Caffeine enhances the physiological response to occupational stress in medical students.

Tested caffeine (3.3 mg/kg) against a placebo in 20 male medical students (aged 19–31 yrs) during periods of low (no exams) vs high (final exams) work stress. On each of 8 test days, heart rate and blood pressure were measured at baseline and over a 40-min postdrug interval; immediately afterward, blood was drawn to test plasma cortisol and serum lipid concentrations. Exams increased heart rate and systolic blood pressure. Caffeine decreased heart rate and increased systolic blood pressure, diastolic blood pressure, plasma cortisol levels, and serum cholesterol levels. Caffeine effects were additive with those of exams, and together they increased the number of Ss showing systolic blood pressures in the borderline hypertensive range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motives for occupational goal setting among male and female college students.

Information regarding motives for occupational goals was gathered in an interview setting from 54 male and 54 female college students who were matched for occupational goal. In comparison to males, females expressed expectations for greater intrinsic work enjoyment (p?p?p?     

Behavioral and electrocardiographic responses to social stress in male rats

Telemetry ECGs were recorded from Wistar male rats during social stress induced by exposure to aggressive lactating female rats. Behavioral response to maternal attack was evaluated in terms of relative duration of passive submissive (p/s) and active/nonsubmissive (a/ns) patterns. A decrease of R-R interval (R-R) compared to baseline conditions was found, significantly more pronounced than that observed in control animals exposed just to novel environment. R-R variability during social stress was positively correlated with the amount of p/s behavior. R-R fluctuations, episodes of II degree A-V block, and ventricular arrhythmias were also observed. Most R-R fluctuations and II degree A-V blocks were temporally associated with phases of p/s behavior and periods of high R-R variability. Ventricular arrhythmias generally appeared during a/ns behavior and were temporally linked with periods of low R-R variability. Ventricular arrhythmias, low R-R variability, and concomitant a/ns behavior might be related to an increased sympathetic activity. R-R fluctuations and II degree A-V blocks, associated with high R-R variability and p/s behavior, might be related to a predominant inhibitory effect of vagal activation (accentuated antagonism).     

Sex differences in occupational stress: A meta-analytic review.

Meta-analysis was performed on 15 studies that examined sex differences in occupational stress. Contrary to previous qualitative literature reviews, these results indicate that there are no sex differences in experienced and perceived work stress. Moderator analyses were conducted. Because null results were obtained, a discussion of empirical and theoretical shortcomings in the sex-occupational stress literature was presented for consideration by future researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new role for psychology students in a medical setting.

Describes a 3-wk project in which psychology practicum students assumed primary responsibility for patient care on the psychiatric unit of a large medical center hospital. The project had interesting implications for issues related to clinical training and professional relationships. The pace was intense and demanding and students became totally involved in treating the patients and learning about themselves. Each student worked with about 7 patients primarily through group therapy and family counseling. It is felt that this training model was more likely to test the student's commitment to psychology and to solidify a professional identity than more traditional programs. The project was unique in that the only doctor-patient relationship that the patients had was with the psychology student. 2 physicians were available for medical consultation. Informal observations and analysis of rating scales filled out by the patients indicate that they valued highly the contribution of the students. It is concluded that current trends in medicine toward comprehensive care and family practice necessitate the physician's relinquishment of his exclusive relationship with the patient and to bring in nonmedical specialists on a peer basis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of occupational stress management intervention programs: A meta-analysis.

A meta-analysis was conducted to determine the effectiveness of stress management interventions in occupational settings. Thirty-six experimental studies were included, representing 55 interventions. Total sample size was 2,847. Of the participants, 59% were female, mean age was 35.4, and average length of intervention was 7.4 weeks. The overall weighted effect size (Cohen's d) for all studies was 0.526 (95% confidence interval = 0.364, 0.687), a significant medium to large effect. Interventions were coded as cognitive-behavioral, relaxation, organizational, multimodal, or alternative. Analyses based on these subgroups suggested that intervention type played a moderating role. Cognitive-behavioral programs consistently produced larger effects than other types of interventions, but if additional treatment components were added the effect was reduced. Within the sample of studies, relaxation interventions were most frequently used, and organizational interventions continued to be scarce. Effects were based mainly on psychological outcome variables, as opposed to physiological or organizational measures. The examination of additional moderators such as treatment length, outcome variable, and occupation did not reveal significant variations in effect size by intervention type. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular and testosterone responses to contested dominance in women.

Examined cardiovascular and testosterone responses of 10 dominant and 10 submissive female undergraduates to an acute stressor involving contested dominance. Ss rated their dominance to a predefined reference group, participated in a task that involved debating with a trained technician, and were continuously provided with bogus feedback throughout the task concerning biochemical substances in their blood that purportedly covaried with dominance. Dominant Ss were much more reactive to the stressor in several cardiovascular parameters than submissive Ss. Serum testosterone did not vary as a function of the experimental manipulation, and at each measurement point, dominant and submissive Ss had essentially identical serum levels of this hormone. Baseline testosterone for dominant Ss was related to changes in systolic blood pressure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responses to stress in adolescence: Measurement of coping and involuntary stress responses.

The development of a measure of coping and involuntary stress responses in adolescence is described. The Responses to Stress Questionnaire (RSQ) reflects a conceptual model that includes volitional coping efforts and involuntary responses to specific stressful events or specified domains of stress. The psychometric characteristics of the RSQ were examined across 4 domains of stress in 3 samples of adolescents and parent reports obtained in 2 samples. The factor structure of the RSQ was tested and replicated with an adequate degree of fit using confirmatory factor analysis across 3 stressors in -2 samples. Internal consistency and retest reliability for the 5 factors were adequate to excellent. Concurrent validity was established through correlations with another measure of coping, heart rate reactivity, and correlations of self- and parent-reports. Significant correlations with both adolescents' and parents' reports of internalizing and externalizing symptoms were consistent with hypotheses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients as teachers: an integrated approach to teaching medical students about the ambulatory care of HIV infected patients

Our experience with medical students in a large inner city hospital left us concerned that students' fears affect their ability to learn about and care for HIV-positive people. Therefore, we decided to create an environment in which the students could feel safe exploring their own attitudes and feelings about HIV. To accomplish the goal, we developed a curriculum in the ambulatory care of HIV-positive people. We recruited and trained patients from an HIV support group at our hospital to work with students in one-on-one sessions to teach interviewing, physical exam, and patient counseling skills. As part of a 4-week ambulatory clerkship for third year students we developed a minicourse which included four sessions with didactic and experiential components. The first week consisted of an orientation and group discussion in which patients told the students about what its like to live with HIV. During each of the following three sessions, students met with a preceptor to learn about HIV in an ambulatory care setting. The didactic session was followed by one-on-one student/patient encounters in which students practised skills discussed that week and patients gave them feedback. At the close of the day, the entire group reconvened to discuss what had happened. As a result of this integrated approach, students are experiencing the relational aspects of providing medical care, often for the first and only time. In the process they are learning to take good social histories and are learning how patients with HIV relate to and sometimes reorganize their family and social support systems. Students have the opportunity to get to know, in depth, a relatively healthy person who is living with a chronic, stigmatizing illness. Both patients and students are talking to each other on a level of intimacy that is rare in the training environment. Patients express a new appreciation of their own role and power in the relationship and a new insight into the struggles of the provider. Faculty experience a renewed commitment to the importance of creating an environment where the students can discover for themselves the joy of the connection between doctor and patient. Students have an opportunity to relate to patients not as pathology, but as people with lives before and beyond the medical system. This model is practical and may be useful in teaching about other chronic diseases in the ambulatory setting.     

Nonverbal affect responses to male and female leaders: Implications for leadership evaluations.

It was hypothesized that female leaders would elicit more negative nonverbal affect responses from other group members than male leaders offering the same initiatives. Male and female subjects participated in 4-person discussions in which male or female confederates assumed leadership. During the discussion subjects' nonverbal affect responses to the confederates were coded from behind one-way mirrors. Female leaders received more negative affect responses and fewer positive responses than men offering the same suggestions and arguments. Female leaders received more negative than positive responses, in contrast to men, who received at least as many positive as negative responses. The data demonstrate a concrete social mechanism known to cause devaluation of leadership, and thus support a more social interpretation of female leadership evaluations, in contrast to previous interpretations based on private perceptual bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior and occupational stress: A cross-cultural study of blue-collar workers.

Psychophysiological, archival, unobtrusive observation, and self-report data were compared for Type A and Type B male bus drivers in the United States and India. Type A bus drivers in comparison with their Type B counterparts have more accidents, absenteeism, official reprimands, and self-reports of occupational stress. In India, but not in the United States, Type A drivers brake, pass, and blow their horns more often than Type B drivers. Although drivers exhibited expected elevations in blood pressure and catecholamines on the job, the magnitude of these increases did not differ as a function of the Type A/B classification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A human-centered approach to medical informatics for medical students, residents, and practicing clinicians

The authors have developed a curriculum in medical informatics that focuses on practical problems in clinical medicine, rather than on the details of informatics technologies. Their development of this human-centered curriculum was guided by the identification of six key clinical challenges that must be addressed by practitioners in the near future and by an examination of the failures of past informatics efforts to make a significant difference in the everyday practice of clinical medicine. Principles of human factors engineering--the body of knowledge about those human abilities, limitations, and characteristics that are relevant to design--are an essential part of this curriculum. Human factors engineering also provides the necessary perspective, as well as the concrete knowledge and methods, that can enable practitioners to properly evaluate their clinical information needs, weight the merits of proposed technology-based solutions, and understand their own inherent performance limitations.     

Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight.

The human stress response has been characterized, both physiologically and behaviorally, as "fight-or-flight." Although fight-or-flight may characterize the primary physiological responses to stress for both males and females, we propose that, behaviorally, females' responses are more marked by a pattern of "tend-and-befriend." Tending involves nurturant activities designed to protect the self and offspring that promote safety and reduce distress; befriending is the creation and maintenance of social networks that may aid in this process. The biobehavioral mechanism that underlies the tend-and-befriend pattern appears to draw on the attachment-caregiving system, and neuroendocrine evidence from animal and human studies suggests that oxytocin, in conjunction with female reproductive hormones and endogenous opioid peptide mechanisms, may be at its core. This previously unexplored stress regulatory system has manifold implications for the study of stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of perceived discrimination on ambulatory blood pressure and affective responses to interpersonal stress modeled over 24 hours.

Objective: This research examined the impact of perceived discrimination on ambulatory blood pressure (ABP) and daily level affect during social interaction. Design: For 24 hrs, adult Black and White participants wore an ABP monitor and completed palm pilot diary entries about their social interactions. Main Outcome Measures: Mean level and time-trend trajectories of blood pressure and heart rate were examined as well as mean level measures of positive and negative affect after stressful and nonstressful social interactions. Results: Analyses showed that, after controlling for important covariates, perceived discrimination predicted the slopes of both wake and nocturnal ABP responses, with those who reported more discrimination having steeper daytime trajectories for systolic and diastolic blood pressure and less nighttime dipping in heart rate over time as compared to those who had reported relatively infrequent discrimination. High levels of perceived discrimination were also related to positive and negative affective responses after stressful encounters. Conclusions: These results suggest that, regardless of race, perceived discrimination is related to cardiovascular and affective responses that may increase vulnerability to pathogenic processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular responses to postural changes: differences with age for women and men

The cardiovascular responses to postural change, and how they are affected by aging, are inadequately described in women. Therefore, the authors examined the influence of age and sex on the responses of blood pressure, cardiac output, heart rate, and other variables to change in posture. Measurements were made after 10 minutes each in the supine, seated, and standing positions in 22 men and 25 women who ranged in age from 21 to 59 years. Several variables differed, both by sex and by age, when subjects were supine. On rising, subjects' diastolic and mean arterial pressures, heart rate, total peripheral resistance (TPR), and thoracic impedance increased; cardiac output, stroke volume, and mean stroke ejection rate decreased; and changes in all variables, except heart rate, were greater from supine to sitting than sitting to standing. The increase in heart rate was greater in the younger subjects, and increases in TPR and thoracic impedance were greater in the older subjects. Stroke volume decreased less, and TPR and thoracic impedance increased more, in the women than in the men. The increase in TPR was particularly pronounced in the older women. These studies show that the cardiovascular responses to standing differ, in some respects, between the sexes and with age. The authors suggest that the sex differences are, in part, related to greater decrease of thoracic blood volume with standing in women than in men, and that the age differences result, in part, from decreased responsiveness of the high-pressure baroreceptor system.     

Scholarship in psychology: A paradigm for the twenty-first century.

Numerous changes in higher education (e.g., the demand for accountability, threats to tenure, new modes of instruction) and discontent with narrow definitions of scholarship have created the need for a broader and more precise definition of the nature of scholarship psychology. The 5-part definition that we propose includes (a) original research (creation of knowledge), (b) integration of knowledge (synthesis and reorganization), (c) application of knowledge, (d) the scholarship of pedagogy, and (e) the scholarship of teaching in psychology. Scholarly activities require high levels of discipline-specific expertise, are innovative, can be replicated, are documented, can be subject to peer review, and have significance. This broader conceptualization of scholarship will benefit all stakeholders in higher education students—faculty, colleges and universities, the community, and society at large. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: A conceptual framework and five validation studies.

Attempted to study predisposition to bipolar manic-depressive disorder by developing a behavioral paradigm to identify persons at risk for various forms of the disorder. A theoretical discussion is given for defining bipolar disorder within the broader framework of common human diseases, and this framework is used to derive dimensions of bipolar disorder that define its distinctness from the normal phenotype. These dimensions (behavioral and nonbehavioral features of disorder) are operationalized in the form of a self-report inventory that estimates the probability that an individual is at risk. Five external validation studies using nontest criteria are presented, including interview, roommate, family history, clinical characteristics, and longitudinal mood rating investigations. Results indicate that the inventory serves as a promising 1st-stage case identification procedure for bipolar disorder when employed in a research context. (2? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dogmatic responses to belief dissimilarity in the "bogus stranger" paradigm.

Investigated the relationship between dogmatism and responses to belief dissimilarity in 3 studies, using 599 undergraduates in the bogus-stranger paradigm. In Study 1, 273 Ss completed an opinion survey and were subsequently telephoned and asked to participate in the 2nd phase of the research. Ss were seated individually in a cubicle and shown how another individual (bogus stranger) responded to 7 attitude statements on the questionnaire. Ss were asked to indicate perceived agreement, the relative importance of topics, and attraction to the stranger. In Study 2, 80 Ss were used in a single experimental session. In Study 3, with 246 Ss a single-session, mass-administered procedure was employed. Results show a positive relation between dogmatism and rejection of a disagreeing other. There was also evidence of a positive relation between dogmatism and evaluation of the issues of disagreement and minimization of the discrepancy in opinion. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)