Breaking bad news (BBN) is among the most distressing communication tasks in the medical field, wherein physicians disclose serious diagnoses to their patients. Under stress, physicians may resort to maladaptive communication behaviors, potentially affecting patient’s health in the long-term. Therefore, it is essential to support medical professionals in effectively managing their stress responses early in their careers. Using the biopsychosocial model of challenge and threat as theoretical framework, we employed a 2 x 2 study design to examine the effects of stress arousal reappraisal (SAR; i.e., reinterpretation of bodily changes as functional coping resources) and worked example (WE; i.e., step-by-step demonstration of how to BBN) interventions on demand and resource appraisals and cardiovascular responses of 229 medical students engaged in simulated BBN encounters. Participants who prepared with WE reported more coping resources relative to demands after the BBN encounter than participants not preparing with WE. Participants receiving SAR instructions exhibited improved cardiovascular responses during the BBN task, indicated by increased cardiac output and decreased total peripheral resistance, than participants not receiving SAR instructions. These findings align with the notion that both interventions facilitate a shift from a threat to a challenge state, supporting their potential for integration into BBN training.

Background:Passive leg raising is used to predict who will benefit from fluid therapy in critically ill patients, including children. Patients with a Fontan circulation may have a different haemodynamic response to a fluid challenge by passive leg raising.Methods:The haemodynamic response of 31 paediatric patients with a Fontan circulation from the outpatient clinic (median age 14.0 years) and 35 healthy controls (median age 12.8 years) to passive leg raising was evaluated non-invasively by echocardiography for the assessment of, e.g., velocity time integral across the (neo)aortic valve, blood pressure measurements, and respiration. Participants were considered responders when the velocity time integral increased ≥ 10.0%.Results:Overall, patients and controls did not differ in the haemodynamic response. Twelve patients (38.7%) and 8 controls (22.9%) were responders, which was not statistically different (P = 0.22). Responders in the patient and control group also had a similar echo-estimated velocity time integral increase of + 18.9% and + 15.2%, respectively (P = 0.91). There was no difference in echo-estimated velocity time integral change between patient and control non-responders with a decrease of −1.4% and −6.4%, respectively (P = 0.70) and no difference in the amount of patients who were negatively affected by passive leg raising, ith a decrease of ≤−10.0% in 7 patients (22.6%) and 9 controls (25.7%)(P = 0.77).Conclusion:The haemodynamic response of ambulatory paediatric patients with a Fontan circulation to passive leg raising is like that of healthy controls. Patients who did not respond were similarly affected as healthy controls. Whether the haemodynamic response is different in critically ill patients warrants further investigation.Trail registration:The Netherlands National Trial Register (NTR), Trial: NL6415; date of registration 20-07-2017; Trial information: https://www.trialregister.nl/trial/6415.

Objectives 
Whereas some work links trauma exposure to poor subjective sleep quality, studies largely rely upon limited trauma measures and self-reported sleep at one time point. It is unknown whether trauma is related to persistent poor sleep, whether associations differ based on childhood versus adulthood trauma, and whether trauma exposure is related to poorer objectively assessed sleep. We tested whether childhood or adult trauma associated with persistent poor objectively and subjectively measured sleep at two time points in midlife women.
Methods 
One hundred sixty-seven women aged 40-60 at baseline were assessed twice 5 years apart. At baseline, women reported childhood trauma (Child Trauma Questionnaire), adult trauma (Brief Trauma Questionnaire), demographics, depressive symptoms, apnea symptoms, and medical history, and provided physical measures. At both visits, women completed 3 days of actigraphy (total sleep time [TST], wake after sleep onset [WASO]) and reported sleep quality (Pittsburgh Sleep Quality Index). Relations of childhood and adult trauma exposure, respectively, with persistent poor sleep at both baseline and follow-up visits (TST [<6 hours], WASO [>30 minutes], Pittsburgh Sleep Quality Index [>5]) were assessed in logistic regression models, adjusted for age, race/ethnicity, education, body mass index, sleep medications, nightshift work, apnea, depressive symptoms, vasomotor symptoms, and alcohol use.
Results 
Childhood trauma was related to persistent high WASO (odds ratio [95% confidence interval] = 2.16 [1.04-4.50], P = 0.039, multivariable). Adult trauma was related to persistent poor sleep quality (odds ratio [95% confidence interval] = 2.29 [1.07-4.93], P = 0.034, multivariable). Trauma was unrelated to persistent short TST.
Conclusions 
Childhood and adult trauma, respectively, were related to persistent poor objective sleep continuity and subjective sleep quality in midlife women, independent of risk factors.

During interpersonal emotion regulation, relationship partners mutually regulate each other’s emotional states. Interpersonal emotion regulation occurs at three main timescales: phasic (from several hundred milliseconds to about 10s), tonic (from 10s to 1 hour), and chronic (from weeks to months and years). Prior research has examined interpersonal emotion regulation at only one or two timescales simultaneously. The proposed research will examine variables relating to interpersonal emotion regulation in close relationships across all three timescales. A total of 150 romantic couples will engage in an emotional sharing task, in which they will be instructed to either engage in natural sharing or co-rumination. At the phasic timescale, primary outcomes will be interpersonal synchrony in movements and cardiovascular responses throughout the sharing task. At the tonic timescale, primary outcomes will be changes in mood and emotional appraisals pre- and post-sharing. At the chronic timescale, the study will primarily assess individual differences in relationship quality and dyadic coping style prior to the task, which are expected to shape phasic and tonic patterns during emotional sharing. Our general expectation is that phasic patterns in interpersonal emotion regulation (e.g., movement synchrony) will be meaningfully related to tonic patterns (e.g., mood change), which, in turn, will be meaningfully related to chronic patterns (e.g., relationship quality). More differentiated hypotheses and exploratory analyses are detailed in the protocol. The results of this research will contribute to the integration of interpersonal emotion regulation theories across different time scales.

Ambulatory wearable monitoring of human physiology is increasingly utilized in the fields of psychology, movement sciences, and medicine. With the rapid growth of available consumer- and research-oriented wearables, researchers are faced with a multitude of devices to choose from. It is unfeasible timewise for researchers to determine all relevant technical specifications, available signals, signal sampling details, and (raw) data availability, and conduct a search of studies regarding the reliability, validity, and usability of wearables. Thus, selection of wearables for a given study proves highly challenging and will often be unsystematic and uninformed. The 10-year research program Stress in Action initiated a publicly accessible database of wearable ambulatory monitoring devices. We outline the genesis and final structure of the first version of the Stress in Action Wearables Database (SiA-WD) and a summary of the characteristics of the wearables it currently contains. Furthermore, one short-term (2 days) and one long-term (3 months) scenario from the field of stress research are provided with walkthroughs of how the SiA-WD can help select the optimal wearable for a specific research project. Insights gathered include the scarceness of studies testing wearable user-friendliness, inconsistencies in reported validity statistics, and imprecise manufacturer documentation on recorded physiological data such as sampling rate (or window) of signals and parameter extraction. The SiA-WD is the first open-access database to simultaneously include physiological sampling information and technical specifications along with a systematic reliability, validity, and usability search. It will be iteratively expanded to facilitate informed and time-efficient wearable selection. For access to the database, see the following: https://osf.io/umgvp/.

Esports refers to competitive video gaming where individuals compete against each other in organized tournaments for prize money. Here, we present the Competitive Esports Physiological, Affective, and Video (CEPAV) dataset, in which 300 male Counter Strike: Global Offensive gamers participated in a study aimed at optimizing affect during esports tournament1. The CEPAV dataset includes (1) physiological data, capturing the player’s cardiovascular responses from before, during, and after over 3000 CS: GO matches; (2) self-reported affective data, detailing the affective states experienced before gameplay; and (3) video data, providing a visual record of 552 in-laboratory gaming sessions. We also collected (affect-related) individual differences measures (e.g., well-being, ill-being) across six weeks in three waves. The self-reported affective data also includes gamers’ natural language descriptions of gaming affective situations. The CEPAV dataset provides a comprehensive resource for researchers and analysts seeking to understand the complex interplay of physiological, affective, and behavioral factors in esports and other performance contexts.

Breaking bad news (BBN) is among the most distressing communication tasks in the medical field, wherein physicians disclose serious diagnoses to their patients. Under stress, physicians may resort to maladaptive communication behaviors, potentially affecting patient’s health in the long term. Therefore, it is essential to support medical professionals in effectively managing their stress responses early in their careers. Using the biopsychosocial model of challenge and threat as theoretical framework, we employed a 2 × 2 study design to examine the effects of stress arousal reappraisal (SAR; i.e., reinterpretation of bodily changes as functional coping resources) and worked example (WE; i.e., step-by-step demonstration of how to BBN) interventions on demand and resource appraisals and cardiovascular responses of 229 medical students engaged in simulated BBN encounters. Participants who prepared with WE reported more coping resources relative to demands after the BBN encounter than participants not preparing with WE. Participants receiving SAR instructions exhibited improved cardiovascular responses during the BBN task, as indicated by increased cardiac output and decreased total peripheral resistance, than participants not receiving SAR instructions. These findings align with the notion that both interventions facilitate a shift from a threat to a challenge state, supporting their potential for integration into BBN training.

BackgroundEarly detection of elevated acute stress is necessary if we aim to reduce consequences associated with prolonged or recurrent stress exposure. Stress monitoring may be supported by valid and reliable machine-learning algorithms. However, investigation of algorithms detecting stress severity on a continuous scale is missing due to high demands on data quality for such analyses. Use of multimodal data, meaning data coming from multiple sources, might contribute to machine-learning stress severity detection. We aimed to detect laboratory-induced stress using multimodal data and identify challenges researchers may encounter when conducting a similar study.MethodsWe conducted a preliminary exploration of performance of a machine-learning algorithm trained on multimodal data, namely visual, acoustic, verbal, and physiological features, in its ability to detect stress severity following a partially automated online version of the Trier Social Stress Test. College students (n = 42; M age = 20.79, 69% female) completed a self-reported stress visual analogue scale at five time-points: After the initial resting period (P1), during the three stress-inducing tasks (i.e., preparation for a presentation, a presentation task, and an arithmetic task, P2-4) and after a recovery period (P5). For the whole duration of the experiment, we recorded the participants’ voice and facial expressions by a video camera and measured cardiovascular and electrodermal physiology by an ambulatory monitoring system. Then, we evaluated the performance of the algorithm in detection of stress severity using 3 combinations of visual, acoustic, verbal, and physiological data collected at each of the periods of the experiment (P1-5).ResultsParticipants reported minimal (P1, M = 21.79, SD = 17.45) to moderate stress severity (P2, M = 47.95, SD = 15.92), depending on the period at hand. We found a very weak association between the detected and observed scores (r2 = .154; p = .021). In our post-hoc analysis, we classified participants into categories of stressed and non-stressed individuals. When applying all available features (i.e., visual, acoustic, verbal, and physiological), or a combination of visual, acoustic and verbal features, performance ranged from acceptable to good, but only for the presentation task (accuracy up to.71, F1-score up to.73).ConclusionsThe complexity of input features needed for machine-learning detection of stress severity based on multimodal data requires large sample sizes with wide variability of stress reactions and inputs among participants. These are difficult to recruit for laboratory setting, due to high time and effort demands on the side of both researcher and participant. Resources needed may be decreased using automatization of experimental procedures, which may, however, lead to additional technological challenges, potentially causing other recruitment setbacks. Further investigation is necessary, with the emphasis on quality ground truth, i.e., gold standard (self-report) instruments, but also outside of laboratory experiments, mainly in general populations and mental health care patients.

Background and objectives
People with posttraumatic stress disorder (PTSD) may experience heightened stress reactivity. Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment involving eye movements while retrieving memories. We evaluated if EMD participants had less stress reactivity than retrieval-only participants after personal trauma scripts. We also investigated changes in daily cortisol levels related to treatment outcomes.
Methodology
PTSD participants (N = 91) were randomly assigned to EMD (N = 47) or retrieval-only conditions (N = 44). Baseline and post-treatment data were collected and measured using Heart rate variability (HRV), heart rate (HR), pre-ejection period (PEP), and cortisol levels (AUC; the area under the curve, and CAR; the cortisol awakening response). We conducted a linear mixed model to analyze the main outcomes.
Results
No difference between EMD and retrieval-only in the reduction of stress reactivity and acceleration of recovery over time. Both groups showed that HR and PEP reactivity to the trauma script decreased significantly after treatment. In contrast, only EMD group experienced an acceleration of HR recovery in response to trauma scripts following treatment. Cortisol measures showed an inconsistent pattern, with a higher CAR in retrieval-only after treatment compared to EMD. However, no significant difference was found between groups in terms of AUC levels after treatment.
Limitation
The precision of measuring and analyzing saliva samples is highly dependent on the participant’s adherence to the schedule.
Conclusion
No specific benefits for eye movements was found in the current study. Both EMDR and retrieval-only can reduce stress reactivity in treating PTSD.
Clinical Trial Registration
[www.ClinicalTrials.gov], identifier [ISRCTN55239132].

INTRODUCTION Disrupted rest-activity rhythms (RARs) have been linked to poorer cognitive function and Alzheimer’s disease (AD) biomarkers. Here we extend this work to midlife women, who commonly experience menopause-related sleep and cognitive problems. METHODS One hundred ninety-four postmenopausal participants underwent a neuropsychological evaluation, 72 h of wrist actigraphy generating RAR variables, and a blood draw to measure AD biomarkers: phosphorylated tau (p-tau181, p-tau231) and amyloid beta (Aβ40, Aβ42). RESULTS Lower interdaily stability (IS) and relative amplitude (RA) and higher interdaily variability (IV) and least active 5 h (L5) were associated with worse processing speed, independent of sleep. Adjustment for sleep significantly attenuated the associations of RA with memory. Lower RA was associated with higher p-tau231 level, independent of sleep. Further adjustment for menopause-related factors modestly accounted for the associations between RAR, cognitive measures, and AD biomarkers. DISCUSSION Weaker RAR, particularly RA, was associated with worse cognitive functions, and higher AD biomarkers levels, possibly linking RAR with AD pathology in women. Highlights Lower rhythm stability and robustness and higher fragmentation were associated with worse processing speed. Lower robustness was associated with higher levels of phosphorylated tau-231. Menopause factors did not attenuate the association between rest-activity rhythms and cognitive function.