The Selah study protocol of three interventions to manage stress among clergy: a preference-based randomized waitlist control trial

Introduction Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms. Methods and analysis The overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control. Ethics and dissemination Ethical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community. Strengths and limitations of this study While evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals. Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training. If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day. This study is limited by the inclusion of Christian clergy of only one denomination. Trial registration ClinicalTrials.gov NCT04625777. November 12, 2020.

The Selah pilot study of spiritual, mindfulness, and stress inoculation practices on stress-related outcomes: A non-randomized participant preference control pilot study

Background The job-demand-control-support model indicates that clergy are at high risk for chronic stress and adverse health outcomes. Methods A non-randomized participant preference design with a control group was used to evaluate the feasibility, acceptability, and range of outcome effect sizes for four potentially stress-reducing interventions: stress inoculation training, mindfulness-based stress reduction (MBSR), the Daily Examen, and Centering Prayer. All United Methodist clergy in North Carolina were eligible and recruited via email to attend their preferred intervention: in-person workshops of one (Daily Examen, Centering Prayer) or two days (stress inoculation training) at retreat centers, or eight weekly online 90-minute sessions (MBSR). Surveys at 0, 3, and 12 weeks assessed symptoms of stress, anxiety, and perceived stress reactivity. Heart rate variability was assessed at baseline and 12 weeks using data from 24h ambulatory heart rate monitoring. A patched-up control group was recruited after recruitment commenced. A subset of participants completed in-depth interviews and reported skill practice using daily text messages. Standardized mean differences with 95% and 75% confidence intervals were calculated for each intervention relative to control to determine the range of effect sizes likely to be observed in a definitive trial. Results 78 clergy participated in an intervention and 7 provided data as a control group. The daily percentage of participants engaging in stress management practices ranged from 47% (MBSR) to 69% (Examen). Every participant interviewed (n=23) reported that learning content was acceptable and they would recommend their intervention to others. Small-to-large effect sizes on measures of stress and anxiety were observed for Daily Examen, stress inoculation, and MBSR relative to control. Little evidence for change in HRV was observed between intervention and control, with the most favorable effects observed for MBSR. Results were mixed for Centering Prayer. Conclusions All four interventions were feasible and acceptable, with the best trends in outcomes for MBSR, although other interventions were promising. Participants welcomed daily text messages reminding them to engage in practice and wore ambulatory heart rate monitoring devices without incident. Three-week survey data did not contribute to study findings. Trial registration: ClinicalTrials.gov trial registration number: NCT04625777, November 12, 2020 (retrospectively registered).

The Selah Study Protocol of Three Interventions to Manage Stress among Clergy: A Preference-based Randomized Waitlist-control Trial

Introduction: Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles, and practiced at a high enough level to meaningfully reduce stress symptoms. Methods and analysis: The overall design is a preference-based randomized waitlist-control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist-control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include: Mindfulness-Based Stress Reduction, Daily Examen and stress inoculation training. Surveys will be conducted at 0, 12 and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control. Ethics and dissemination: Ethical approval was obtained from the Duke University Campus IRB (2019-0238). Results will be made available to researchers, funders, and members of the clergy community.ClinicalTrials.gov trial registration number: NCT04625777.

Military Exposures Predict Mental Health Symptoms in Explosives Personnel but Not Always as Expected

ABSTRACT Objective The aim of this study was to determine the unique and combined associations of various military stress exposures with positive and negative mental health symptoms in active duty service members. Materials and Methods We investigated 87 male U.S. Navy Explosive Ordnance Disposal (EOD) technicians (age M ± SE, range 33.7 ± 0.6, 22-47 years). Those who endorsed a positive traumatic brain injury diagnosis were excluded to eliminate the confounding effects on mental health symptoms. Using a survey platform on a computer tablet, EOD technicians self-reported combat exposure, deployment frequency (total number of deployments), blast exposure (vehicle crash/blast or 50-m blast involvement), depression, anxiety, posttraumatic stress, perceived stress, and life satisfaction during an in-person laboratory session. Results When controlling for other military stressors, EOD technicians with previous involvement in a vehicle crash/blast endorsed worse mental health than their nonexposed counterparts. The interactions of vehicle crash/blast with deployment frequency and combat exposure had moderate effect sizes, and combat and deployment exposures demonstrated protective, rather than catalytic, effects on negative mental health scores. Conclusions Military stressors may adversely influence self-reported symptoms of negative mental health, but deployment experience and combat exposure may confer stress inoculation.

The socio-cognitive theory of personality and its clinical applications

Personality is a cognitive-affective processing system, which, according to the socio-cognitive theory, creates four dimensions. They are reflected in the skills, beliefs, standards and goals of the individual, which are consistent and consistent patterns of behaviour. Self-efficacy judgments and self-patterns determine the choice of goals and persistence in achieving them. On the other hand, the emotions preceding and accompanying the achievement of goals affect coping with stress and problems. The review of the clinical and therapeutic applications of this theory included stress inoculation training, REBT rational emotive therapy, Beck's cognitive depression therapy, schema therapy and modelling methods. The great advantage of this theory is the possibility of verifying its theoretical assumptions and confirming their huge amount of research. Besides, it has a practical application as many types of cognitive-behavioural therapies have been developed on its basis.

The effectiveness of adaptive training for stress inoculation in a simulated astronaut task

Astronauts operate in an environment with multiple hazards that can develop into life-threatening emergency situations. Managing stress in emergencies may require cognitive resources and lead to diminishing performance. Stress training aims to maintain performance under stress by methodically increasing stressor levels to build inoculation against stress. An adaptive virtual reality (VR) training system was developed with real-time stress detection by using machine learning on psychophysiological responses. Using a VR simulation of a spaceflight emergency fire, stress classifications were used to trigger adaptations of the VR environmental stressors (e.g., smoke, alarms, flashing lights), with the goal of maintaining a manageable level of stress during training. Fifty-seven healthy subjects underwent task training over eight trials with adaptive training (adaptive, n=19); results were compared to trials with predetermined gradual increases in stressors (graduated, n=18), and with trials with constant low-level stressors (skill-only, n=20). Stress responses were measured through heart rate, heart rate variability (i.e., root mean squared of successive differences (RMSSD), low frequency to high frequency (LF/HF) ratio), and task performance (distance-from-fire). Heart rate decreased and RMSSD increased pre-post training for all experimental conditions. The LF/HF ratio decreased pre-post training for the adaptive condition, but not in the other conditions. Results suggests that all conditions had lower stress, but the adaptive condition was more successful. Task performance showed a marginal increase across trials for the adaptive condition. Preliminary results suggest that training with the adaptive stress system can prepare individuals for responding to stressors better than skill-only and graduated training.

Perception during use of force and the likelihood of firing upon an unarmed person

Stress can impact perception, especially during use-of-force. Research efforts can thus advance both theory and practice by examining how perception during use-of-force might drive behavior. The current study explored the relationship between perceptual judgments and performance during novel close-combat training. Analyses included perceptual judgments from close-combat assessments conducted pre-training and post-training that required realistic use-of-force decisions in addition to an artificially construed stress-inoculation event used as a training exercise. Participants demonstrated significant reductions in situational awareness while under direct fire, which correlated to increased physiological stress. The initial likelihood of firing upon an unarmed person predicted the perceptual shortcomings of later stress-inoculation training. Subsequently, likelihood of firing upon an unarmed person was reduced following the stress-inoculation training. These preliminary findings have several implications for low or zero-cost solutions that might help trainers identify individuals who are underprepared for field responsibilities.

Phomopsis Liquidambaris Contributes to the Decease of Ethylene Biosynthesis in Rice under Salt Stress via Inhibiting the Activity of 1-Aminocyclopropane-1-Carboxylate Deaminase

The endophytic fungus Phomopsis liquidambaris is characterized as a plant growth-promoting agent under salt stress, but its mechanism is unknown. Herein, 1-Aminocyclopropane-1-Carboxylate Deaminase (ACCD) from the strain was confirmed that it had the ability of utilizing 1-Aminocyclopropane-1-Carboxylate as the sole nitrogen source. The full-length ACCD gene was 1,152 bp, which encodes a mature protein of 384 amino acids with a molecular mass of 41.53 kDa. The ACCD activity was 3.9-fold in 3 mmol L− 1 ACC by qRT-PCR under salt stress comparing with no salt tress. Ethylene production was increased to 34.55–70.60% and reduced the growth of rice by 23–69.73% under salt stress. Inoculation of P. liquidambaris increased root-shoot length, fresh and dry weight, and overall growth of stressed rice seedlings. ACC accumulation, ACC synthase and ACC oxidase activities increased in salt-treated rice seedlings, while they were significantly reduced when P. liquidambaris was inoculated into Rice by qRT-PCR. It therefore can be concluded that P. liquidambaris can be used as a plant growth promoting fungus against salt stress and other biotic or abiotic stresses.