Background: Itch and scratching are distressing symptoms in diverse diseases. Both negative expectancies and stress have been shown to increase symptom severity. However, especially the role of...Show moreBackground: Itch and scratching are distressing symptoms in diverse diseases. Both negative expectancies and stress have been shown to increase symptom severity. However, especially the role of stress remains unclear as it has mostly been tested in pain studies. Methods: To investigate whether the effect of stress on itch is mediated by negative expectancies; cowhage, verbal suggestions and a video fragment were used to induce itch in a within-subjects design of 11 healthy participants. Itch, scratching and negative expectancies were measured on a scale from 0 to 10. Stress was assessed by the DASS-21 questionnaire. Results: Using mediation analysis, results suggested that stress was not predictive of itch symptoms at all, even when taking into account negative expectancies. Nonetheless, negative expectancies on their own were related to itch and scratching. Conclusions: These findings demonstrate that negative expectancies should be treated as a key aspect in psychological treatment targeting chronic pruritus, such as rational-emotive therapy (RET). However, future research should still investigate stress in relation to itch, as the current study did not assess the impact of severe stress levels and experimentally-induced stress.Show less
This retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit...Show moreThis retrospective cohort study aimed to investigate the influence of stress on atypical symptom amelioration to first-choice psychostimulant medication in individuals with attention deficit hyperactivity disorder (ADHD). Understanding the impact of stress on the effectiveness of psychostimulant medications is crucial, given the high prevalence of stress-related psychiatric comorbidity in ADHD and the potential stress effects on psychostimulant effectivity. It was hypothesized that cardiovascular stress and stress-related psychiatric comorbidity are related to atypical symptom amelioration and that these two characteristics are interrelated. Additionally, the effect of medication and time will be explored. A unique subset from the SOPHISTICATE cohort was analysed, comprising of 460 patients diagnosed with ADHD who exhibited atypical treatment response following first-choice medication registration and were switched to a second-choice medication within 3 weeks. The adult version of the Quantified Behavioral Test (QbTest), a computerized tool that quantifies the core symptoms of ADHD was used to determine baseline symptom severity and treatment response, i.e. QbActivity (QbAct); QbImpulsivity (QbImp); and QbInattention (QbIna). Patients were divided into groups based on stresscharacteristics, and linear mixed models were employed to examine the impact of stresscharacteristics, first-choice medication and time on symptom amelioration (i.e. QbTest score after first- or second-choice medication – QbTest score at baseline; ∆). The results reveal that stress-characteristics were not related to atypical symptom amelioration after first-choice medication. However, patients with stress related psychiatric comorbidity show more inattentive symptom amelioration after second-choice medication registration β=.21, SE=.10, 95% CI [.02, .41], p=.031. Importantly, the effect of time was significant for all three symptom domainssuggesting a role of time to enable a typical response, i.e. ∆QbAct (F(1,462) = 387.818, p < .001), ∆QbImp (F(1, 462) = 235.224, p < .001) and on ∆QbIna (F(1, 463) = 319.655, p = .242). Additionally it was found that baseline symptom severity confounds the medication effect for ∆QbImp and for ∆QbAct. In conclusion, the results indicate that stress characteristics nor medication is related to an atypical response pattern to first-choice medication. The current study did reveal an important role of time to enable a ‘typical’ response. Limitations of the study included the lack of a reference group, the possibility of random effects, and quality of the cardiovascular data. In conclusion, while the impact of stress on treatment response could not be definitively determined based on the available data, future research should explore the complex interplay between stress, psychiatric comorbidity, and medication types to optimize treatment strategies and improve outcomes for patientsShow less
This thesis research investigates the indirect relationship between role conflict and sleep quality. It is investigated whether anxiety complaints have a mediating effect, and whether burnout has a...Show moreThis thesis research investigates the indirect relationship between role conflict and sleep quality. It is investigated whether anxiety complaints have a mediating effect, and whether burnout has a moderating effect. An association has been found in the literature for the relationship between role conflict and anxiety symptoms, as well as for anxiety symptoms and reduced sleep quality. In addition, it turned out that burnout has an effect on these three variables. Four online questionnaires were used for this study, which were completed over a period of three weeks. The results of this study showed no significant indirect effect, also burnout was not a significant moderator. However, a non-significant association was found between decreased sleep quality and role conflict. It is recommended that more research be done on this in the futureShow less
