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Background/rationale: The carbon dioxide (CO2) challenge has been reliably used in laboratory settings as a panicogen in clinical populations. However, the magnitude of these effects on healthy and non-clinical control populations are not clear. The aim of this meta-analysis and systematic review is to provide quantitative estimates of those effects. Specifically, the current paper will evaluate the relative efficacy of the CO2 challenge in eliciting both subjective and physiological arousal in healthy and non-clinical control populations.Method: A total of 16 articles with 35 independent samples were included in the meta-analysis, while 37 studies with 74 independent samples were included in the systematic review.Results: Both the meta-analysis and systematic review found the CO2 challenge to elicit an increase in subjective distress via self-reported anxiety and fear. Physiological responses via blood pressure and heart rate were heterogeneous in studies sampled, with no significant changes observed across studies. Moderator analyses revealed the variations in findings may be attributed to participant screening and invasive sampling.Discussion: Findings highlight the CO2 challenge as a useful tool in the provocation of subjective distress. Implications for both the use of the CO2 challenge and its anticipated effects in healthy and non-clinical control populations are discussed. [ABSTRACT FROM AUTHOR]

Background and Objectives: Internet-based interventions are a viable treatment option for various mental problems. However, their effects on the burnout syndrome yielded mixed results. In this paper, we examine the efficacy of a structured and therapist-guided internet intervention, based on solution-focused and cognitive-behavioral therapy, for individuals with symptoms of burnout.Design: Two-arm, Internet-based, randomized, wait-list controlled trial (RCT).Methods: Participants were recruited through in-house events and online advertising. They were randomly assigned to the intervention or a wait-list. Group comparison was conducted three months after randomization. Outcomes were the burnout level according to the Maslach Burnout Inventory (MBI-GS) and the levels of depression, anxiety and stress according to the DASS-21.Results: Thirty-nine participants were included in the trial; 36 (92.3%) took part at the 3-months-follow-up. Intention-to-treat analyses revealed significant group differences in favor of the intervention group in depression (d = 0.66), cynicism (d = 0.87) and personal accomplishment (d = 0.75).Conclusions: The intervention helped ameliorate symptoms of work-related stress and burnout. Although limited by a small sample size, the study suggests that the program provides effective support for affected individuals. However, further studies with bigger sample sizes should be conducted to examine the effects of such programs more precisely. [ABSTRACT FROM AUTHOR]

Background and objectives: Social anxiety disorder is a common comorbidity in psychotic disorders and impacts significantly on functioning and recovery. Conflicting theories and evidence exist on its relationship with other psychopathologies. This study examined this complex network of relationship using path analysis.Design: Clinical assessment and self-report in a cross-sectional consecutive outpatient sample.Methods: Face-to-face interviews were conducted in 137 outpatients with early psychosis. A theoretical model of relationship between social anxiety, insight, persecutory delusions, ideas of reference, negative symptoms, and depression was tested using path analysis.Results: Clinically significant social anxiety was observed in 45% of this sample. The final model suggested a direct link between ideas of reference (standardized path coefficient, β = 0.26, p < 0.002) and negative symptoms (β = 0.29, p < 0.001) to social anxiety. Insight was related to both persecutory delusions and negative symptoms but had no direct relationship with social anxiety. The model has excellent goodness-of-fit (Chi-square 6.62, comparative fit index 1.00, root mean square error of approximation 0.00).Conclusions: This model provided a new framework for understanding the complex interplay between psychosis symptoms and social anxiety, which may be unique to outpatients with early psychosis and require further confirmatory research and targeted intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Post-event processing (PEP) refers to negative rumination following anxiety-inducing social situations. The Post-Event Processing Inventory (PEPI; Blackie & Kocovski, 2017, Development and validation of the trait and state versions of the post-event processing inventory. Anxiety, Stress, & Coping, 30, 202-218.) consists of both trait and state forms. Although the psychometric properties of the PEPI have been very good in past research, the factor structure of the scale was examined with student samples only.Objectives: The primary purpose of the present study was to confirm the factor structure of the PEPI with a sample of individuals seeking self-help for social anxiety and shyness.Design and Method: Individuals interested in receiving self-help (N = 155) completed a battery of questionnaires, including the trait and state forms of the PEPI.Results: On each version of the scale, we confirmed that a second-order factor (global PEP) could be inferred from three first-order factors (frequency, intensity, and self-judgment).Conclusions: The hierarchical factor structure of the PEPI in the present study is consistent with previous research. The findings from the present study illustrate the utility of the PEPI amongst a community sample of individuals seeking self-help for social anxiety. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t = -2.49, p = .013), anxiety (t = -3.08, p = .002), and PTSD (t = -2.94, p = .003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed. [ABSTRACT FROM AUTHOR]

Background and Objectives: The YOMI program is a psychoeducational training and physical practice-based program that bridges knowledge from evidence-based psychotherapy with the practice of mindfulness and yin yoga. It consists of 10 content-specific sessions and does not include home assignments. The primary purpose of this randomized controlled trial is to evaluate the effects of the five-week YOMI program on perceived stress, worry and mindfulness in a non-clinical sample.Design and Method: In this randomized controlled trial participants were assigned to two groups. Group 1 participated in the five-week intervention twice a week while Group 2 was assigned to a waiting-list condition and participated in the intervention after Group 1. All measures were administered through self-report questionnaires, conducted via a web-based program.Results and Conclusions: The results of the study indicated significant effects of the YOMI program on decreasing stress and worry, and increasing mindfulness. Notably these changes were still present at five-week follow up. Consistent with the hypotheses, results suggested that the YOMI program established a group setting where individuals learned to use tools and methods to facilitate better self-directed practice. The study shows moderate to large effect sizes. [ABSTRACT FROM AUTHOR]

Background: Self-focused attention (SFA) and safety behaviors are two variables implicated in the maintenance of social anxiety disorder (SAD).Design: The present study examined SFA and safety behaviors across two therapies for SAD, cognitive behavioral group therapy (CBGT) and mindfulness and acceptance-based group therapy (MAGT).Method: Participants with symptoms meeting criteria for SAD (N = 137) were randomly assigned to the 12-week-treatment groups (n = 53 for each condition) or a waitlist control (n = 31). Variables were assessed at baseline, midtreatment, posttreatment, and a 3-month follow-up.Results: Both treatment conditions reported significantly lower SFA and safety behaviors compared to control, but did not differ from one another at posttreatment. Mediation analyses supported the following models: (1) safety behaviors mediating the relationship between SFA and social anxiety, and (2) SFA mediating the relationship between safety behaviors and social anxiety. These models were supported for both treatment groups.Conclusions: Both treatments may have the potential to reduce the SFA and safety behaviors that serve to maintain SAD. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study sought to examine the effects of performance feedback and individual differences in self-esteem on cardiovascular habituation to repeat stress exposure.Methods: Sixty-six university students (n = 39 female) completed a self-esteem measure and completed a cardiovascular stress-testing protocol involving repeated exposure to a mental arithmetic task. Cardiovascular functioning was sampled across four phases: resting baseline, initial stress exposure, a recovery period, and repeated stress exposure. Participants were randomly assigned to receive fictional positive feedback, negative feedback, or no feedback following the recovery period.Results: Negative feedback was associated with a sensitized blood pressure response to a second exposure of the stress task. Positive feedback was associated with decreased cardiovascular and psychological responses to a second exposure. Self-esteem was also found to predict reactivity and this interacted with the type of feedback received.Conclusions: These findings suggest that negative performance feedback sensitizes cardiovascular reactivity to stress, whereas positive performance feedback increases both cardiovascular and psychological habituation to repeat exposure to stressors. Furthermore, an individual's self-esteem also appears to influence this process. [ABSTRACT FROM AUTHOR]

Background and Objectives: Anxiety and insomnia can be treated with internet-delivered Cognitive Behavioral Therapy (iCBT). iCBT may be well-suited to students who are known to be poor help-seekers and suffer these symptoms. iCBT can offer easy access to treatment and increase service availability. The aim of this study was to evaluate the efficacy of anxiety and insomnia iCBT programs in students.Design: A randomized, controlled study.Methods: Students were randomly allocated to intervention ("Anxiety Relief": n = 43; "Insomnia Relief": n = 48; control: n = 47). Interventions lasted six weeks. Outcome measures were the State-Trait Anxiety Inventory and the Pittsburgh Sleep Quality Index.Results: Significant within-group reductions in anxiety (t(31) = 2.00, p = .03) with moderate between-groups (compared to control) effect size (d = .64) and increases in sleep quality (t(31) = 3.46, p = .002) with a moderate between-groups effect size (d = .55) were found for completers of the anxiety program from pre- to post-intervention. Significant within-group increases in sleep quality were found for completers of the insomnia program from pre- to post-intervention (t(35) = 4.28, p > .001) with a moderate between-groups effect size (d = .51).Conclusions: Findings support the use of iCBT for anxiety and insomnia in students, and indicate that further research is needed. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed at systematically reviewing and meta-analyzing the strength of associations between self-efficacy and job burnout (the global index and its components). We investigated whether these associations would be moderated by: (a) the type of measurement of burnout and self-efficacy, (b) the type of occupation, (c) the number of years of work experience and age, and (d) culture.Design and Methods: We systematically reviewed and analyzed 57 original studies (N = 22,773) conducted among teachers (k = 29), health-care providers (k = 17), and other professionals (k = 11).Results: The average effect size estimate for the association between self-efficacy and burnout was of medium size (-.33). Regarding the three burnout components, the largest estimate of the average effect (-.49) was found for the lack of accomplishment. The estimates of the average effect were similar, regardless of the type of measures of burnout and self-efficacy measurement (general vs. context-specific). Significantly larger estimates of the average effects were found among teachers (compared to health-care providers), older workers, and those with longer work experience.Conclusions: Significant self-efficacy-burnout relationships were observed across countries, although the strength of associations varied across burnout components, participants' profession, and their age. [ABSTRACT FROM AUTHOR]

Background: Levels of stress and burnout increase during nursing education. This development has consequences for nursing students' health, learning, competence, and interest in quality issues in health care.Design: In a randomized controlled pilot trial with a sample of 113 nursing students the effect of an intervention using techniques from acceptance and commitment training (ACT) to prevent the development of stress and burnout was evaluated.Method: The 6 × 2-hour program was compared to standard treatment (reflection seminars) post-intervention and at a three-month follow-up using longitudinal analysis of mean response profiles. Mechanisms of change were investigated using a baseline-post intervention two-mediator model.Results: The intervention resulted in increased mindful awareness and decreased experiential avoidance, as well as decreased perceived stress and burnout. Levels of mindful awareness and perceived stress were sustained at follow-up. The proposed mechanisms of change were partly supported by the data.Conclusion: This study shows that techniques from ACT might have the potential to contribute to preventing the development of stress and burnout during nursing education. However, additional studies are needed to validate these results. [ABSTRACT FROM AUTHOR]