaster response and recovery.

Disasters like Hurricane Florence and Typhoon Mangkhut draw massive media coverage, trauma interventions, and financial donations to victims. But psychological research shows the efforts don’t always yield the intended benefits.

Environment and Climate Change

Psychological scientists are studying how we’re all weathering a warming planet.

Myths and Misinformation

How does misinformation spread and how do we combat it? Psychological science sheds light on the mechanisms underlying misinformation and ‘fake news.’

Learn about the mechanisms underlying our generous motivations and behaviors.

For psychological scientists, exploring the less pleasant aspects of individual and social nature, like violence and aggression, is an occasional necessity.

Aggression and Violence

Research is showing that aging equals anything but cognitive decline and unhappiness.

Psychological scientists have done extensive research on the aging brain, Alzheimer's Disease, different types of dementias, and much more.

Alzheimer’s Disease and Other Dementias

How do pets influence our well-being? Why does the face of a puppy or the purr of a cat soothe us? Psychological research provides some insights.

Animal Behavior

Developments in AI and machine learning herald unprecedented leaps in many applications, including human psychology itself. Algorithmic bias is just one issue of concern.

Artificial Intelligence (AI) and Machine Learning

Whether you're driving, studying, or listening to a business presentation, keeping focused can be a challenge when boredom and distractions compete for your focus. Research findings have identified the factors that keep our minds on task -- or off track.

Attention and Distraction

Psychological science on the effects of prejudice, and how to counter these beliefs.

Bias and Stigma

Learn what researchers have discovered about the factors that lead to bullying and the long-term consequences it can have.

The World Health Organization has added "burnout" to its International Classification of Diseases. Learn what psychological scientists have discovered about the possible causes and symptoms of burnout.

Psychological research reveals the long-lasting cognitive, social, and neurobiological consequences of stress and trauma experienced in childhood.

Childhood Adversity

A growing body of research connects various aspects of children's environments and their emotional well-being.

Childhood and Adolescent Mental Health

Psychological scientists have designed cognitive tests that can help identify everything from memory deficits to cultural heritage.

Cognitive Testing

A collection of studies shows that compassion gets stronger with training and this training can even change brain function.

It's a big-time showdown for France and Croatia in the upcoming FIFA World Cup final. Science reveals how players and fans alike handle the pressure of climactic competition.

Competition

From international wars to political arguments at the dinner table, conflict is an integral part of the human experience. Psychological scientists have uncovered a wealth of knowledge about the ways cooperation and acceptance can overpower those clashes.

Conflict and Conflict Resolution

What drives people to believe in vast conspiracies and dismiss facts as hoaxes? Psychological research identifies some motivations.

Conspiracy Theories

The criminal justice system was designed to find and punish perpetrators guilty of the crimes of which they are accused. Psychological science helps repair and maintain the public’s trust in the system and eliminate threats to equal justice.

Criminal Justice

How do people respond to increasing cultural diversity in their communities, cities, and countries? Researchers investigate.

Cultural Diversity

Being curious about the world around us can have benefits at school, work, and other contexts, studies show.

Psychological scientists are exploring how we use digital media and the consequences, both positive and negative, it can have in everyday life.

Digital Media

Disasters like Hurricane Florence and Typhoon Mangkhut draw massive media coverage, trauma interventions, and financial donations to victims. But psychological research shows the efforts don't always yield the intended benefits.

How do motorists develop the higher-order cognitive processes required to navigate safely? Research explores this and more.

Driving and Cars

Read what psychological researchers have discovered about the effects of eating on mood, behavior, and cognition.

Eating and Food

Psychological scientists are studying how we're all weathering a warming planet.

The psychology and science behind how individuals and groups respond to epidemics.

Epidemics and Public Health Behavior

Psychological scientists identify factors that prompt people to lie, cheat, bribe, and steal and strategies for addressing such unethical behavior.

What motivates us to exercise? And what effects does exercise have on mental function? Psychological scientists are exploring the ins and outs of physical activity.

Understanding the science behind eyewitness memory can have important implications for criminal justice procedures.

Eyewitness Memory

APS offers some scientific insights into family dynamics.

Family Relationships

Why are we scared of some things and not others? Psychological scientists are exploring the many facets of fear and the mechanisms that drive it.

Friendships are unique relationships that offer researchers a window into many aspects of life, including personality, longevity, health, and well-being.

Researchers explore the factors that perpetuate gender inequality and the effects that such bias can have on women in the workplace and beyond.

Gender and Bias

Effort, stamina, and purpose drive our accomplishments — science shows us what to do to keep motivation going.

Goals and Motivation

In some of the most famous cases of money laundering, corporate fraud, and tax evasion lies a relentless appetite for big profits and personal wealth. How does greed affect our sense of morality?

Greed and Corruption

Psychological scientists are leading the way in addressing the mental health issues resulting from traumatic events.

Grief and Trauma

Psychological science sheds light on happiness, from a personal to an economic level.

Learn how the human brain influences what our ears register - and what they don't.

Psychological science offers a variety of reasons to be hopeful about progress in science and the well-being of individuals and societies worldwide. Read about the most promising discoveries and advances of the past few years.

Learn about the research on what makes you laugh, why something you find funny is offensive to someone else, and more.

We’re averse to hypocrites because their disavowal of bad behavior sends a false signal about their true nature.

Unconscious bias can lurk below the level of conscious awareness, but researchers are working to uncover more effective methods of reducing these prejudices.

Implicit Bias

Psychological and educational interventions can make a positive difference in a person's trajectory or even their life. What factors influence how interventions either persist over the long term or fade out?

Interventions

Psychological science has played a leading role in busting misconceptions about sexual orientation and gender identity, and in changing people's attitudes toward individuals who are part of the LGBTQIA+ community.

Psychology researchers are identifying how we build strong reading skills in early childhood and the factors that contribute to difficulty with reading comprehension.

Researchers explore the causes, impacts, and possible interventions for loneliness and social isolation.

Loneliness and Social Isolation

Frank Sinatra crooned that they go together like a horse and carriage, but in truth love and marital health can falter over time. Scientists have identified a number of factors that sustain love through better or worse.

Love and Attraction

Learn about the vast stores of memory research that psychological scientists have amassed in recent years.

Psychological scientists have amassed a vast amount of empirical knowledge on the causes of and best treatments for mental disorders.

Mental Health

Researchers explore how practices associated with mindfulness and meditation can affect decision-making and other cognitive processes.

Mindfulness and Meditation

Psychological scientists are identifying cognitive, developmental, and cultural aspects of music perception and the essential role that music plays in our everyday lives.

How does misinformation spread and how do we combat it? Psychological science sheds light on the mechanisms underlying misinformation and 'fake news.'

Scientists are increasingly busting some myths and making new discoveries about a dark personality trait.

Deal making at the international, business, and interpersonal levels involves a variety of emotional, social, and language factors that lead to a final agreement -- or a stalemate.

Negotiation

Read about the wealth of psychological studies on neurodiversity and the differences in learning, attention, and mood.

Neurodivergence

Psychological scientists are devoting an increasing amount of their research time examining the role of the brain in human behavior, emotion, and cognitive health.

Neuroscience

Recent news events have sparked a surge of interest in the Dunning-Kruger effect -- a distorted view of one's knowledge and ability. Learn how this cognitive bias can spark overconfidence among world leaders and corporate giants.

Overconfidence

Amid the epidemic of opioid addiction, psychological science has demonstrated that pain relief doesn't have to be pharmaceutical.

Pain Management

Personality tests are the center of countless psychological studies exploring targeted marketing, workplace dynamics, and different brain structures.

Personality Traits

Public trust in the police has remained flat for decades, a problem that has become especially salient due to recent events.

Policing and Law Enforcement

A scientific analysis upends the notion that people on the political right are more biased about their ideological views than are people on the left.

Political Differences

Why do we dawdle and delay, even on the most important tasks? Researchers explore the causes and consequences of procrastination.

Procrastination

Plenty of beliefs about human psychology are based on myth masquerading as facts. Psychological scientists have not only exposed the weak evidence for these notions, but can recommend strategies to help us to distinguish true science from bunk.

Pseudoscience

Psychological researchers are examining the complexities of racism and xenophobia at both the interpersonal and societal levels.

Racism and Discrimination

Psychological research explores how we evaluate, perceive, and choose whether to take risks.

Why does self-control fail, and how can we boost it? Researchers explore the mechanisms underlying this important ability and how it develops over time.

Self-Control

The #metoo movement has brought sexual harassment to the center of public consciousness, raising questions about the causes of predatory actions. Psychological research shows how feeling powerful relates to sexually coercive behavior.

Sexual Assault and Harassment

Insufficient sleep has been shown to have adverse effects at work, in driving, and even in court.

From the scent of flowers to the stench of hazardous chemicals, our sense of smell guides us through our environment and significantly influences our emotions, as scientists have discovered.

How does athletic engagement and competition affect our thoughts and behaviors? Learn what psychological science has uncovered.

New discoveries about the ill effects of psychological stress abound, but scientists are also learning about buffers to stress.

Psychological scientists delve into study strategies, math anxiety, reading comprehension, and more.

Studying and Learning

Research from APS on addiction and substance abuse.

Substance Abuse and Addiction

Scientists show how get-aways and enjoyable activities affect our work lives and relationships.

Taking a Break

Psychological research is fostering understanding of the important factors that contribute to effective teaching, from individual instruction to school climate.

The psychological mechanisms that lead us to have faith in certain people and be suspicious of others are vast. Learn what psychological researchers have discovered about interpersonal trust.

September 10 is World Suicide Prevention Day. Read about the steps that psychological scientists are taking to identify and help people at risk of taking their own lives.

Understanding and Preventing Suicide

Psychological science suggests that behavioral 'nudges' which aim to alter individuals' actions rather than their attitudes are essential to promoting vaccination against COVID-19 and other vaccine-preventable diseases.

Vaccination

The effects of playing video games on well-being seem to depend largely on why and how an individual chooses to partake.

Video Games

The way the brain and the human eye process visual stimuli, including illusions, is a thriving area of psychological science.

Researchers unravel the mystery of voting behavior, including why people vote in seemingly unpredictable or illogical ways.

How does weather, both ordinary and extreme, affect decision-making, behavior, and emotions?

Weather and Behavior

Research in psychological science reveals the causes and consequences of bullying behavior in the office.

Workplace Bullying

When done well, efforts to improve intergroup harmony at work can uplift individuals and lead entire organizations to perform at a higher level.

Workplace Diversity

Privacy overview.

61 intriguing psychology research topics to explore

Last updated

11 January 2024

Reviewed by

Brittany Ferri, PhD, OTR/L

Psychology is an incredibly diverse, critical, and ever-changing area of study in the medical and health industries. Because of this, it’s a common area of study for students and healthcare professionals.

We’re walking you through picking the perfect topic for your upcoming paper or study. Keep reading for plenty of example topics to pique your interest and curiosity.

• How to choose a psychology research topic

Exploring a psychology-based topic for your research project? You need to pick a specific area of interest to collect compelling data. 

Use these tips to help you narrow down which psychology topics to research:

Focus on a particular area of psychology

The most effective psychological research focuses on a smaller, niche concept or disorder within the scope of a study. 

Psychology is a broad and fascinating area of science, including everything from diagnosed mental health disorders to sports performance mindset assessments. 

This gives you plenty of different avenues to explore. Having a hard time choosing? Check out our list of 61 ideas further down in this article to get started.

Read the latest clinical studies

Once you’ve picked a more niche topic to explore, you need to do your due diligence and explore other research projects on the same topic. 

This practice will help you learn more about your chosen topic, ask more specific questions, and avoid covering existing projects. 

For the best results, we recommend creating a research folder of associated published papers to reference throughout your project. This makes it much easier to cite direct references and find inspiration down the line.

Find a topic you enjoy and ask questions

Once you’ve spent time researching and collecting references for your study, you finally get to explore. 

Whether this research project is for work, school, or just for fun, having a passion for your research will make the project much more enjoyable. (Trust us, there will be times when that is the only thing that keeps you going.) 

Now you’ve decided on the topic, ask more nuanced questions you might want to explore. 

If you can, pick the direction that interests you the most to make the research process much more enjoyable.

• 61 psychology topics to research in 2024

Need some extra help starting your psychology research project on the right foot? Explore our list of 61 cutting-edge, in-demand psychology research topics to use as a starting point for your research journey.

• Psychology research topics for university students

As a university student, it can be hard to pick a research topic that fits the scope of your classes and is still compelling and unique. 

Here are a few exciting topics we recommend exploring for your next assigned research project:

Mental health in post-secondary students

Seeking post-secondary education is a stressful and overwhelming experience for most students, making this topic a great choice to explore for your in-class research paper. 

Examples of post-secondary mental health research topics include:

Student mental health status during exam season

Mental health disorder prevalence based on study major

The impact of chronic school stress on overall quality of life

The impacts of cyberbullying

Cyberbullying can occur at all ages, starting as early as elementary school and carrying through into professional workplaces. 

Examples of cyberbullying-based research topics you can study include:

The impact of cyberbullying on self-esteem

Common reasons people engage in cyberbullying 

Cyberbullying themes and commonly used terms

Cyberbullying habits in children vs. adults

The long-term effects of cyberbullying

• Clinical psychology research topics

If you’re looking to take a more clinical approach to your next project, here are a few topics that involve direct patient assessment for you to consider:

Chronic pain and mental health

Living with chronic pain dramatically impacts every aspect of a person’s life, including their mental and emotional health. 

Here are a few examples of in-demand pain-related psychology research topics:

The connection between diabetic neuropathy and depression

Neurological pain and its connection to mental health disorders

Efficacy of meditation and mindfulness for pain management

The long-term effects of insomnia

Insomnia is where you have difficulty falling or staying asleep. It’s a common health concern that impacts millions of people worldwide. 

This is an excellent topic because insomnia can have a variety of causes, offering many research possibilities. 

Here are a few compelling psychology research topics about insomnia you could investigate:

The prevalence of insomnia based on age, gender, and ethnicity

Insomnia and its impact on workplace productivity

The connection between insomnia and mental health disorders

Efficacy and use of melatonin supplements for insomnia

The risks and benefits of prescription insomnia medications

Lifestyle options for managing insomnia symptoms

The efficacy of mental health treatment options

Management and treatment of mental health conditions is an ever-changing area of study. If you can witness or participate in mental health therapies, this can make a great research project. 

Examples of mental health treatment-related psychology research topics include:

The efficacy of cognitive behavioral therapy (CBT) for patients with severe anxiety

The benefits and drawbacks of group vs. individual therapy sessions

Music therapy for mental health disorders

Electroconvulsive therapy (ECT) for patients with depression 

• Controversial psychology research paper topics

If you are looking to explore a more cutting-edge or modern psychology topic, you can delve into a variety of controversial and topical options:

The impact of social media and digital platforms

Ever since access to internet forums and video games became more commonplace, there’s been growing concern about the impact these digital platforms have on mental health. 

Examples of social media and video game-related psychology research topics include:

The effect of edited images on self-confidence

How social media platforms impact social behavior

Video games and their impact on teenage anger and violence

Digital communication and the rapid spread of misinformation

The development of digital friendships

Psychotropic medications for mental health

In recent years, the interest in using psychoactive medications to treat and manage health conditions has increased despite their inherently controversial nature. 

Examples of psychotropic medication-related research topics include:

The risks and benefits of using psilocybin mushrooms for managing anxiety

The impact of marijuana on early-onset psychosis

Childhood marijuana use and related prevalence of mental health conditions

Ketamine and its use for complex PTSD (C-PTSD) symptom management

The effect of long-term psychedelic use and mental health conditions

• Mental health disorder research topics

As one of the most popular subsections of psychology, studying mental health disorders and how they impact quality of life is an essential and impactful area of research. 

While studies in these areas are common, there’s always room for additional exploration, including the following hot-button topics:

Anxiety and depression disorders

Anxiety and depression are well-known and heavily researched mental health disorders. 

Despite this, we still don’t know many things about these conditions, making them great candidates for psychology research projects:

Social anxiety and its connection to chronic loneliness

C-PTSD symptoms and causes

The development of phobias

Obsessive-compulsive disorder (OCD) behaviors and symptoms

Depression triggers and causes

Self-care tools and resources for depression

The prevalence of anxiety and depression in particular age groups or geographic areas

Bipolar disorder

Bipolar disorder is a complex and multi-faceted area of psychology research. 

Use your research skills to learn more about this condition and its impact by choosing any of the following topics:

Early signs of bipolar disorder

The incidence of bipolar disorder in young adults

The efficacy of existing bipolar treatment options

Bipolar medication side effects

Cognitive behavioral therapy for people with bipolar 

Schizoaffective disorder

Schizoaffective disorder is often stigmatized, and less common mental health disorders are a hotbed for new and exciting research. 

Here are a few examples of interesting research topics related to this mental health disorder:

The prevalence of schizoaffective disorder by certain age groups or geographic locations

Risk factors for developing schizoaffective disorder

The prevalence and content of auditory and visual hallucinations

Alternative therapies for schizoaffective disorder

• Societal and systematic psychology research topics

Modern society’s impact is deeply enmeshed in our mental and emotional health on a personal and community level. 

Here are a few examples of societal and systemic psychology research topics to explore in more detail:

Access to mental health services

While mental health awareness has risen over the past few decades, access to quality mental health treatment and resources is still not equitable. 

This can significantly impact the severity of a person’s mental health symptoms, which can result in worse health outcomes if left untreated. 

Explore this crucial issue and provide information about the need for improved mental health resource access by studying any of the following topics:

Rural vs. urban access to mental health resources

Access to crisis lines by location

Wait times for emergency mental health services

Inequities in mental health access based on income and location

Insurance coverage for mental health services

Systemic racism and mental health

Societal systems and the prevalence of systemic racism heavily impact every aspect of a person’s overall health.

Researching these topics draws attention to existing problems and contributes valuable insights into ways to improve access to care moving forward.

Examples of systemic racism-related psychology research topics include: 

Access to mental health resources based on race

The prevalence of BIPOC mental health therapists in a chosen area

The impact of systemic racism on mental health and self-worth

Racism training for mental health workers

The prevalence of mental health disorders in discriminated groups

LGBTQIA+ mental health concerns

Research about LGBTQIA+ people and their mental health needs is a unique area of study to explore for your next research project. It’s a commonly overlooked and underserved community.

Examples of LGBTQIA+ psychology research topics to consider include:

Mental health supports for queer teens and children

The impact of queer safe spaces on mental health

The prevalence of mental health disorders in the LGBTQIA+ community

The benefits of queer mentorship and found family

Substance misuse in LQBTQIA+ youth and adults

• Collect data and identify trends with Dovetail

Psychology research is an exciting and competitive study area, making it the perfect choice for projects or papers.

Take the headache out of analyzing your data and instantly access the insights you need to complete your next psychology research project by teaming up with Dovetail today.

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50+ Research Topics for Psychology Papers

How to Find Psychology Research Topics for Your Student Paper

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

• Specific Branches of Psychology
• Topics Involving a Disorder or Type of Therapy
• Human Cognition
• Human Development
• Critique of Publications
• Famous Experiments
• Historical Figures
• Specific Careers
• Case Studies
• Literature Reviews
• Your Own Study/Experiment

Are you searching for a great topic for your psychology paper ? Sometimes it seems like coming up with topics of psychology research is more challenging than the actual research and writing. Fortunately, there are plenty of great places to find inspiration and the following list contains just a few ideas to help get you started.

Finding a solid topic is one of the most important steps when writing any type of paper. It can be particularly important when you are writing a psychology research paper or essay. Psychology is such a broad topic, so you want to find a topic that allows you to adequately cover the subject without becoming overwhelmed with information.

I can always tell when a student really cares about the topic they chose; it comes through in the writing. My advice is to choose a topic that genuinely interests you, so you’ll be more motivated to do thorough research.

In some cases, such as in a general psychology class, you might have the option to select any topic from within psychology's broad reach. Other instances, such as in an  abnormal psychology  course, might require you to write your paper on a specific subject such as a psychological disorder.

As you begin your search for a topic for your psychology paper, it is first important to consider the guidelines established by your instructor.

Research Topics Within Specific Branches of Psychology

The key to selecting a good topic for your psychology paper is to select something that is narrow enough to allow you to really focus on the subject, but not so narrow that it is difficult to find sources or information to write about.

One approach is to narrow your focus down to a subject within a specific branch of psychology. For example, you might start by deciding that you want to write a paper on some sort of social psychology topic. Next, you might narrow your focus down to how persuasion can be used to influence behavior .

Other social psychology topics you might consider include:

• Prejudice and discrimination (i.e., homophobia, sexism, racism)
• Social cognition
• Person perception
• Social control and cults
• Persuasion, propaganda, and marketing
• Attraction, romance, and love
• Nonverbal communication
• Prosocial behavior

Psychology Research Topics Involving a Disorder or Type of Therapy

Exploring a psychological disorder or a specific treatment modality can also be a good topic for a psychology paper. Some potential abnormal psychology topics include specific psychological disorders or particular treatment modalities, including:

• Eating disorders
• Borderline personality disorder
• Seasonal affective disorder
• Schizophrenia
• Antisocial personality disorder
• Profile a  type of therapy  (i.e., cognitive-behavioral therapy, group therapy, psychoanalytic therapy)

Topics of Psychology Research Related to Human Cognition

Some of the possible topics you might explore in this area include thinking, language, intelligence, and decision-making. Other ideas might include:

• False memories
• Speech disorders
• Problem-solving

Topics of Psychology Research Related to Human Development

In this area, you might opt to focus on issues pertinent to  early childhood  such as language development, social learning, or childhood attachment or you might instead opt to concentrate on issues that affect older adults such as dementia or Alzheimer's disease.

Some other topics you might consider include:

• Language acquisition
• Media violence and children
• Learning disabilities
• Gender roles
• Child abuse
• Prenatal development
• Parenting styles
• Aspects of the aging process

Do a Critique of Publications Involving Psychology Research Topics

One option is to consider writing a critique paper of a published psychology book or academic journal article. For example, you might write a critical analysis of Sigmund Freud's Interpretation of Dreams or you might evaluate a more recent book such as Philip Zimbardo's  The Lucifer Effect: Understanding How Good People Turn Evil .

Professional and academic journals are also great places to find materials for a critique paper. Browse through the collection at your university library to find titles devoted to the subject that you are most interested in, then look through recent articles until you find one that grabs your attention.

Topics of Psychology Research Related to Famous Experiments

There have been many fascinating and groundbreaking experiments throughout the history of psychology, providing ample material for students looking for an interesting term paper topic. In your paper, you might choose to summarize the experiment, analyze the ethics of the research, or evaluate the implications of the study. Possible experiments that you might consider include:

• The Milgram Obedience Experiment
• The Stanford Prison Experiment
• The Little Albert Experiment
• Pavlov's Conditioning Experiments
• The Asch Conformity Experiment
• Harlow's Rhesus Monkey Experiments

Topics of Psychology Research About Historical Figures

One of the simplest ways to find a great topic is to choose an interesting person in the  history of psychology  and write a paper about them. Your paper might focus on many different elements of the individual's life, such as their biography, professional history, theories, or influence on psychology.

While this type of paper may be historical in nature, there is no need for this assignment to be dry or boring. Psychology is full of fascinating figures rife with intriguing stories and anecdotes. Consider such famous individuals as Sigmund Freud, B.F. Skinner, Harry Harlow, or one of the many other  eminent psychologists .

Psychology Research Topics About a Specific Career

​Another possible topic, depending on the course in which you are enrolled, is to write about specific career paths within the  field of psychology . This type of paper is especially appropriate if you are exploring different subtopics or considering which area interests you the most.

In your paper, you might opt to explore the typical duties of a psychologist, how much people working in these fields typically earn, and the different employment options that are available.

Topics of Psychology Research Involving Case Studies

One potentially interesting idea is to write a  psychology case study  of a particular individual or group of people. In this type of paper, you will provide an in-depth analysis of your subject, including a thorough biography.

Generally, you will also assess the person, often using a major psychological theory such as  Piaget's stages of cognitive development  or  Erikson's eight-stage theory of human development . It is also important to note that your paper doesn't necessarily have to be about someone you know personally.

In fact, many professors encourage students to write case studies on historical figures or fictional characters from books, television programs, or films.

Psychology Research Topics Involving Literature Reviews

Another possibility that would work well for a number of psychology courses is to do a literature review of a specific topic within psychology. A literature review involves finding a variety of sources on a particular subject, then summarizing and reporting on what these sources have to say about the topic.

Literature reviews are generally found in the  introduction  of journal articles and other  psychology papers , but this type of analysis also works well for a full-scale psychology term paper.

Topics of Psychology Research Based on Your Own Study or Experiment

Many psychology courses require students to design an actual psychological study or perform some type of experiment. In some cases, students simply devise the study and then imagine the possible results that might occur. In other situations, you may actually have the opportunity to collect data, analyze your findings, and write up your results.

Finding a topic for your study can be difficult, but there are plenty of great ways to come up with intriguing ideas. Start by considering your own interests as well as subjects you have studied in the past.

Online sources, newspaper articles, books , journal articles, and even your own class textbook are all great places to start searching for topics for your experiments and psychology term papers. Before you begin, learn more about  how to conduct a psychology experiment .

What This Means For You

After looking at this brief list of possible topics for psychology papers, it is easy to see that psychology is a very broad and diverse subject. While this variety makes it possible to find a topic that really catches your interest, it can sometimes make it very difficult for some students to select a good topic.

If you are still stumped by your assignment, ask your instructor for suggestions and consider a few from this list for inspiration.

• Hockenbury, SE & Nolan, SA. Psychology. New York: Worth Publishers; 2014.
• Santrock, JW. A Topical Approach to Lifespan Development. New York: McGraw-Hill Education; 2016.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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244 Stress Research Topics & Essay Examples

📝 stress research papers examples, 💡 essay ideas on stress, 👍 good stress essay topics to write about.

• ⭐ Simple & Easy Stress Essay Titles

🔎 Interesting Topics to Write about Stress

🏆 best stress essay titles, 🎓 simple research topics about stress, 📣 stress topics for discussion, ❓ stress research questions.

• Posttraumatic Stress Disorder: Effects of Child Sexual Abuse Psychology essay sample: Child sexual abuse is among the common problems facing children. This paper looks at the causes and effects of child sexual abuse, the posttraumatic stress disorder, and its treatment.
• Occupational Stress and Stress Management Techniques Psychology essay sample: The paper discusses and evaluates the current state of literature about psychological debriefing in organizations and their effectiveness in managing acute occupational stress.
• Military Post-Traumatic Stress Disorder Issues Psychology essay sample: The paper discusses conditions that influence post-traumatic stress disorder, symptoms and treatment of the disorder, adjustment and transitional issues faced by soldiers.
• Children Under Stress and Its Management Psychology essay sample: In the current technological world and societies, people tend to experience various kinds of stress at all levels of their lives whether as children, adolescents or as adults.
• Post Traumatic Stress Disorder in the Military Psychology essay sample: The psychological diagnosis posttraumatic stress disorder appeared in 1980 to hallmark long-term reactive psychological disorders in response to exposure to war environment.
• Post Traumatic Stress Disorder in Combat Veterans Psychology essay sample: War is a major cause of Post Traumatic Stress Disorder. About seventeen percent of a veteran returning from war in places such as Iraq and Afghanistan show signs of PTSD.
• Work-Related Stress Reasons and Prevention Psychology essay sample: The psychological well-being of employees in the workplace is critical to avoid stress and improve employees’ performance. Stress is inevitable in the workplace and the effects of stress are mostly negative.
• Work-Place Stress Problem Analysis Psychology essay sample: Stress is inevitable in the workplace, and the effects of stress are mostly negative, as it has outcomes on the incomes of the organization and the health of the worker.
• Human Factors: Workload and Stress Relationship Psychology essay sample: Federico and Won, in their WIHI podcast, examine the relationship between stress and workload. They refer to human factors and their role in work-related stress in health care.
• Post-Traumatic Stress Disorder: Causes, Symptoms, Treatment Psychology essay sample: Post-traumatic stress disorder (PTSD) is a mental disorder associated with trauma and stress, especially from severe physical harm or and exposure to painful events.
• Post-traumatic Stress Disorder and Bereavement Psychology essay sample: In diagnosing bereavement, the first complication is drawing the line between grieving as the ‘normal' reaction and the traumatic distressed caused by the death of the loved one.
• Perceived Stress and Social Support Received Psychology essay sample: Psychological and biological stress models have been put forward to explain the events that take place when one is under stressful conditions.
• Post Traumatic Stress Disorder in the United States Psychology essay sample: Post Traumatic Stress Disorder (PTSD) is an emotional illness that is characterized by constant anxiety and is often the result of continuing frightening.
• "Introduction to Psychology" by Hawkes Learning Systems Psychology essay sample: The paper is about discussion posts on the Introduction to psychology. The each chapter discuss the human psyche, capabilities and behavior.
• Stress Perception in Students Psychology essay sample: The students from Western countries reported that they face greater stress from their relationships with parents, females’ stress levels were higher than those of males.
• Natural Ways to Manage Stress Psychology essay sample: Researchers have shown that respiration techniques help realign the sympathetic and the parasympathetic systems, simply by tuning the brain waves.
• Stress Management Among University Students Psychology essay sample: This paper presents a brief description of the methodology and results of research on the factors and levels of stress in students.
• How to Manage Stress: Key Tips Psychology essay sample: According to Sarafino, stress is a combination of emotional and physical tension in one’s mind and body. It can appear as a response to any traumatic experience.
• Definition of Stress: Pain or Motivation Psychology essay sample: Stress is often understood as a kind of psychological pain. In some circumstances, it can motivate a person to overcome difficulties and develop new skills.
• Stress Management Techniques Psychology essay sample: In this article, the author shares his knowledge of the different types of stress, and also talks about the methods that he uses to overcome them.
• Signs and Symptoms of Stress Psychology essay sample: Stress is a physical or emotional disorder, which can result from any frustrating experience. The signs of stress can be understood through a review of the theories of its causes.
• How Stress Affects Child Brain Development Psychology essay sample: Stress is an unavoidable and important part of any child’s life. Depending on how significant it is it can have a positive or negative effect on the child’s development.
• The Impact of Stress on Academic Performance Psychology essay sample: Stress had a universal presence in living creatures since the dawn of life, it does not mean that we should not try to avoid it and help reduce it for others.
• Post-Traumatic Stress Disorder and Pregnancy Psychology essay sample: The purpose of this paper is to identify the connection between pregnancy and stress. The most famous stress disorder is the so-called post-traumatic stress disorder or PTSD.
• Family Coping With Stressful Events and Transitions Psychology essay sample: Before analyzing the stages of the crisis and using the Double ABC-X Model, it is necessary to describe a hypothetical stressful family situation.
• Psychology of Social Stress. Stress and Health Psychology essay sample: It is important to justify the relevance of a theoretical understanding of the concept of social stress in psychological science.
• The Application of Key Psychological Concepts Psychology essay sample: This essay discusses the application of key psychological concepts in personal life and future aspirations as an anesthesiologist.
• About Stress Reduction Methods Psychology essay sample: In this article, the author shares her knowledge of stress reduction techniques and talks about how her life changed after she started practicing them.
• The Phenomenon of Post-Traumatic Stress Disorder Psychology essay sample: This research paper aims to discuss the phenomenon of post-traumatic stress disorder and its relationship to evidence-based medicine.
• Reaction to Stress: Anxiety and Yoga Psychology essay sample: The paper discusses stress. It is the reaction of the human nervous system to disbalance with the environment caused by internal or external factors.
• Problem of Stress and Its Impact on Student Performance Psychology essay sample: The problem of stress and its impact on student performance at Khalifa University is relevant, and the results of the research confirm the value of addressing this issue.
• Stress: Curriculum, Curricular Divisions and Writing Strategies Psychology essay sample: There are different actions to be so as to reduce the stresses and strains so as to prevent them from occurring, this includes thorough counseling, doing a lot of exercises.
• The Psychological and the Biological Stress Models: Comparative Analysis Psychology essay sample: Psychological and biological models have been constructed to explain the events that take place when a person is stressed.
• Stress Negatively Affects the Decision-Making Process of Business Leaders Psychology essay sample: The purpose of this article is to determine the extent to which stress affects the key elements of decision-making.
• The Effectiveness of Mindfulness Meditation Intervention in Reducing Stress in Adolescents Psychology essay sample: The research proposed in this work intends to examine adolescent stress when treated via the Mindfulness-Based Stress Reduction Intervention.
• Stress Management: Imagery Psychology essay sample: The paper discusses imagery. It is a very effective way of dealing with stress especially when accompanied by physical relaxation through exercising.
• Differents Forms to Stress, Pandemic of Stress Psychology essay sample: In this paper, stress is a major problem in the world today. Many countries and many individuals and families are victims of stress-related problems.
• The Importance of Assessment of Post-traumatic Stress Disorder Psychology essay sample: The purpose of this article is to consider the mechanisms of occurrence of post-traumatic stress disorder, as well as existing methods of its treatment.
• Post-Traumatic Stress Disorder Psychology essay sample: The purpose of this article is to consider the mechanisms of occurrence of post-traumatic stress disorder, as well as existing methods of its treatment.
• PTSD Treatment and Plan of Care Psychology essay sample: The purpose of this article is to review the causes of post-traumatic stress disorder, as well as its clinical manifestations, treatment and care plan.
• Understanding the Psychology of Stress in Everyday Life Psychology essay sample: The paper explains how does stress impacts the body, the relationship between motivation, emotion, and stress, describes two ways that can change stress symptoms.
• Addressing the Post-Traumatic Stress Disorder Psychology essay sample: The purpose of this article is to review the causes of post-traumatic stress disorder, as well as its symptoms and treatment.
• The Notion of Stress as Both a Biological Process Psychology essay sample: In the following paper, the notion of stress as both a biological process and psychological condition will be evaluated.
• Work-Related Stress and Burnout Psychology essay sample: The purpose of this article is to discuss work-related stress and burnout in terms of causes and effects, as well as interventions.
• The Impact of Stress on the Human Organism Psychology essay sample: Two job-related stresses have been affecting me the most, these are decreasing work efficiency. At this time of the year, people who are in the corporate world, tend to work fast.
• Stress as the Main Cause of Students’ Academic Failure Psychology essay sample: The connection between stress and the academic failure of students is quite explicit, specifically, being unable to cope with the emotional strain leads to poor performance.
• Occupation, Culture, and Stress in Middle Adulthood Psychology essay sample: For people in middle adulthood, the main stress-inducing problems are related to their occupations, their particular workplace situation, as well as to cultural determinants.
• Underappreciated Veterans with Post-Traumatic Stress Disorder Psychology essay sample: Veterans with PTSD are underappreciated and are not given enough help to enhance their well-being. PTSD is a health concern among veterans due to the nature of their work.
• Mental Health: Case Study of S. Psychology essay sample: This paper is devoted to the case of a woman I know personally. S. is a 31-year-old single mother with a family history of anxiety disorders.
• Stress and Its Effect on Health Psychology essay sample: Stress is defined as an individual’s reaction to a situation that destabilizes their mental, physical, psychological, or emotional state.
• Stress and Health: How People React to Stressors Psychology essay sample: In this paper, I support my agreement with the concept that different people react differently to different stressors.
• Stress and Anxiety Sources Amongst Students Psychology essay sample: This paper discusses some of the major sources of physiological, social, and psychological stress and anxiety in students.
• Patient's Concentration: Applied Behavior Analysis Psychology essay sample: This paper explores how memories are created, stored, and recalled. The paper investigates how the perception of stress might have affected the patient’s ability to focus.
• Psychology. Holmes-Rahe Life Stress Inventory Psychology essay sample: There are situations when several psychological tests, which are relatively similar to one another, can yield very different results.
• Exploring the Concepts of Productivity and Stress Levels in the Workplace Psychology essay sample: This article examines the impact of multitasking on employee stress levels, as well as ways to deal with stress.
• Secondary Post-Traumatic Stress Disorder in Military Families Psychology essay sample: Secondary Post-Traumatic Stress Disorder is a psychological condition that is common among military families of victims of primary Post-Traumatic Stress Disorder.
• The Stress Refraining Exercise Psychology essay sample: This study is worth reading because it provides invaluable insight into the ways people can effectively counter their stress-induced anxiety
• Handling Organizational Stress Psychology essay sample: Stress is a psychological effect that can affect any individual at some point in their lives regardless of their job capacity.
• Stress Management and Personal Life Experience Psychology essay sample: People need to learn how to manage stress and turn such a situation to their advantage. Stress management is a whole system of sequential actions.
• Post Traumatic Stress Disorder (PTSD) Psychology essay sample: The current research paper is aimed at underscoring a research proposal that is related to Post Traumatic Stress Disorder (PTSD).
• Mind and Body: Stress is Part of Human Life Psychology essay sample: Stress is part of human life and it influences mental health, behavior, moods, and overall sense of wellbeing.
• Stress and Workplace Production Psychology essay sample: The problem of increased stress and emotional pressure in the workplace is a major constituent in shaping people’s motivation, enthusiasm, and performance rates.
• Stress Management Strategies for Working Students Psychology essay sample: The strategies which might help manage stress for the working students are finding trustful mentors and noting positive events of the day in the diary.
• Social Stress and Its Impact on Memory Psychology essay sample: The paper points out that psychological stressors have shown significant impacts on cognition function. This study is meant to determine how and when memory is strained.
• Perceived Stress Among Undergraduate Students Psychology essay sample: In 2016, Abdollahi published a study on the role of hardiness in relieving stress among undergraduate students, which was published in the Journal of Health Psychology.
• The Impacts of Stress on Human Memory Psychology essay sample: Human memory performance can be impacted by several factors, encompassing non-cognitive elements such as the emotional condition of the test-taker.
• Habits, Stress, and Health Psychology essay sample: Personal habits, stress, and health interact in disparate ways. Everyday activities can exacerbate stress levels that an individual might not realize.
• Stress Identification and Management Psychology essay sample: Stress can be defined as any type of change in the human body that can cause physiological, emotional, and physical strain.
• Stress and Meditation as a Form of Treatment Psychology essay sample: Modern medicine eradicated many diseases that once posed a significant threat to humanity, but a new and relatively invisible issue, which came to be nowadays is stress.
• Workplace Stress and Managerial Counterstrategies Psychology essay sample: Workplace stress leads to significant losses and additional costs for enterprises. Most often, stress is caused by excessive workload and too long working hours.
• When the Body Says No by Dr. Gabor Mate: The Cost of Hidden Stress Psychology essay sample: When the Body Says No by Dr. Gabor Mate is a book written by Dr. Gabor Mate. It explores the link between the mind and the body.
• Stress Management (Abnormal Psychology) Psychology essay sample: Stress has devastating effects on one’s life. Coping with stress demands one to have an idea of what gives rise to the stressed condition.
• Psychology: Impact of Stressors Psychology essay sample: The concept of mind, body, and soul connection can help to effectively deal with physical manifestations of stress or use them to recognize and manage it.
• Stress at Work. Steps to Reduce Psychology essay sample: Stress is tension that occurs in the life of a person. There is a way in which an individual manages to control stress in the workplace.
• Effects of Secondary Ptsd in Military Families Psychology essay sample: Veterans with PTSD fail to address their mental health concerns, instead, transferring their trauma to their family members and creating an intergenerational trauma.
• Cognitive Techniques for Preventing Unhealthy Stress Psychology essay sample: As prolonged stress may lead to various physical and mental problems, it is essential to use cognitive techniques for preventing it.
• Intact and Non-Intact Dual Earners: Stress Levels Psychology essay sample: Stress levels occur in both intact and non-intact dual earners. How to deal with the stress levels depends on the individuals and the people around them.
• Stress Among Ethnic Minority Adolescents and Mindfulness Intervention Psychology essay sample: The purpose of the proposed research is to investigate the effect of a school-based mindfulness-based intervention on stress among ethnic minority adolescents.
• Mindfulness-Based Stress Reduction for Adults Psychology essay sample: The study explores the implementation of an adapted mindfulness program for adults, having traumatic brain injuries and substance use problems.
• Developing PTSD: Trauma at a Younger Age Psychology essay sample: Some people are more prone to developing PTSD than others because of trauma at a younger age, like physical assault or major accidents.
• Aspects of Stress Management Psychology essay sample: There are various causes of stress, and they include troubles and challenges, which require significant efforts to cope with them.
• A Qualitative Study of Mindfulness among Veterans With Posttraumatic Stress Psychology essay sample: The study examines post-traumatic stress disorder with a focus on deployment trauma among military veterans, outlining the most effective mindful intervention strategies.
• Psychological Harm in Stressful Environment Psychology essay sample: The issue of a stressful working environment is exceptionally widespread today, with stress-related illnesses and disorders earned by employees even being brought to court.
• "How to Make Stress Your Friend" TED Talk by McGonigal Psychology essay sample: In her TED talk, McGonigal reveals crucial information regarding the effects of stress on the human body. It is beneficial for people to recognize the positive impact of stress.
• The Role Stress Plays in People’s Personal Lives Psychology essay sample: This paper involves a set of psychological reactions that affect people’s behaviors and can have diverse outcomes, both positive and negative.
• The Risk and Protective Factors Linked to Post-Traumatic Growth in Women Psychology essay sample: The paper aims to explore the risk and protective factors linked to post-traumatic growth in women who have experienced sexual violence.
• Early-Life Stress and Behavioral Outcomes Psychology essay sample: The study aims to understand the mechanisms behind the long-lasting consequences of early-life stress exposure. It is accomplished by comparing the results of tests.

⭐ Simple & Easy Stress Essay Titles

• Maintaining Mental Health for Teenagers in the Pandemic Psychology essay sample: The paper states that the pandemic harmed students' lives, who more often began to experience stress and missed communicating with their classmates.
• Deviant Behavior Related to Stress and Strain Psychology essay sample: With the knowledge of new alternatives to self-destructing actions, people could adopt new behavior patterns and activate feelings of excitement and joy.
• Stress Coping Theory in Radiology Career Pathway Psychology essay sample: This paper will discuss possible stressors in a radiologist's job and the application of stress and coping theory to alleviate them.
• Stress Management and Weight Control Psychology essay sample: Effective stress management requires natural body relaxation responses induced by practicing regular meditation and muscle relaxation activities.
• Psychology: Overview and Understanding Psychology essay sample: Like many sciences, psychology has evolved from philosophy and inherited questions and concepts which philosophy had been developing.
• Managing Stress: Techniques for Relaxation Psychology essay sample: Diaphragmatic breathing, meditation as well as imagery, and visualization are discussed as effective techniques for relaxation.
• A Study of Causes of Stress and Stress Management Among Youth Psychology essay sample: “A Study of Causes of Stress and Stress Management Among Youth” strives to expound on the probable causes of stress among students and help counselors give appropriate advice.
• Parental Stresses and Child’s Emotional Development Psychology essay sample: Raising a child as a head of a single-parent family is associated with various challenges. Firstly, a single-parent family may be struggling to afford even the basic needs.
• The Stress Coping Mechanisms Analysis Psychology essay sample: The stress coping mechanisms are based on various aspects and are classified into: problem-based, appraisal-based, emotion-based and occupation-based.
• Coping With School Stress on Support Group Session Psychology essay sample: This paper aims to give a reflection on a support group presentation on the coping mechanism with school stress.
• A Stress-Management Program for College Students Psychology essay sample: A stress-management program for this academic period involves training learners on how to effectively eliminate or at the very least reduce their anxiety levels.
• College Students' Stress Management Psychology essay sample: There is a significant need to evaluate if physical exercise may be employed as a stress management method to boost academic performance among college students.
• Applying Concepts of Psychology Psychology essay sample: The paper explores how the concepts of psychology learned have affected development. They are learning, stress, memory, consciousness, and motivation.
• Critical Incident Stress Management in Emergency Preparedness Psychology essay sample: CISM is a crisis intervention that is vital to a stress management program as part of emergency preparedness.
• Counselors’ Stress: “Meeting Someone at the Edge” Psychology essay sample: “Meeting someone at the edge” focuses on occupational stress in a specific profession; the major exclusion criterion is the lack of professional experience in counseling.
• Trauma and Abuse: Psychoanalysis vs. Person-Centered Approach Psychology essay sample: In terms of the present paper, person-centered and psychoanalytic approaches were closely examined on the matter of their essence and interaction with trauma.
• Deception in Social Psychological Research Psychology essay sample: Current professional codes of ethics are designed to prevent psychological experiments using deception where they are likely to cause psychological harm to research participants.
• Parental and Psychotherapeutic Role in Development of Children With Autism Psychology essay sample: Parents have a significant role in developing and preparing an autistic child for future life, and in such cases, the work of a psychotherapist with the whole family is important.
• Symptoms of Stress and Its Treatment Psychology essay sample: Many people consider stress a normal part of their life and avoid addressing the problem, yet it may have considerable symptoms negatively affecting individuals' health.
• PTSD Among African American Vietnam Veterans Psychology essay sample: Post-traumatic stress disorder is unfortunately common among veterans, and it is especially prevalent among African American Vietnam veterans.
• PTSD Treatment for Earthquake Survivors Psychology essay sample: Post-Traumatic Stress Disorder is a mental illness that occurs in individuals who have experienced severe traumatizing events and have difficulties.
• Symptoms of Posttraumatic Stress Disorder Psychology essay sample: The paper states that African American veterans would report more symptoms of posttraumatic stress disorder as compared to Caucasian Americans.
• Becoming a More Productive Student Psychology essay sample: The paper discusses how to become a more productive student. Sporting events and physical activity are the keys to overall health, immunity, body, mind, and soul.
• Mental Disorders in the "Finding Nemo" Film Psychology essay sample: In Search of Nemo is a 2003 American computer-animated adventure film. According to the plot, a curious Nemo fish went to look for mysterious coral reefs one day.
• Community Counseling: Outreach to Distressed and Marginalized Clients Psychology essay sample: A significant issue in community counseling is community recovery, an effort to rehabilitate the social and physical environment damaged by a disastrous event.
• Prolonged Stress: Negative Effects and Management Psychology essay sample: A person affected by prolonged stress is more likely to develop a shorter memory span, anxious behaviors, secretory changes in the amygdala, and poor sleep.
• Coping with Stress in Athletes Psychology essay sample: Given the specific principles of training, scholastic athletes tend to demonstrate more successful strategies for coping with stress in everyday life and in the academic environment.
• Immigrants' Mental Health and Time Spent in the US Psychology essay sample: The hypothesis of this article is that the prolonged presence of immigrants in the United States for various reasons increases their stress levels.
• Stress Reduction Methods at the Workplace Psychology essay sample: Stress reduction methods may be divided into two categories: those that prevent stress sources and those reducing its consequences.
• Post-Traumatic Stress Disorder After Car Accident Psychology essay sample: This case study assignment will examine and provide a detailed analysis of the case study about Jane, a 54-year-old Black female who became a victim of a terrifying car accident.
• Psychological Disorders: Definitions and Treatments Psychology essay sample: This paper examines such psychological disorders as Social phobia, Generalized anxiety disorder, Post-traumatic stress disorder, and Panic disorder.
• Traumatic Stress in the Justice System Psychology essay sample: The analysis of the article supported by the book shows that experiences of traumatic events in law enforcement affect police officers' mental health.
• Foundational Psychological Processes Psychology essay sample: The basic foundation of psychology is traced back to lifespan development, stressing or emphasizing wellness and overall psychological health.
• The Gendering of Stress and Burn-Out in Modern Policing Psychology essay sample: The psychological strain of executing an aggressive arrest raises the risk of burnout in male officers, and this is the only job variable that is noteworthy.
• Post-Traumatic Stress Disorder in Children Psychology essay sample: Post-traumatic stress disorder in children violates mental activity that develops after an external psychologically traumatic event.
• Aspects of Habit Hacking Mission Psychology essay sample: A good start in hacking any habit is observing and studying their habit routine. Habits are all about behaviors, and these are all about psychology.
• Islamic Psychology and Its Contributors Psychology essay sample: The current paper states that Islamic psychology is a complex topic as there are numerous contributors that created a broad legacy of teachings.
• The COVID-19 Pandemic and Social Well-Being Psychology essay sample: This paper aims to discuss the relationship between the COVID-19 pandemic and the social well-being of people.
• “Psychological Distress: Concept Analysis”: Key Findings Psychology essay sample: "Psychological Distress: Concept Analysis" defines psychological stress as a state that is unique, discomforting, and emotional and appears in response to specific stressors.
• Benefits of Meditations Psychology essay sample: Meditation has many health benefits for humans. It can be exercised at any time, depending on someone’s schedule and comfortable place.
• Post-Traumatic Growth Among Police Officers Psychology essay sample: Effective implementation of Christian counseling has the potential to introduce post-traumatic growth among police officers that are followers of the Christian worldview.
• Secondary Post Traumatic Stress Disorder in Children Psychology essay sample: Understanding child PTSD is fundamental in determining or predicting the future tendencies and outcomes of future life in terms of health, behavior, and social well-being.
• Work-Related Stress and Meditation & Mindfulness Psychology essay sample: An explanation of the two coping strategies, which are meditation and mindfulness and massage therapy, will be provided to reveal how they would be applied to work-related stress.
• How to Increase Happiness Across All Three Types of Subjective Well-Being Psychology essay sample: Some essential benefits of happiness include reduced stress, boosted immune system, a healthy lifestyle, and the maintenance of healthy relationships.
• Childhood Trauma: Causes, Effects, and Preventive Measures Psychology essay sample: It is salient to understand the causative factors and the effects of childhood trauma while also highlighting applicable preventive measures.
• Trauma-Focused Therapy: Effectiveness on Patients Experiencing PTSD Psychology essay sample: The COVID-19 pandemic and its implications ranked first among the predisposing factors for the unprecedented annual statistics.
• Impact of Toxic Stress on Child Refugees Psychology essay sample: More early childhood educators should recognize the complexity of working with child refugees and reduce the amount of stress they tend to experience.
• Sleep Health and Self-Determination Psychology essay sample: Poor sleep is the problem that affects human motivation and performance chosen for this assessment. Poor sleep has become a ubiquitous issue in modern high-paced society.
• The Impact of Stress on Learning Psychology essay sample: The paper states that the level of stress has a long-term impact on many aspects of a person's nervous, physical, and mental development.
• Post-Traumatic Stress Disorder and Animal-Assisted Therapy Psychology essay sample: Dogs are attractive animals to study the relationship between the oxytocinergic system and social connections.
• The Psychological Sources of Stress Psychology essay sample: The psychological sources of stress are numerous, but they can be summarized as the failure of an individual to address their particular needs.
• Student Mental Health: Dealing With Stress Psychology essay sample: The paper discusses the probability of positive outcomes of mindfulness practices on students’ mental health. The solution can help reduce depression symptoms.
• The Stress Outcomes Resistance Psychology essay sample: There are many methods of stress correction, and the task is to choose those that would correspond to individual characteristics and real conditions.
• Perceived Academic Stress and Continuing and Returning Students Psychology essay sample: This paper investigates the relationship between perceived academic stress, continuing, and returning students variables. It adopted a descriptive study design.
• Discussion: Abuse, Work, and Burnout Psychology essay sample: The growth of mental and emotional pressure, as well as the adverse effects of the environment, lead to an increase in the stress level, which causes burnout.
• Positive Psychology in Educational Settings Psychology essay sample: When students are subjected to high levels of stress, their capacity to learn, memorize, and perform effectively can be affected.
• Psychotherapy and Medications for Post-traumatic Stress Disorder
• Yoga and Music Therapy as Effective Methods of Stress Management
• Impact of Stress on Human Body Almost everyone experiences stress every day due to various reasons. Many people can endure it steadily, but the impact on the human body and on his life, work is very great.
• Anxiety, Fear, Phobias and Stress Behavioral Therapy
• Cognitive Behavioral Therapy and Post Traumatic Stress Disorder in Children
• Stress Management Methods and Their Effectiveness The research investigates approaches applied by employees in managing the job stress and depression and identifies the most appropriate approach to be used.
• Cognitive Behavioral Therapy Used in the Treatment of Post Traumatic Stress Disorder
• Cognitive Behavioural Therapy Based Stress Management Interventions: An Evaluation of Methodology
• Integrated Trauma-Focused Cognitive-Behavioural Therapy for Post-traumatic Stress and Psychotic Symptoms: A Case-Series Study Using Imaginal Reprocessing Strategies
• Managing Stress Through Progressive Relaxation Therapy
• Yoga as an Alternative Treatment Method to Deal With Stress The paper states that yoga may be a highly effective alternative treatment method that will help an individual to deal with stress and anxiety.
• Massage Therapy and Stress Relief
• Metacognitive Therapy for Posttraumatic Stress Disorder in Youth: A Feasibility Study
• Workplace Stress and Resilience in Australian Nursing Workforce The primary purpose of this systematic analysis was to identify and integrate evidence on job stress and resilience using an example of the Australian nursing staff.
• Moderated Online Social Therapy: A Model for Reducing Stress in Carers of Young People Diagnosed With Mental Health Disorders
• Music Therapy for Post Traumatic Stress Disorder
• Posttraumatic Stress Disorder In this research paper, the case study approach will be used to investigate the problem of posttraumatic disorder.
• Music Therapy Interventions for Stress Reduction in Adults With Mild Intellectual Disabilities: Perspectives From Clinical Practice
• Person-Centered Therapy and Cognitive Behavioral Therapy for Post Traumatic Stress Disorder
• Stress and Burnout Among Intensive Care Unit Nurses Ordinarily, nursing practitioners are expected to deal with life and death issues daily and there is no room for a nurse to claim that he or she is fatigued.
• Post-traumatic Stress Disorder: Lucid Dreaming Therapy and Rational Emotive Behavioral Therapy
• Post Traumatic Stress Disorder, Group Therapy, and Recreation Therapy
• Nightmares as a Coping Mechanism for Stress This paper regards the article “Nightmares as a Coping Mechanism for Stress” examining the nightmare and stress correlation and whether nightmare is a coping mechanism for stress.
• Prolonged Exposure Therapy for Post Traumatic Stress
• Trauma-Focused Cognitive Behavioural Therapy on Children and Adolescents With Post Traumatic Stress Disorder
• Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy
• Treating Post-traumatic Stress Disorder in Patients With Multiple Sclerosis
• Abnormal Psychology: Post Traumatic Stress Disorder
• Altruism, Positive Psychology, Stress, and Lifespan
• Stress in the Educational Environment Stress is a set of unspecific protective reactions of the body caused by unfavorable factors and manifested by behavioral and psychological features.
• Psychology: Stress, Motivation and Drug Addiction
• Psychology: Coping Mechanism for Stress Management
• Critical Health Psychology View of Stress
• Decision-Making Skills and Stress Management Psychology
• Dependent Variables in Psychology: Depression, Anxiety, and Stress
• Economic Stress and Psychological Well-Being: An Economic Psychology Framework
• Cultural Factors Contributing to Student Stress The purpose of this article is to identify how cultural issues undermine the efforts of Saudi Arabian students who study in Australia to meet their learning needs.
• Occupational Health Psychology and Structural Stress
• Psychological Disorders: Stress Coping and Well Being
• Health Psychology: Stress, Substance Abuse, Addictive Behavior, Obesity, and Health Promotion
• Occupational Health Psychology and Work-Related Stress
• Psychology at Work: Organizational Stress and Job Satisfaction
• “Perceived Stress Among Students in Virtual Classrooms…” by AlAteeq The researchers examined perceived stress levels among students during the COVID-19 outbreak and the closure of learning institutions in KSA.
• Post Traumatic Stress Disorder and Effect of Memory
• Positive Psychology and Post Traumatic Stress Disorder
• Psychology and Clinical Response of Stress
• Psychology: Stress and Its Impact on Health
• Relationship Between Job Stress and Job Performance
• Stress: Personality Psychology and Stress Management Activities
• Editorial: How Plants Deal With Stress: Exploration Through Proteome Investigation
• The Physiology of Stress: Understanding the Body’s Response Mechanisms
• Chronic Stress: Causes, Effects, and Coping Strategies
• Stress Management Techniques for a Healthy Lifestyle
• Occupational Stress: Identifying, Preventing, and Managing Workplace Stress
• The Impact of Stress on Mental Health: Anxiety and Depression
• Work-Life Balance and Stress Management
• Stress in College Students: Academic Pressure and Coping Mechanisms
• How to Reduce Your Stress Levels
• Stress and Physical Health: The Connection to Chronic Diseases
• Navigating the Inevitability of Stress in Daily Life
• Coping With Financial Stress: Strategies for Budgeting and Financial Wellness
• The New Sources of Stress in Modern Society
• Stress Management: What Is Stress and How to Overcome It
• The Stress-Immunity Connection: How Stress Affects the Immune System
• Causes and Effects of Stress in Daily Life
• Parenting and Stress: Balancing Responsibilities and Self-Care
• Comparing the Stress Rates Among Children and Adults
• Gender Differences in Stress Responses and Coping Mechanisms
• How Constant Stress Can Trigger Acute Coronary Events
• Mindfulness-Based Stress Reduction: Techniques for Stress Management
• Physical and Emotional Effects of Stress
• Stress and Substance Abuse: The Cycle of Addiction and Recovery
• The Effects of Stress on Cognitive Functioning and Decision-Making
• Social Determinants of Stress: The Impact of Socioeconomic Factors
• The Role of Stress in Obesity and Weight Management
• Analyzing the Negative Impact of Stress on an Individual’s Health
• The Issue of Stress in the Nursing Profession
• Stress and Mental Resilience: Building Emotional Strength
• The Impact of Stress on Academic Success in College Students
• Influence of Yogic Techniques on Stress Management
• Can Music Therapy Improve Stress Anxiety?
• How to Use Cognitive Behavioural Therapy for Post-Traumatic Stress?
• Why Group Therapy Improves Symptoms of Posttraumatic Stress?
• How Cognitive-Behavioral Group Therapy Reduces Stress and Improves the Quality of Life in Patients With Parkinson’s Disease?
• How Does Cognitive Behavioral Therapy Deal With Post Traumatic Stress?
• Does Music Therapy Reduce Stress?
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• How Stress Affects the Human Mind?
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• Does Stress Affect Students’ Academic Performance? The main goal of this paper is to establish whether being under stress affects a student’s performance to a noticeable extent and how it’s possible to improve academic performance.
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• How Fear and Stress Shape the Mind?
• How Does Chronic Stress Affect the Body?
• How Stress Affects Our Health, Personality, and Relationship With People?
• How Does Stress Affect Child Development?
• How Does Job Stress Affect Your Health?
• How Stress Affects Memory in Adults?
• How Stress Affects Our Bodies, Minds, and Well Being?

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Two Key Reasons Why You Should Call Your Mom

Research finds that hearing your mom's voice has important benefits..

Updated May 9, 2024 | Reviewed by Abigail Fagan

• What Is Stress?
• Find counselling to overcome stress
• Hearing your mother's voice has the potential to reduce stress, research suggests.
• When young girls spoke to their moms in person or by phone, oxytocin increased and cortisol decreased.
• Texting did not provide the same benefits.

You’ve had a crappy day. Maybe your boss yelled at you, you spilled your coffee, lost your keys, and forgot to pay a bill. When life stresses you out, sometimes you need your momma.

After all, how many times have you heard your mom say how nice it is to hear your voice? If it were up to mom, you would probably talk to her every single day. But research from the University of Wisconsin-Madison suggests that it may be you who benefits from hearing your mother’s voice (Seltzer, Prososki, Ziegler, & Pollak, 2012).

The researchers wanted to determine whether some forms of communication with mom were better than others. They looked at three types of communication (in person, by phone, or by instant message) to determine which was most beneficial. They were also interested in determining whether there was something uniquely valuable about hearing your mother’s voice.

Speaking to Mom After a Stressful Situation

The researchers had 68 young girls, ages 7.5 through 12 years old, experience a stressful situation that involved completing math and verbal problems for 15 minutes in front of an audience. (Just imagine for a moment having to count down backwards from a number like 7,648 by 9s within a time limit while standing in front of an interview panel and knowing that if you make a mistake you have to start over. Yikes! Stressful!)

Next, the researchers randomly assigned the girls to do one of four things for another 15 minutes: (a) wait alone with no contact with mom, (b) talk to their moms in person, (c) talk to their moms via phone, or (d) interact with their moms via instant message. Afterwards, researchers measured the girls’ salivary cortisol (a stress hormone ) and urinary oxytocin (a hormone linked to bonding , trust, and empathy) levels.

The Findings: Speaking Beats Texting

So which group fared the best? The two groups that were able to speak to their moms (either in person or over the phone) had higher oxytocin levels (a good thing) than did the instant message group and the no contact group. There was no difference in oxytocin levels between the in-person group and the phone group, which suggests that the benefits lie in hearing mom’s voice.

When girls messaged their moms, they had salivary cortisol levels that were similar to those who did not communicate with mom at all. That is, at least when it comes to lowering stress levels, communicating via text-based messages isn’t any better than not talking at all. Similar to the oxytocin findings, girls who spoke to their moms either in person or over the phone had the best stress response – they exhibited lower stress levels than both the instant message and no contact groups.

Overall, this study suggests that simply communicating with your mom isn’t enough. A text just isn't enough. Instead, hearing your mom’s voice has a uniquely soothing effect. So the next time you are stressed out by school, work, family, friends, or life…call your mother.

Facebook image: TeodorLazarev/Shutterstock

Seltzer, L. J., Prososki, A. R., Ziegler, T. E., & Pollak, S. D. (2012). Instant messages vs. speech: Hormones and why we still need to hear each other. Evolution And Human Behavior, 33 (1), 42-45.

Gary W. Lewandowski Jr., Ph.D., is the author of Stronger Than You Think: The 10 Blind Spots That Undermine Your Relationship...and How to See Past Them .

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The Impact of Personality Traits on Occupational Stress and Quality of Life among Higher Secondary School Teachers

| Published: May 10, 2024

This research explores the interplay between personality traits, occupational stress, and quality of life among higher secondary school teachers in various schools in Bengaluru. A sample of 150 teaching staff (both males and females) participated in the study, and data analysis was conducted using SPSS through regression, t-tests, and correlation. The study employed three scales: the General Working Stress Scale (GWSS), the Quality-of-Life Questionnaire (QOL), and the Big Five Inventory (BFI). Findings revealed that participants experienced moderate levels of occupational stress and quality of life, with a prevalent inclination towards high agreeableness and conscientiousness, coupled with a low level of neuroticism. Statistical analysis indicated significant gender differences in working stress. The primary interaction effect between occupational stress and quality of life was found to positively, yet non-significantly, predict personality traits among teaching staff. This study contributes to the understanding of occupational stress, quality of life, and personality traits in higher secondary school teachers.

Personality traits , occupational stress , quality of life , Big Five Inventory , working stress , gender differences , education , teaching staff

This is an Open Access Research distributed under the terms of the Creative Commons Attribution License (www.creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any Medium, provided the original work is properly cited.

© 2024, Tabassum, M. & Akshaya, I.

Received: February 29, 2024; Revision Received: May 06, 2024; Accepted: May 10, 2024

Marfuha Tabassum @ [email protected]

Article Overview

Published in   Volume 12, Issue 2, April-June, 2024

A fragment of human brain, mapped in exquisite detail

A cubic millimeter of brain tissue may not sound like much. But considering that tiny square contains 57,000 cells, 230 millimeters of blood vessels, and 150 million synapses, all amounting to 1,400 terabytes of data, Harvard and Google researchers have just accomplished something enormous.   

A Harvard team led by Jeff Lichtman, the Jeremy R. Knowles Professor of Molecular and Cellular Biology and newly appointed dean of science , has co-created with Google researchers the largest synaptic-resolution, 3D reconstruction of a piece of human brain to date, showing in vivid detail each cell and its web of neural connections in a piece of human temporal cortex about half the size of a rice grain.

The feat, published in Science, is the latest in a nearly 10-year collaboration with scientists at Google Research, who combine Lichtman’s electron microscopy imaging with AI algorithms to color-code and reconstruct the extremely complex wiring of mammal brains. The paper’s three co-first authors are former Harvard postdoctoral researcher Alexander Shapson-Coe; Micha? Januszewski of Google Research, and Harvard postdoctoral researcher Daniel Berger.

The collaboration’s ultimate goal, supported by the National Institutes of Health BRAIN Initiative , is to create a high-resolution map of a whole mouse brain’s neural wiring, which would entail about 1,000 times the amount of data they just produced from the 1-cubic-millimeter fragment of human cortex.  

“The word ‘fragment’ is ironic,” Lichtman said. “A terabyte is, for most people, gigantic, yet a fragment of a human brain – just a miniscule, teeny-weeny little bit of human brain – is still thousands of terabytes.”  

The latest map in Science contains never-before-seen details of brain structure, including a rare but powerful set of axons connected by up to 50 synapses. The team also noted oddities in the tissue, such as a small number of axons that formed extensive whorls. Since their sample was taken from a patient with epilepsy, they’re unsure if such unusual formations are pathological or simply rare.

Lichtman’s field is “connectomics,” which, analogous to genomics, seeks to create comprehensive catalogues of brain structure, down to individual cells and wiring. Such completed maps would light the way toward new insights into brain function and disease, about which scientists still know very little.

Google’s state-of-the-art AI algorithms allow for reconstruction and mapping of brain tissue in three dimensions. The team has also developed a suite of publicly available tools researchers can use to examine and annotate the connectome.

“Given the enormous investment put into this project, it was important to present the results in a way that anybody else can now go and benefit from them,” said Google Research collaborator Viren Jain.

Next the team will tackle the mouse hippocampal formation, which is important to neuroscience for its role in memory and neurological disease.

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Materials provided by Harvard University . Original written by Anne J. Manning. Note: Content may be edited for style and length.

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