Publications by authors named "Benedict Herhaus"

14 Publications

  • Page 1 of 1

How acute physical and psychological stress differentially influence the kynurenine pathway: A randomized cross-over trial.

Psychoneuroendocrinology 2021 Sep 25;134:105433. Epub 2021 Sep 25.

Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.

Psychological stress is associated with the pathogenesis of several neuropsychiatric disorders. In contrast, physical stress, as provoked by exercise, counteracts symptoms and potentially also disease progression. The kynurenine pathway, which is imbalanced in neuropsychiatric disorders, responds to both psychological and physical stress. Here, we compared the acute effects of psychological versus physical stress on the kynurenine pathway and inflammatory mediators. Thirty-five healthy males (mean age: 24.09±3.39 years) underwent both the Trier Social Stress Test (psychological stressor) and the Wingate-Test (physical stressor). The kinetics of tryptophan and its metabolites as well as cytokines IL-6, IFN-γ, TNF-α, and IL-10 were measured before and after the two stress conditions. After both stressors, there was a significant change over time for the kinetics of tryptophan metabolites and for cytokines. Furthermore, the reactivity of kynurenine pathway metabolite ratios and cytokines was statistically greater after physical stress than after psychological stress. The increased metabolic flux towards kynurenic acid following acute physical stress suggests an exercise-induced neuroprotective mechanism. Despite the paradoxical influence of both stressors on neuropsychiatric diseases, the acute kynurenine pathway reactivity appears to be similar, although effects were more pronounced in response to physical stress.
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http://dx.doi.org/10.1016/j.psyneuen.2021.105433DOI Listing
September 2021

Effect of a biofeedback intervention on heart rate variability in individuals with panic disorder: A randomized controlled trial.

Psychosom Med 2021 Oct 12. Epub 2021 Oct 12.

Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany Clinic for Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany Department of Psychosomatic Medicine und Psychotherapy, University Bonn, Bonn, Germany.

Objective: Some individuals with panic disorder (PD) display reduced heart rate variability, which may result in an increased risk of cardiovascular mortality. Heart rate variability-biofeedback (HRV-BF) training has been shown to improve the modulation of the autonomic activity. Therefore, this randomized controlled trial was conducted to investigate the effect of a four-week HRV-BF intervention in individuals with PD. Heart rate variability-biofeedback (HRV-BF) training improved the modulation of the autonomic activity. Therefore, with this randomized controlled trial we aimed to investigate the effect of a four-week HRV-BF intervention in people with PD.

Methods: Thirty-six women and sixteen men with PD (mean age: 35.85 ± 15.60 years) were randomly allocated either to HRV-BF with 0.1 Hz breathing as intervention group or to HRV-Sham-BF as active control group. HRV-BF was performed over four weeks while HRV was measured both during a short-term resting condition as well as during a paced breathing condition before and after intervention.

Results: HRV-BF with 0.1 Hz breathing increased HRV and reduced panic symptoms in individuals with PD. HRV-BF with 0.1 Hz breathing demonstrated an increase in the time and frequency domain parameters of HRV during the short-term resting condition (ΔPost-Pre RMSSD: 5.87 ± 14.03 ms; ΔPost-Pre SDNN: 11.63 ± 17.06 ms; ΔPost-Pre Total Power: 464.88 ± 1825.47 ms2; ΔPost-Pre LF: 312.73 ± 592.71 ms2), a decrease in the heart rate during the paced breathing condition (ΔPost-Pre: -5.87 ± 9.14 b/min), and a decrease in the Panic & Agoraphobia Scale (ΔPost-Pre: -3.64 ± 6.30). There was no intervention effect in the HRV-Sham-BF group.

Conclusions: HRV-BF as a non-invasive and non-pharmacological treatment seems to be an important intervention option to improve reduced HRV and decrease panic symptoms in individuals with PD. Future studies are needed to establish whether these effects translate to reductions in the risk of cardiovascular disease in PD.
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http://dx.doi.org/10.1097/PSY.0000000000001031DOI Listing
October 2021

Correction: Cortisol reactivity in patients with anorexia nervosa after stress induction.

Transl Psychiatry 2021 Apr 8;11(1):208. Epub 2021 Apr 8.

Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

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http://dx.doi.org/10.1038/s41398-021-01326-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032664PMC
April 2021

Autonomic Nervous System Response to Psychosocial Stress in Anorexia Nervosa: A Cross-Sectional and Controlled Study.

Front Psychol 2021 17;12:649848. Epub 2021 Mar 17.

Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.

To foster understanding in the psychopathology of patients with anorexia nervosa (P) at the psychological and physiological level, standardized experimental studies on reliable biomarkers are needed, especially due to the lack of disorder-specific samples. To this end, the autonomic nervous system (ANS) response to a psychosocial stressor was investigated in = 19 P (BMI: 18.7 ± 3.3 kg/m), age, and gender-matched to = 19 healthy controls (HC; BMI: 24.23 ± 3.0 kg/m). For this purpose, heart rate (HR) and heart rate variability (HRV) parameters were assessed in a cross-sectional study design under two experimental conditions: (1) rest and (2) stress (Trier Social Stress Test). In addition, psychological indicators of stress were assessed. An 2 × 2 × 8 ANOVA demonstrated similar HR and HRV patterns (except LF-HRV) between P and HC at rest. Under stress, P (vs. HC) demonstrated a blunted HR [conditiontimegroup: = 9.326, = 0.000, η = 0.206] and an attenuated HRV response (reduced SNS/PNS reactivity). Significant effects of stress appraisal (SA) and BMI on HRV-reactivity were revealed. SA on SDNN = ConditiontimeSA = = 2.676, = 0.033, η = 0.073. BMI on LF/HF-Ratio = ConditiontimeBMI = = 3.339, = 0.019, η = 0.164. Psychological indices suggested higher levels of chronic and appraised stress in P relative to HC. Additional analyses demonstrated that ED-symptoms are highly correlated with the latter constructs, as well as with psychological burden, but not with weight. Further, it was shown that abnormalities in reactivity persisted despite normalized ANS activity. Overall, we suggested that besides weight recovery, improvement in stress appraisal could be beneficial for cardiac health. In this light, a combination of therapy (e.g., development and activation of coping skills, cognitive reappraisal) and biofeedback training may improve treatment outcomes and regulate stress reactivity.
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http://dx.doi.org/10.3389/fpsyg.2021.649848DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011538PMC
March 2021

Effects of stress on chewing and food intake in patients with anorexia nervosa.

Int J Eat Disord 2021 07 9;54(7):1160-1170. Epub 2021 Mar 9.

Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

Objective: The present study investigates the impact of psychosocial stress on chewing and eating behavior in patients with anorexia nervosa (P ).

Method: The eating and chewing behavior of P were examined in a standardized setting by means of a chewing sensor. These procedures encompassed n = 19 P , age, and gender matched to n = 19 healthy controls (HC). Food intake and chewing frequency were assessed in two experimental conditions: rest versus stress (via Trier Social Stress Test). To verify stress induction, two appraisal scales were employed. In addition, chronic stress, psychological distress and eating disorder symptoms were assessed.

Results: In terms of food intake and chewing frequency, the results of the 2x2 ANOVA demonstrated a significant effect of condition and group. During stress, all participants demonstrated a higher chewing frequency and a decreased ingestion. In general, patients ate less at a lower chewing frequency (vs. HC). However, sample specific analyses demonstrated that the eating and chewing behavior of P remained unchanged regardless of the condition, except for their drinking. Food choices were comparable between the groups, but appetite values significantly differed.

Discussion: The increase in chewing frequency in all participants during stress suggests that chewing might impact affect regulation, however, not specifically in P . Future research should clarify to what extent the normalization of chewing behavior could ameliorate ED-symptoms (incl. food intake) in P . The application of a chewing sensor could support this aim and future interventions.
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http://dx.doi.org/10.1002/eat.23500DOI Listing
July 2021

Hormonal responsiveness in the Trier Social Stress Test and the dexamethasone-corticotropin releasing hormone test in healthy individuals.

Psych J 2021 Apr 28;10(2):305-317. Epub 2021 Jan 28.

Department of Internal Medicine III, University Hospital Carl Gustav Carus Dresden, Technische Universitaet Dresden, Dresden, Germany.

A number of different laboratory procedures investigate the hormonal response in a standardized pharmacological challenge test (dexamethasone-corticotropin releasing hormone; DEX-CRH) or in a psychosocial stress induction on the hypothalamic-pituitary-adrenocortical axis by the Trier Social Stress Test (TSST). However, the magnitude of the response related to the different stressors and the interaction of the responsiveness between the two tests is still unclear. Fifty-two participants underwent both the DEX-CRH test and the TSST on two separate days. The cortisol and the plasma adrenocorticotropic hormone (ACTH) release were assessed before and after the stress tests. For a specification of the cortisol response to both conditions, subgroups of high- and low-cortisol responders to the TSST and the DEX-CRH test were formed. The healthy participants showed a substantial increase in the ACTH and the cortisol concentration after the two tests. This increase was 3 times greater in the TSST than the DEX-CRH test. High responders in both tests demonstrated a higher factor of the cortisol reactivity ratio (TSST/DEX-CRH test). Psychosocial stress as induced by the TSST was associated with a significantly greater increase in cortisol compared to the DEX-CRH test, even though the ACTH response displayed no differences. Our findings indicate an interaction of the hormonal responsiveness between the two tests with regard to the cortisol patterns.
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http://dx.doi.org/10.1002/pchj.424DOI Listing
April 2021

The effect of restrained eating on acute stress-induced food intake in people with obesity.

Appetite 2021 04 21;159:105045. Epub 2020 Nov 21.

Medical Psychology & Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Mainz, Germany.

Restrained eating, defined as a form of intense dieting or restrictive food intake of specific macronutrients or types of food with sporadic episodes of overeating, results in an increased risk of overweight and obesity. Acute stress situations cause irregular eating patterns and are connected to restrained eating. Therefore, the present study investigates the effect of high/low restrained eating on eating behavior in people with obesity after standardized acute stress induction as well as resting condition. Fifty men and women with obesity (BMI: 33.62 ± 3.93 kg/m) were categorized into high restrained eaters (HRE) and low restrained eaters (LRE). The total energy intake was measured during a standardized laboratory meal after a resting and stress condition (Trier Social Stress Test) on two separate days. HRE and LRE showed differences in the total energy intake in response to acute stress but not after resting condition (F = 9.188, p = .004, η2 = 0.164). Lower total energy intake after stress compared to resting condition could be observed in HRE (t (23) = -2.617, p = .015). LRE showed higher total energy intake after stress than after resting condition (t (25) = 2.155, p = .041). The present data suggest that restrained eating behavior might be an influencing factor for stress-induced eating in obesity. It is highly necessary to understand the association between restrained eating behavior, acute stress and obesity for the improvement of the behavioral intervention of dietary restriction.
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http://dx.doi.org/10.1016/j.appet.2020.105045DOI Listing
April 2021

Cortisol reactivity in patients with anorexia nervosa after stress induction.

Transl Psychiatry 2020 08 10;10(1):275. Epub 2020 Aug 10.

Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

There is a need of experimental studies on biomarkers in patients with anorexia nervosa (P), especially in the context of stress, in order to foster understanding in illness maintenance. To this end, the cortisol response to an acute stressor was investigated in n = 26 P (BMI: 19.3 ± 3.4 kg/m), age, and gender matched to n = 26 healthy controls (HC; BMI: 23.08 ± 3.3 kg/m). For this purpose, salivary cortisol parameters were assessed in two experimental conditions: (1) rest/no intervention and (2) stress intervention (TSST; Trier Social Stress Test). In addition, psychological indicators of stress were assessed (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, and Trier Inventory for the assessment of Chronic Stress), as well as psychological distress, depression, and eating disorder (ED) symptoms. A 2 × 2 × 8 ANOVA demonstrated elevated cortisol levels in P in the resting condition. In the stress intervention no significant group effect in terms of cortisol (F (1, 50) = 0.69; p = 0.410; [Formula: see text]). A significant condition (F (1, 50) = 20.50; p = 0.000; [Formula: see text]) and time effect (F(2.71, 135.44) = 11.27; p = 0.000; [Formula: see text]) were revealed, as well as two significant interaction effects. First: Condition × group (F (1, 50) = 4.17, p = 0.046; [Formula: see text]) and second: Condition × time (F (2.71, 135.44) = 16.07, p = 0.000, [Formula: see text]). In terms of AUC, no significant differences between both groups were exhibited. Regardless, significant results were evinced in terms of an increase (AUC: F(1, 50) = 20.66, p = 0.015, [Formula: see text]), baseline to peak (+20 min post-TSST: t = 16.51 (9.02), p = 0.029) and reactivity (M = 0.73 vs. M = 4.25, p = 0.036). In addition, a significant correlation between AUC and BMI: r (24) = -0.42, p = 0.027 was demonstrated, but not between AUC and BMI (r (24) = -0.26, p = 0.20). Psychological indices suggested higher levels of chronic and perceived stress in P relative to HC. However, stress perception in the stress condition (VAS) was comparable. Additional analyses demonstrated that ED-symptoms are highly correlated with psychological distress and depression, but not with BMI. In addition, it could be demonstrated that reactivity is rather related to ED-symptoms and psychological burden than to BMI. In conclusion, P showed elevated basal cortisol levels at rest and exhibited a blunted cortisol reactivity to the TSST as evinced by salivary cortisol parameters. Further, it was shown that weight recovery influences reversibility of hypercortisolemia, i.e., cortisol levels normalize with weight gain. However, HPAA (hypothalamus-pituitary-adrenal axis) irregularities in terms of reactivity persist even at a BMI ≤ 19.3 (±3.4). Our data suggest that pronounced psychological burden in P, have a greater impact on the HPAA functionality (secondary to the ED) than BMI itself.
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http://dx.doi.org/10.1038/s41398-020-00955-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417562PMC
August 2020

Depression, anxiety and health status across different BMI classes: A representative study in Germany.

J Affect Disord 2020 11 11;276:45-52. Epub 2020 Jul 11.

Medical Psychology & Medical Sociology, University Medical Center Mainz, Johannes Gutenberg University of Mainz, Duesbergweg 6, 55128 Mainz, Germany.

Background: Changes in body mass index (BMI) over the course of one's lifetime are related to the development of mental disorders. In the current study we compared symptoms of depression, generalized anxiety as well as general health status in the four BMI-classes: underweight, normal weight, overweight and obesity. Furthermore, mediator role of general health status on the relationship between BMI and depression and generalized anxiety was analyzed.

Methods: A representative sample (random-route sampling) of the German population (N = 2350) was investigated in a cross-sectional survey by measuring the three questionnaires PHQ-9, GAD-7 and EQ-5D-5L.

Results: The results showed significant differences between the four BMI-classes in all three questionnaires. Individuals with obesity demonstrated higher values in depression, anxiety and general health compared to the three other BMI-classes. However, there was no U-shaped association between BMI and depression, anxiety and health-related quality of life. Regarding to the mediation analysis, general health status fully mediated the association between BMI, depressive symptoms as well as generalized anxiety symptoms.

Limitations: The assessment of the three factors depression, anxiety and general health status were measured by questionnaires, but no clinical diagnoses can be provided.

Conclusions: Evidence supports that individuals with obesity have an increased risk for depression and anxiety as well as lower general health. Further research on potential intervention and strategies in public health policies is needed to be able to target the developing of mental disorders in individuals with obesity. Taking their general health status into account is also of great importance.
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http://dx.doi.org/10.1016/j.jad.2020.07.020DOI Listing
November 2020

High/low cortisol reactivity and food intake in people with obesity and healthy weight.

Transl Psychiatry 2020 01 27;10(1):40. Epub 2020 Jan 27.

Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany.

Increased food intake, termed "comfort eating", is a pathologic coping mechanism in chronic stress. Cortisol reactivity under stress is a potent predictor of stress-induced eating behavior affecting the body mass index (BMI). However, cortisol reactivity and food intake under stress in people with obesity has not been evaluated. The aim of this study was to investigate the effect of high/low cortisol reactivity on food intake in people with obesity and healthy weight test controls, following standardized stress induction and a resting condition. Thirty-six men and women with obesity (BMI: 33.00 ± 3.23 kg/m²), as well as 36 age- and gender-matched healthy weight controls (BMI: 21.98 ± 1.81 kg/m²) were categorized into high cortisol reactors (HCR) and low cortisol reactors (LCR) in the Trier Social Stress Test (TSST). Following the TSST and a resting condition, the food intake of all participants was recorded in a standardized laboratory meal. Obese HCR demonstrated a significantly higher food intake than LCR (t (34) = -2.046, p ≤ 0.05). However, there were no significant differences between HCR and LCR in the healthy weight controls (p = 0.26). In addition, HCR of the people with obesity showed lower values in the emotion coping strategy of cognitive reappraisal than obese LCR (t (32) = 2.087, p ≤ 0.05). In conclusion, the magnitude of the cortisol reactivity to stress predicts stress-induced food intake in people with obesity, but not in the healthy weight controls. Limited use of cognitive reappraisal in emotion regulation in the obese HCR may be a marker of vulnerability to stress-induced eating.
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http://dx.doi.org/10.1038/s41398-020-0729-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026436PMC
January 2020

Continuous HRV analysis of HEMS emergency physicians to specify the work load over the different working days.

Int Arch Occup Environ Health 2020 05 16;93(4):525-533. Epub 2019 Dec 16.

Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Duesbergweg 6, 55128, Mainz, Germany.

Introduction: Up to date, there has been little research about the acute stress load of emergency physicians of the Helicopter Emergency Medical Service (HEMS). Therefore, this study investigates the physiological stress level between an air-rescue day, a clinic day, and a day off (control day). Furthermore, phases of activity and resting were compared to assess the activity of the autonomic nervous system (ANS).

Methods: In this field study (within-subjects design), heart rate variability (HRV) and self-perceived stress levels were monitored on an air-rescue day, a clinic day, and a control day of 20 HEMS EPs [three females, 17 males; age: mean (M) = 44.95, standard deviation (SD) = 4.80].

Results: When comparing the activity phases, significant differences were found for HR and HRV. The highest HR was found on the air-rescue day during the phase of landing at the operation site with M = 107.30 bpm (SD = 22.66 bpm), which was significantly higher than during activity phases of the clinic day (M = 88.28 bpm, SD = 11.81 bpm) and the control day (M = 83.28 bpm, SD = 14.83 bpm). The SDNN is significantly higher on the air-rescue day for the phase before the alarm (M = 72.23 ms, SD = 38.60 ms), the phase of the alarm (M = 77.52 ms, SD = 40.52 ms), and the average of all phases (M = 60.04 ms, SD = 34.07 ms) than on the clinic day (M = 38.42 ms, SD = 15.16 ms) and the control day, where the lowest value was reached (M = 39.11 ms, SD = 17.65 ms). The highest LF/HF was found during activity phases of the clinic day with M = 1281.84% (SD = 587.33%), which was significantly higher than the first five phases of the emergency operations and the average of all phases of the emergency operations of the air-rescue day, where a maximum of M = 896.57 ms (SD = 681.79 ms) during the phase before the alarm and a minimum of M = 764.69 ms (SD = 372.28 ms) during the phase of landing at the operation site. The lowest LF/HF for all testing days was found during the activity phases of the control day with M = 693.74% (SD = 404.73%). Overall, 60 observations were analyzed. In the psychological assessment, on average, the EPs shows lower values than the norm sample.

Discussion: In the comparison of the activity phases, significant effects were found on the clinic day and during the phases of the emergency operations of the air-rescue day for the HR and HRV. Hereby, a significant activation of the EPs ANS and an outweigh of the sympathetic nervous system could be shown, whereby the subjective stress load was reported mainly as low. For the resting phases, no significant differences were found between all testing days. We interpret this as a good sign for the ability of regeneration between the phases of high stress load.
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http://dx.doi.org/10.1007/s00420-019-01507-3DOI Listing
May 2020

Cortisol Stress Reactivity to the Trier Social Stress Test in Obese Adults.

Obes Facts 2018 11;11(6):491-500. Epub 2018 Dec 11.

Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany.

Objective: Approximately 600 million adults worldwide suffer from obesity. In addition to individual's eating behavior and lack of physical activity in the development of obesity and overweight, psychosocial stress as well as hormonal stress reactivity must also be considered as important contributing factors. In the current study we compared the cortisol stress response pathway in a psychosocial stress induction (Trier Social Stress Test; TSST) with obese individuals and normal-weight controls.

Method: 32 obese individuals (17 females; mean age = 33.94 years, SD = 11.31 years) and 32 normal-weight controls (17 females; mean age = 29.09 years, SD = 10.46 years) underwent the TSST. The salivary cortisol responses and three appraisal questionnaires (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, Trier Inventory for Chronic Stress) were measured.

Results: After stress induction, there was a significant main group difference between the obese individuals and the normal-weight controls for cortisol, with lower baseline and post-stress cortisol levels in the obese individuals. Nevertheless, the obese individuals as well as the normal-weight controls showed no significant difference in the self-reported assessment of the stress condition but some significant differences in the cognitive appraisal of the TSST.

Conclusion: In conclusion, the induction of psychosocial stress showed differences in the cortisol patterns between the obese individuals and the normal-weight controls. Furthermore, the present data suggest that obesity leads to lower cortisol activity, which may indicate alterations in the Hypothalamic-pituitary-adrencortical (HPA) axis.
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http://dx.doi.org/10.1159/000493533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341320PMC
September 2019

Stress load of emergency service: effects on the CAR and HRV of HEMS emergency physicians on different working days (N = 20).

Int Arch Occup Environ Health 2019 02 12;92(2):155-164. Epub 2018 Oct 12.

University Center for Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Dresden, Germany.

Purpose: The occupation of the emergency physicians (EPs) of helicopter emergency medical services (HEMS) can be characterized as a high-strain occupation (Karasek in Adm Sci Q 24(2):285-308. https://doi.org/10.2307/2392498 , 1979). Therefore, the aim of this study was to measure and compare the stress load of the EPs of HEMS on duty on air ambulance workdays and on 2 control days.

Methods: In this field study (within-subjects design), hormonal, physiological, and self-perceived stress levels of 20 EPs [3 females, 17 males; mean age (M) = 44.95 years, SD = 4.80, 95% confidence interval (CI) (42.71, 47.19)] of HEMS, were recorded on different test days. Measurements of the cortisol awakening response (CAR) and the heart rate variability (HRV) were performed while on duty on the air ambulance and during workdays at the outpatient clinic as well as at home on days of rest.

Results: There were significant differences in the CAR (area under the curve with respect to ground F(2,38) = 12.81, p < 0.001) between the 3 test days with the highest values on the workday at the outpatient clinic [M = 81.24; 98.75% CI (61.24, 101.24)] and not on the air ambulance day [M = 61.82; 98.75% CI (45.18, 78.46)] or on the day of rest [M = 52.96; 98.75% CI (38.17, 67.76)]. In addition, the HRV parameter SDNN [F(2,38) = 6.369; p = 0.004] presented significant differences between the 3 test days with lower levels on the day at the outpatient clinic [M = 101.44; 98.75% CI (83.50, 119.38)] in contrast to the air ambulance day [M = 120.16; 98.75% CI (100.02, 140.30)] and to the resting day [M = 123.79; 98.75% CI (106.49, 141.10)]. Furthermore, there were significant differences in the HRV parameter LF/HF [F(2,38) = 6.215; p = 0.005] between the 3 testing days with the highest values on the workday at the outpatient clinic [M = 8.69; 98.75% CI (6.29, 11.09)] compared to the air ambulance day [M = 6.54; 98.75% CI (4.50, 8.57)] and the day of rest [M = 6.43; 98.75% CI (4.57, 8.29)].

Conclusions: Compared with the standard values and previous studies, EPs of HEMS have an increase in hormonal reactivity in the morning and a lack of recovery of the ANS. It can be concluded that-with respect to the psychobiological stress model by McEwen and Lasley (The end of stress as we know it, National Academic Press, Washington, 2003)-work-related stressors persist too long or the stress response is exaggerated (allostatic load) due to chronic stress induction and lack of recovery.
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http://dx.doi.org/10.1007/s00420-018-1362-zDOI Listing
February 2019

Stress-related laboratory eating behavior in adults with obesity and healthy weight.

Physiol Behav 2018 11 29;196:150-157. Epub 2018 Aug 29.

Medical Psychology and Medical Sociology, Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medicine Mainz, Mainz, Germany.

Stress is an important factor in the progression of irregular eating patterns and has an additional exacerbating impact in people with overweight and obesity. Therefore, in this study, the chewing and food intake was observed after standardized acute stress induction, as well as resting, in people with obesity and healthy weight controls. Twenty-eight women and men with obesity (BMI: 32.76 ± 2.25 kg/m) were matched with regard to sex and age to 28 people with healthy weight (BMI: 22.58 ± 2.04 kg/m). After two conditions (Trier Social Stress Test vs. resting condition) the chewing frequency and food intake were measured during a standardized laboratory meal on two separate days. Additionally, for manipulation check of stress induction salivary cortisol and two appraisal questionnaires (Primary Appraisal Secondary Appraisal, Visual Analogue Scale) were used. People with obesity showed after stress and resting condition a lower chewing frequency in contrast to healthy weight controls (F = 12.816, p ≤ .001). Thereby, both groups demonstrated a higher chewing frequency after the stress induction than after the resting condition (F = 7.436, p ≤ .01). There was no difference between the healthy weight controls and the people with obesity in food intake. In conclusion, the present data indicate a possible 'obese eating style' with regard to chewing performance. Furthermore, the demonstrated higher chewing frequency after stress induction, in people with obesity and people with healthy weight, might be a stress reduction strategy.
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http://dx.doi.org/10.1016/j.physbeh.2018.08.018DOI Listing
November 2018
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