research topics on stress management

Recent developments in stress and anxiety research

• Published: 01 September 2021
• Volume 128 , pages 1265–1267, ( 2021 )

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• Urs M. Nater 1 , 2  

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Stress and anxiety are virtually omnipresent in today´s society, pervading almost all aspects of our daily lives. While each and every one of us experiences “stress” and/or “anxiety” at least to some extent at times, the phenomena themselves are far from being completely understood. In stress research, scientists are particularly grappling with the conceptual issue of how to define stress, also with regard to delimiting stress from anxiety or negative affectivity in general. Interestingly, there is no unified theory of stress, despite many attempts at defining stress and its characteristics. Consequently, the available literature relies on a variety of different theoretical approaches, though the theories of Lazarus and Folkman ( 1984 ) or McEwen ( 1998 ) are relatively pervasive in the literature. One key issue in conceptualizing stress is that research has not always differentiated between the perception of a stimulus or a situation as a stressor and the subsequent biobehavioral response (often called the “stress response”). This is important, since, for example, psychological factors such as uncontrollability and social evaluation, i.e. factors that may influence how an individual perceives a potentially stressful stimulus or situation, have been identified as characteristics that elicit particularly powerful physiological stressful responses (Dickerson and Kemeny 2004 ). At the core of the physiological stress response is a complex physiological system, which is located in both the central nervous system (CNS) and the body´s periphery. The complexity of this system necessitates a multi-dimensional assessment approach involving variables that adequately reflect all relevant components. It is also important to consider that the experience of stress and its psychobiological correlates do not occur in a vacuum, but are being shaped by numerous contextual factors (e.g. societal and cultural context, work and leisure time, family and dyadic systems, environmental variables, physical fitness, nutritional status, etc.) and dispositional factors (e.g. genetics, personality, resilience, regulatory capacities, self-efficacy, etc.). Thus, a theoretical framework needs to incorporate these factors. In sum, as stress is considered a multi-faceted and inherently multi-dimensional construct, its conceptualization and operationalization needs to reflect this (Nater 2018 ).

The goal of the World Association for Stress Related and Anxiety Disorders (WASAD) is to promote and make available basic and clinical research on stress-related and anxiety disorders. Coinciding with WASAD’s 3rd International Congress held in September 2021 in Vienna, Austria, this journal publishes a Special Issue encompassing state-of-the art research in the field of stress and anxiety. This special issue collects answers to a number of important questions that need to be addressed in current and future research. Among the most relevant issues are (1) the multi-dimensional assessment that arises as a consequence of a multi-faceted consideration of stress and anxiety, with a particular focus on doing so under ecologically valid conditions. Skoluda et al. 2021 (in this issue) argue that hair as an important source of the stress hormone cortisol should not only be taken as a complementary stress biomarker by research staff, but that lay persons could be also trained to collect hair at the study participants’ homes, thus increasing the ecological validity of studies incorporating this important measure; (2) the incongruence between psychological and biological facets of stress and anxiety that has been observed both in laboratory and field research (Campbell and Ehlert 2012 ). Interestingly, there are behavioral constructs that do show relatively high congruence. As shown in the paper of Vatheuer et al. ( 2021 ), gaze behavior while exposed to an acute social stressor correlates with salivary cortisol, thus indicating common underlying mechanisms; (3) the complex dynamics of stress-related measures that may extend over shorter (seconds to minutes), medium (hours and diurnal/circadian fluctuations), and longer (months, seasonal) time periods. In particular, momentary assessment studies are highly qualified to examine short to medium term fluctuations and interactions. In their study employing such a design, Stoffel and colleagues (Stoffel et al. 2021 ) show ecologically valid evidence for direct attenuating effects of social interactions on psychobiological stress. Using an experimental approach, on the other hand, Denk et al. ( 2021 ) examined the phenomenon of physiological synchrony between study participants; they found both cortisol and alpha-amylase physiological synchrony in participants who were in the same group while being exposed to a stressor. Importantly, these processes also unfold over time in relation to other biological systems; al’Absi and colleagues showed in their study (al’Absi et al. 2021 ) the critical role of the endogenous opioid system and its relation to stress-related analgesia; (4) the influence of contextual and dispositional factors on the biological stress response in various target samples (e.g., humans, animals, minorities, children, employees, etc.) both under controlled laboratory conditions and in everyday life environments. In this issue, Sattler and colleagues show evidence that contextual information may only matter to a certain extent, as in their study (Sattler et al. 2021 ), the biological response to a gay-specific social stressor was equally pronounced as the one to a general social stressor in gay men. Genetic information is probably the most widely researched dispositional factor; Kuhn et al. show in their paper (Kuhn et al. 2021 ) that the low expression variant of the serotonin transporter gene serves as a risk factor for increased stress reactivity, thus clearly indicating the important role of dispositional factors in stress processing. An interesting factor combining both aspects of dispositional and contextual information is maternal care; Bentele et al. ( 2021 ) in their study are able to show that there was an effect of maternal care on the amylase stress response, while no such effect was observed for cortisol. In a similar vein, Keijser et al. ( 2021 ) showed in their gene-environment interaction study that the effects of FKBP5, a gene very closely related to HPA axis regulation, and early life stress on depressive symptoms among young adults was moderated by a positive parenting style; and (5) the role of stress and anxiety as transdiagnostic factors in mental disorders, be it as an etiological factor, a variable contributing to symptom maintenance, or as a consequence of the condition itself. Stress, e.g., as a common denominator for a broad variety of psychiatric diagnoses has been extensively discussed, and stress as an etiological factor holds specific significance in the context of transdiagnostic approaches to the conceptualization and treatment of mental disorders (Wilamowska et al. 2010 ). The HPA axis, specifically, is widely known to be dysregulated in various conditions. Fischer et al. ( 2021 ) discuss in their comprehensive review the role of this important stress system in the context of patients with post-traumatic disorder. Specifically focusing on the cortisol awakening response, Rausch and colleagues provide evidence for HPA axis dysregulation in patients diagnosed with borderline personality disorder (Rausch et al. 2021 ). As part of a longitudinal project on ADHD, Szep et al. ( 2021 ) investigated the possible impact of child and maternal ADHD symptoms on mothers’ perceived chronic stress and hair cortisol concentration; although there was no direct association, the findings underline the importance of taking stress-related assessments into consideration in ADHD studies. As the HPA axis is closely interacting with the immune system, Rhein et al. ( 2021 ) examined in their study the predicting role of the cytokine IL-6 on psychotherapy outcome in patients with PTSD, indicating that high reactivity of IL-6 to a stressor at the beginning of the therapy was associated with a negative therapy outcome. The review of Kyunghee Kim et al. ( 2021 ) also demonstrated the critical role of immune pathways in the molecular changes due to antidepressant treatment. As for the therapy, the important role of cognitive-behavioral therapy with its key elements to address both stress and anxiety reduction have been shown in two studies in this special issue, evidencing its successful application in obsessive–compulsive disorder (Ivarsson et al. 2021 ; Hollmann et al. 2021 ). Thus, both stress and anxiety are crucial transdiagnostic factors in various mental disorders, and future research needs elaborate further on their role in etiology, maintenance, and treatment.

In conclusion, a number of important questions are being asked in stress and anxiety research, as has become evident above. The Special Issue on “Recent developments in stress and anxiety research” attempts to answer at least some of the raised questions, and I want to invite you to inspect the individual papers briefly introduced above in more detail.

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Ivarsson T, Melin K, Carlsson A, Ljungberg M, Forssell-Aronsson E, Starck G, Skarphedinsson G (2021) Neurochemical properties measured by 1 H magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study. J Neural Transm. https://doi.org/10.1007/s00702-021-02407-y

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Nater, U.M. Recent developments in stress and anxiety research. J Neural Transm 128 , 1265–1267 (2021). https://doi.org/10.1007/s00702-021-02410-3

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• Published: 15 April 2020

Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study

• Gebrezabher Niguse Hailu 1  

BMC Psychiatry volume  20 , Article number:  162 ( 2020 ) Cite this article

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Stress is one of the top five threats to academic performance among college students globally. Consequently, students decrease in academic performance, learning ability and retention. However, no study has assessed the practice of stress management behaviors and associated factors among college students in Ethiopia. So the purpose of this study was to assess the practice of stress management behaviors and associated factors among undergraduate university students at Mekelle University, Tigray, Ethiopia, 2019.

A cross-sectional study was conducted on 633 study participants at Mekelle University from November 2018 to July 2019. Bivariate analysis was used to determine the association between the independent variable and the outcome variable at p  < 0.25 significance level. Significant variables were selected for multivariate analysis.

The study found that the practice of stress management behaviors among undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. The study also indicated that sex, year of education, monthly income, self-efficacy status, and social support status were significant predictors of stress management behaviors of college students.

This study found that the majority of the students had poor practice of stress management behaviors.

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Stress is the physical and emotional adaptive response to an external situation that results in physical, psychological and behavioral deviations [ 1 ]. Stress can be roughly subdivided into the effects and mechanisms of chronic and acute stress [ 2 ]. Chronic psychological stress in early life and adulthood has been demonstrated to result in maladaptive changes in both the HPA-axis and the sympathetic nervous system. Acute and time-limited stressors seem to result in adaptive redistribution of all major leukocyte subpopulations [ 2 ].

Stress management behaviors are defined as behaviors people often use in the face of stress /or trauma to help manage painful or difficult emotions [ 3 ]. Stress management behaviors include sleeping 6–8 h each night, Make an effort to monitor emotional changes, Use adequate responses to unreasonable issues, Make schedules and set priorities, Make an effort to determine the source of each stress that occurs, Make an effort to spend time daily for muscle relaxation, Concentrate on pleasant thoughts at bedtime, Feel content and peace with yourself [ 4 ]. Practicing those behaviors are very important in helping people adjust to stressful events while helping them maintain their emotional wellbeing [ 3 ].

University students are a special group of people that are enduring a critical transitory period in which they are going from adolescence to adulthood and can be one of the most stressful times in a person’s life [ 5 ]. According to the American College Health Association’s National College Health Assessment, stress is one of the top five threats to academic performance among college students [ 6 ]. For instance, stress is a serious problem in college student populations across the United States [ 7 ].

I have searched literatures regarding stress among college students worldwide. For instance, among Malaysian university students, stress was observed among 36% of the respondents [ 8 ]. Another study reported that 43% of Hong Kong students were suffered from academic stress [ 9 ]. In western countries and other Middle Eastern countries, including 70% in Jordan [ 10 ], 83.9% in Australia [ 11 ]. Furthermore, based on a large nationally representative study the prevalence of stress among college students in Ethiopia was 40.9% [ 12 ].

Several studies have shown that socio-demographic characteristics and psychosocial factors like social support, health value and perceived self-efficacy were known to predict stress management behaviors [ 13 , 14 , 15 , 16 , 17 ].

Although the prevalence of stress among college students is studied in many countries including Ethiopia, the practice of stress management behaviors which is very important in promoting the health of college students is not studied in Ethiopia. Therefore this study aimed to assess the practice of stress management behaviors and associated factors among undergraduate students at Mekelle University.

The study was conducted at Mekelle university colleges from November 2018 to July 2019 in Mekelle city, Tigray, Ethiopia. Mekelle University is a higher education and training public institution located in Mekelle city, Tigray at a distance of 783 Kilometers from the Ethiopian capital ( http://www.mu.edu.et/ ).

A cross-sectional study was conducted on 633 study participants. Students who were ill (unable to attend class due to illness), infield work and withdrawal were not included in the study.

The actual sample size (n) was computed by single population proportion formula [n = [(Za/2)2*P (1 − P)]/d2] by assuming 95% confidence level of Za/2 = 1.96, margin of error 5%, proportion (p) of 50% and the final sample size was estimated to be 633. A 1.5 design effect was used by considering the multistage sampling technique and assuming that there was no as such big variations among the students included in the study.

Multi-stage random sampling was used. Three colleges (College of health science, college of business and Economics and College of Natural and Computational Science) were selected from a total of the seven Colleges from Mekelle University using a simple random sampling technique in which proportional sample allocation was considered from each college.

Data were collected using a self-administered questionnaire by trained research assistants at the classes.

The questionnaire has three sections. The first section contained questions on demographic characteristics of the study participants. The second section contained questions to assess the practice of stress management of the students. The tool to assess the practice of stress management behaviors for college students was developed by Walker, Sechrist, and Pender [ 4 ]. The third section consisted of questions for factors associated with stress management of the students divided into four sub-domains, including health value used to assess the value participants place on their health [ 18 ]. The second subdomain is self-efficacy designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life [ 19 ] and was adapted by Yesilay et al. [ 20 ]. The third subdomain is perceived social support measures three sources of support: family, friends, and significant others [ 21 ] and was adapted by Eker et al. [ 22 ]. The fourth subscale is perceived stress measures respondents’ evaluation of the stressfulness of situations in the past month of their lives [ 23 ] and was adapted by Örücü and Demir [ 24 ].

The entered data were edited, checked visually for its completeness and the response was coded and entered by Epi-data manager version 4.2 for windows and exported to SPSS version 21.0 for statistical analysis.

Bivariate analysis was used to determine the association between the independent variable and the outcome variable. Variables that were significant at p  < 0.25 with the outcome variable were selected for multivariable analysis. And odds ratio with 95% confidence level was computed and p -value <= 0.05 was described as a significant association.

Operational definition

Good stress management behavior:.

Students score above or equal to the mean score.

Poor stress management behavior:

Students score below the mean score [ 4 ].

Seciodemographic characteristics

Among the total 633 study participants, 389(61.5%) were males, of those 204(32.2%) had poor stress management behavior. The Median age of the respondents was 20.00 (IQR = ±3). More ever, this result showed that 320(50.6%) of the students came from rural areas, 215(34%) of them had poor stress management behavior.

The result revealed that 363(57.35%) of the study participants were 2nd and 3rd year students, of them 195 (30.8%) had poor stress management.

This result indicated that 502 (79.3%) of the participants were in the monthly support category of > = 300 ETB with a median income of 300.00 ETB (IQR = ±500), from those, 273(43.1%) students had poor stress management behavior (Table  1 ).

Status of practice of stress management behaviors of under graduate students at Mekelle University, Ethiopia

Psychosocial factors

This result indicated that 352 (55.6%) of the students had a high health value status of them 215 (34%) had good stress management behavior. It also showed that 162 (25.6%) of the students had poor perceived self-efficacy, from those 31(4.9%) had a good practice of stress management behavior. Moreover, the result showed that 432(68.2%) of the study participants had poor social support status of them 116(18.3%) had a good practice of stress management behavior (Table  1 ).

Practice of stress management behaviors

The result showed that the majority (49.8%) of the students were sometimes made an effort to spend time daily for muscle relaxation. Whereas only 28(4.4%) students were routinely concentrated on pleasant thoughts at bedtime.

According to this result, only 169(26.7%) of the students were often made an effort to determine the source of stress that occurs. It also revealed that the majority (40.1%) of the students were never made an effort to monitor their emotional changes. Similarly, the result indicated that the majority (42.5%) of the students were never made schedules and set priorities.

The result revealed that only 68(10.7%) of the students routinely slept 6–8 h each night. More ever, the result showed that the majority (34.4%) of the students were sometimes used adequate responses to unreasonable issues (Table  2 ).

Status of the practice of stress management behaviors

The result revealed that the practice of stress management behaviors among regular undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. (Fig  1 )

Factors associated with stress management behaviors

In the bivariate analysis sex, college, year of education, student’s monthly income’, perceived-self efficacy, perceived social support and perceived stress were significantly associated with stress management behavior at p < =0.25. Whereas in the multivariate analysis sex, year of education, student’s monthly income’, perceived-self efficacy and perceived social support were significantly associated with stress management behavior at p < =0.05.

Male students were 3.244 times more likely to have good practice stress management behaviors than female students (AOR: 3.244, CI: [1.934–5.439]). Students who were in the age category of less than 20 years were 70% less to have a good practice of stress management behaviors than students with the age of greater or equal to 20 year (AOR: 0.300, CI:[0.146–0.618]).

Students who had monthly income less than300 ETB were 64.4% less to have a good practice of stress management behaviors than students with monthly income greater or equal to 300 ETB (AOR: 0.356, CI:[0.187–0.678]).

Students who had poor self- efficacy status were 70.3% less to have a good practice of stress management behaviors than students with good self-efficacy status (AOR: 0.297, CI:[0.159–0.554]). Students who had poor social support were 70.5% less to have a good practice of stress management behaviors than students with good social support status (AOR: 0.295[0.155–0.560]) (Table  3 ).

The present study showed that the practice of stress management behaviors among regular undergraduate students was 367(58%) poor and 266(42%) good. The study indicated that sex, year of education, student’s monthly income, social support status, and perceived-self efficacy status were significant predictors of stress management behaviors of students.

The current study revealed that male students were more likely to have good practice of stress management behaviors than female students. This finding is contradictory with previous studies conducted in the USA [ 13 , 25 ], where female students were showed better practice of stress management behaviors than male students. This difference might be due to socioeconomic and measurement tool differences.

The current study indicated that students with monthly income less than 300 ETB were less likely to have good practice of stress management behaviors than students with monthly income greater than or equal to 300 ETB. This is congruent with the recently published book which argues a better understanding of our relationship with money (income). The book said “the people with more money are, on average, happier than the people with less money. They have less to worry about because they are not worried about where they are going to get food or money for their accommodation or whatever the following week, and this has a positive effect on their health” [ 26 ].

The present study found that first-year students were less likely to have good practice of stress management behaviors than senior students. This finding is similar to previous findings from Japan [ 27 ], China [ 28 ] and Ghana [ 29 ]. This might be because freshman students may encounter a multitude of stressors, some of which they may have dealt with in high school and others that may be a new experience for them. With so many new experiences, responsibilities, social settings, and demands on their time. As a first-time, incoming college freshman, experiencing life as an adult and acclimating to the numerous and varied types of demands placed on them can be a truly overwhelming experience. It can also lead to unhealthy amounts of stress. A report by the Anxiety and Depression Association of America found that 80% of freshman students frequently or sometimes experience daily stress [ 30 ].

The current study showed that students with poor self-efficacy status were less likely to have good practice of stress management behaviors. This is congruent with the previous study that has demonstrated quite convincingly that possessing high levels of self-efficacy acts to decrease people’s potential for experiencing negative stress feelings by increasing their sense of being in control of the situations they encounter [ 14 ]. More ever this study found that students with poor social support were less likely to have a good practice of stress management behaviors. This finding is similar to previous studies that found good social support, whether from a trusted group or valued individual, has shown to reduce the psychological and physiological consequences of stress, and may enhance immune function [ 15 , 16 , 17 ].

Ethics approval and consent to participate

Ethical clearance and approval obtained from the institutional review board of Mekelle University. Moreover, before conducting the study, the purpose and objective of the study were described to the study participants and written informed consent was obtained. The study participants were informed as they have full right to discontinue during the interview. Subject confidentiality and any special data security requirements were maintained and assured by not exposing the patient’s name and information.

Limitation of the study

There is limited literature regarding stress management behaviors and associated factors. There is no similar study done in Ethiopia previously. More ever, using a self-administered questionnaire, the respondents might not pay full attention to it/read it properly.

This study found that the majority of the students had poor practice of stress management behaviors. The study also found that sex, year of education, student’s monthly income, social support status, and perceived-self efficacy status were significant predictors of stress management behaviors of the students.

Availability of data and materials

The datasets used during the current study is available from the corresponding author on reasonable request.

Abbreviations

Adjusted Odd Ratio

College of Business& Economics

College of health sciences

Confidence interval

College of natural and computational sciences

Crud odds ratio

Ethiopian birr

Master of Sciences

United States of America

United kingdom

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Hailu, G.N. Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study. BMC Psychiatry 20 , 162 (2020). https://doi.org/10.1186/s12888-020-02574-4

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Transforming stress through awareness, education and collaboration.

Stress Research

“The difficulty in science is often not so much how to make the discovery but rather to know that one has made it.” – J.D. Bernal

2022 Stress Statistics

Two years after the World Health Organization declared COVID-19 a global pandemic, inflation, money issues and the war in Ukraine have pushed U.S. stress to alarming levels, according to polls conducted for the American Psychological Association .

A late-breaking poll, fielded March 1-3 by The Harris Poll on behalf of APA, revealed striking findings, with more adults rating inflation and issues related to the invasion of Ukraine as stressors than any other issue asked about in the 15-year history of the Stress in America TM  poll. This comes on top of money stress at the highest recorded level since 2015, according to a broader Stress in America poll fielded last month.

Top sources of stress were the rise in prices of everyday items due to inflation (e.g., gas prices, energy bills, grocery costs, etc.) (cited by 87%), followed by supply chain issues (81%), global uncertainty (81%), Russia’s invasion of Ukraine (80%) and potential retaliation from Russia (e.g., in the form of cyberattacks or nuclear threats) (80%).

Adults also reported separation and conflict as causes for straining and/or ending of relationships. Half of adults (51%, particularly essential workers at 61%) said they have loved ones they have not been able to see in person in the past two years as a result of the COVID-19 pandemic. Strikingly, more than half of all U.S. adults (58%) reported experiencing a relationship strain or end as a result of conflicts related to the COVID-19 pandemic, including canceling events or gatherings due to COVID-19 concerns (29%); difference of opinion over some aspect of vaccines (25%); different views of the pandemic overall (25%); and difference of opinion over mask-wearing (24%).

Key Stress Statistics

Americans are one of the most stressed out in the world. The current stress level experienced by Americans is 20 percentage points higher than the global average. The country’s rate is similar to Louisiana’s, the most stressed state. Globally, Greece has the highest reported stress level at 59%.

• 55% of Americans are stressed during the day.
• The global average of the number of stressed people out of 143 countries is 35%.
• Paraguay is the country with the highest positive experience index.
• Afghanistan is the least positive country in the world with a positive experience index of 43% lower than its score in the previous year.
• Stress causes 57% of US respondents to feel paralyzed.
• 63% of US workers are ready to quit their job to avoid work-related stress.
• Chronic stress is commonplace at work with 94% of workers reporting feeling stress at work.
• 59% of Greeks have reported experiencing stress in the previous day.
• Montana is the least stressed US state with a total stress score of 26.81 while Louisiana the most stressed with 59.94.

Causes and Sources of Stress

Living conditions, the political climate, financial insecurity, and work issues are some stressors US adults cite as the cause of their stress. Ineffective communications increase work stress to the point of frustration that workers want to quit.  These stressors, unfortunately, are not something people can just ignore. Quitting a job would result in debt and financial instability which, in turn, would be added stressors.

• 35% of workers say their boss is a cause of their workplace stress.
• 80% of US workers experience work stress because of ineffective company communications.
• 39% of North American employees report their workload the main source of the work stress.
• 49% of 18 – 24 year olds who report high levels of stress felt comparing themselves to others is a stressor.
• 71% of US adults with private health insurance say the cost of healthcare causes them stress while 53% with public insurance say the same.
• 54% of Americans want to stay informed about the news but following the news causes them stress.
• 42% of US adults cite personal debt as a source of significant stress.
• 1 in 4 American adults say discrimination is a significant source of stress.
• Mass shootings are a significant source of stress across all races; 84% of Hispanic report this, the highest among the races.

Stress and Relationships

People under stress admit to taking out their frustration on other people. Targets for venting out include strangers and those they have personal relationships with. Men and women report different levels of how work stress affects their relationships with their spouses.

• 76% of US workers say their workplace stress has had a negative impact on their personal relationships.
• Seven in 10 adults report work stress affects their personal relationships.
• 79% of men report work stress affects their personal relationship with their spouse compared to 61% for women.
• 36% of adults reported experiencing stress caused by a friend or loved one’s long-term health condition.

Stress Management Statistics

A look at the stress management techniques employed by US adults to deal with their stress, an overwhelming majority are self-care practices. Though very helpful, it does not address the stressor at the root of the problem. Stress management programs would be beneficial not only for employees but for the company in the long run.

• 30% of Us adults eat comfort food “more than the usual” when faced with a challenging or stressful event.
• 51% of US adults engage in prayer—a routine activity—when faced with a challenge or stressful situation.
• Coping mechanisms of Gen Z and Millenials experiencing stress in the US 44% of Gen Z and 40% of Millenials sleep in while exercising counts for 14% and 20% respectively.
• 49% of US adults report enduring stressful situations as a coping behavior to handle stress.
• Less than 25% of those with depression worldwide have access to mental health treatments.

CompareCamp

American Psychological Association

Cardiac Coherence and Post-traumatic Stress Disorder in Combat Veterans

Jay P. Ginsberg, Ph.D.; Melanie E. Berry, M.S.; Donald A Powell, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010;16 (4):52-60. PDF version of the complete paper: Cardiac Coherence and PTSD in Combat Veterans

Abstract-PTSD

Background: The need for treatment of posttraumatic stress disorder (PTSD) among combat veterans returning from Afghanistan and Iraq is a growing concern. PTSD has been associated with reduced cardiac coherence (an indicator of heart rate variability [HRV]) and deficits in early-stage information processing (attention and immediate memory) in different studies. However, the co-occurrence of reduced coherence and cognition in combat veterans with PTSD has not been studied before.

Primary Study Objective: A pilot study was undertaken to assess the covariance of coherence and information processing in combat veterans. An additional study goal was an assessment of the effects of HRV biofeedback (HRVB) on coherence and information processing in these veterans.

Methods/Design: A two-group (combat veterans with and without PTSD), a pre-post study of coherence and information processing was employed with baseline psychometric covariates.

Setting: The study was conducted at a VA Medical Center outpatient mental health clinic.

Participants: Five combat veterans from Iraq or Afghanistan with PTSD and five active-duty soldiers with comparable combat exposure who were without PTSD.

Intervention: Participants met with an HRVB professional once weekly for 4 weeks and received visual feedback in HRV patterns while receiving training in resonance frequency breathing and positive emotion induction.

Primary Outcome Measures: Cardiac coherence, word list learning, commissions (false alarms) in go—no go reaction time, digits backward.

Results: Cardiac coherence was achieved in all participants, and the increase in coherence ratio was significant post-HRVB training. Significant improvements in the information processing indicators were achieved. Degree of increase in coherence was the likely mediator of cognitive improvement.

Conclusion: Cardiac coherence is an index of the strength of control of parasympathetic cardiac deceleration in an individual that has cardinal importance for the individual’s attention and affect regulation.

The Effect of a Biofeedback-based Stress Management Tool on Physician Stress: A Randomized Controlled Clinical Trial

Jane B. Lemaire, Jean E. Wallace, Adriane M. Lewin, Jill de Grood, Jeffrey P. Schaefer

Open Medicine 2011; 5(4)E154. PDF version of the complete paper: physician-stress-randomized-controlled-clinical-trial

Abstract- Biofeedback-based Stress Management

Background: Physicians often experience work-related stress that may lead to personal harm and impaired professional performance. Biofeedback has been used to manage stress in various populations.

Objective: To determine whether a biofeedback-based stress management tool, consisting of rhythmic breathing, actively self-generated positive emotions and a portable biofeedback device, reduces physician stress.

Design: Randomized controlled trial measuring the efficacy of a stress-reduction intervention over 28 days, with a 28-day open-label trial extension to assess effectiveness.

Setting: Urban tertiary care hospital.

Participants: Forty staff physicians (23 men and 17 women) from various medical practices (1 from primary care, 30 from a medical specialty and 9 from a surgical specialty) were recruited by means of electronic mail, regular mail and posters placed in the physicians’ lounge and throughout the hospital.

Intervention: Physicians in the intervention group were instructed to use a biofeedback-based stress management tool three times daily. Participants in both the control and intervention groups received twice-weekly support visits from the research team over 28 days, with the intervention group also receiving re-inforcement in the use of the stress management tool during these support visits. During the 28-day extension period, both the control and the intervention groups received the intervention, but without intensive support from the research team.

Main outcome measure: Stress was measured with a scale developed to capture short-term changes in global perceptions of stress for physicians (maximum score 200).

Results: During the randomized controlled trial (days 0 to 28), the mean stress score declined significantly for the intervention group (change -14.7, standard deviation [SD] 23.8; p = 0.013) but not for the control group (change -2.2, SD 8.4; p = 0.30). The difference in mean score change between the groups was 12.5 (p = 0.048). The lower mean stress scores in the intervention group were maintained during the trial extension to day 56. The mean stress score for the control group changed significantly during the 28-day extension period (change -8.5, SD 7.6; p < 0.001).

Conclusion: A biofeedback-based stress management tool may be a simple and effective stress-reduction strategy for physicians.

Coherence Training In Children With Attention-Deficit Hyperactivity Disorder: Cognitive Functions and Behavioral Changes

Anthony Lloyd, Ph.D.; Davide Brett, B.Sc.; Ketith Wesnes, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010; 16 (4):34-42

PDF version of the complete paper: coherence-training-in-children-with-adhd

Abstract-ADHD

Attention-deficit hyperactivity disorder (ADHD) is the most prevalent behavioral diagnosis in children, with an estimated 500 000 children affected in the United Kingdom alone. The need for an appropriate and effective intervention for children with ADHD is a growing concern for educators and childcare agencies. This randomized controlled clinical trial evaluated the impact of the HeartMath self-regulation skills and coherence training program (Institute of HeartMath, Boulder Creek, California) on a population of 38 children with ADHD in academic year groups 6, 7, and 8. Learning of the skills was supported with heart rhythm coherence monitoring and feedback technology designed to facilitate self-induced shifts in cardiac coherence. The cognitive drug research system was used to assess cognitive functioning as the primary outcome measure. Secondary outcome measures assessed teacher and student reposted changes in behavior. Participants demonstrated significant improvements in various aspects of cognitive functioning such as delayed word recall, immediate word recall, word recognition, and episodic secondary memory. Significant improvements in behavior were also found. The results suggest that the intervention offers a physiologically based program to improve cognitive functioning in children with ADHD and improve behaviors that is appropriate to implement in a school environment.

Coherence and Health Care Cost – RCA Actuarial Study: A Cost-Effectiveness Cohort Study

Woody Bedell; Mariette Kaszkin-Bettag, Ph.D.

Alternative Therapies in Health and Medicine, A Peer-Reviewed Journal, 2010;16 (4):26-31. PDF version of the complete paper: rca-actuarial-study-coherence-and-health-care

Abstract-Health and Medicine

Chronic stress is among the most costly health problems in terms of direct health costs, absenteeism, disability, and performance standards. The Reformed Church in America (RCA) identified stress among its clergy as a major cause of higher-than-average health claims and implemented HeartMath (HM) to help its participants manage stress and increase physiological resilience. The 6-week HM program Revitalize You! was selected for the intervention including the emWave Personal Stress Reliever technology.

From 2006 to 2007, completion of a health risk assessment (HRA) provided eligible clergy with the opportunity to participate in the HM program or a lifestyle management program (LSM). Outcomes for that year were assessed with the Stress and Well-being Survey. Of 313 participants who completed the survey, 149 completed the Revitalize You! The program and 164 completed the LSM. Well-being, stress management, resilience, and emotional vitality were significantly improved in the HM group as compared to the LSM group.

In an analysis of the claims costs data for 2007 and 2008, 144 pastors who had participated in the HM program were compared to 343 non-participants (control group). Adjusted medical costs were reduced by 3.8% for HM participants in comparison with an increase of 9.0% for the control group. For the adjusted pharmacy costs, an increase of 7.9% was found compared with an increase of 13.3% for the control group. Total 2008 savings as a result of the HM program are estimated at $585 per participant, yielding a return on investment of 1.95:1. These findings show that HM stress-reduction and coherence-building techniques can reduce health care costs.

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261 Stress Topics & Research Questions

Need a well-formulated topic for an essay or research paper about stress and anxiety? We want to share creative titles and research questions about stress with you. Discover the intricacies of psychological, physiological, and societal factors and shed light on the causes of stress. Assess the significance of mental well-being with these stress-related topics!

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• Stress Tolerance: New Challenges for Millennial College Students College with its numerous assignments, hectic schedule, and exams requiring total commitment and concentration is more or less stressful for everyone who enters tertiary education.
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• Psychology. Stress Management Approaches There are some unhealthy ways of coping with stress such as excessive smoking, overeating, using sleeping pills or marijuana, or any tranquilizers to relax.
• Stress After Leaving Home in Students Most people perceive stress as a negative emotional state, whereas some consider it to be something that happens to us when we are anxious.
• Stress on Law Enforcement Officers and Available Programs Police officers are subject to significant amounts of tension and stress, regardless of the nature and size of the agency for which they work.
• Stress and Coping: Social Support and Social Ties In this paper, the notions of social ties and social support will be defined, and how social support might depend on the cultural background a person has will be discussed.
• Stress and Cognitive Appraisal Cognitive appraisal means the internal interpretation that a person gives to external changes. The role of cognitive appraisal in stress can be significant.
• Stress Management Memo: Creative Arts Interventions Research and analysis of current scientific research and previous practice experience show several strategies for stress control.
• Post-Traumatic Stress Disorder: A Critical Perspective Post-traumatic stress disorder (PTSD) is a relatively common condition affecting individuals who have experienced severe trauma.
• Bullying and Work-Related Stress in the Irish Workplace One of the best analyses of relationships between workplace stress and bullying has been done in the research study called “Bullying and Work-Related Stress in the Irish Workplace.”
• Stress at the Workplace and Strategies of Its Reduction Job stress has become a growing concern among managers and supervisors in organizations. This is because of the adverse effects on both employees and the company.
• Midlife Crisis and Its Effect on Women’s Stress This paper aims to focus on the psychological problem of stress among this section of the population, its effects on women, and how it can be solved.
• Stress in Nursing Practice Stress can be attributed to many factors in the nursing profession, the principal one being extended work schedules. In the medical field, such errors could be fatal.
• Corrections Officers Stress: Causes and Outcomes This paper analyses the effective ways that can be implemented by the administrators for the prevention and treatment of the stress affecting correction officers.
• Coping Strategies in Job Related Stress in Nurses Job-related stress among nurses is an issue that has raised massive concern among contemporary scholars. Nurses are forced to undergo very traumatizing environmental factors.
• “Work Stress Among Newly Graduated Nurses” by Blomberg The article by Blomberg et al. is an experimental cross-sectional comparative study aimed to investigate occupational stress among newly graduated nurses.
• Organizational Problems: Stress and Burnout of Employees Stress and burnout are the major causes of employee-related problems in organizations. Both stress and burnout have serious effects on the productivity of an organization.
• Stress and Wellness – Psychology Stress affects the emotional wellness of an individual. People who are under stress find it difficult to relate with other individuals in a normal manner.
• Psychology Issues: Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder is one of the main challenges that people deal with after a traumatizing event. PTSD should be treated as soon as any of the symptoms start to be recognized.
• Post-Traumatic Stress Disorder Diagnosis People who work in risky environments have a high propensity of developing PTSD than their counterparts in safer working environments.
• The Role of Stress Hormones: Physiology The correct care for youngsters from conception onwards guarantees that the child’s brain develops healthily and to its maximum potential.
• Anxiety, Depression, and Post-Traumatic Stress Disorder Currently, many people experience anxiety, depression, and post-traumatic stress disorder that affect their general health.
• Causes and Management of Stress at Work Stress is a condition that arises when an individual’s resources are inadequate to deal with the responsibilities and pressures of the situation.
• Stress Response Plan for Massachusetts Respondent’s stress is one of the unpleasant consequences of emergency events. People who are the first to experience such crises, feel psychological and physical pressure.
• Parents With Pediatric Terminal Patients: Stress Management Certain family-centered care principles should be used by healthcare providers in order to mitigate parental stress in the situations where their child battles terminal illness.
• Treatment Options for Post-Traumatic Stress Disorder Using psychological interventions as treatment is a productive tool that is used everywhere. Trauma-focused therapy has reduced PTSD symptoms.
• Why Women Experience Stress Throughout Life Females may experience more significant difficulties and anxiety as they age than individuals previously believed.
• Hypnotherapy in the Treatment of Post-Traumatic Stress Disorder Post-traumatic stress disorder refers to a behavioral disorder that occurs as a result of being subject to a shocking event or situation.
• Videogames & Stress Level Reduction Among Students To deal with stress, students do activities that include video games. Video games became available due to technological advances in recent decades.
• Racism, Ethnoviolence, and Post-Traumatic Stress Disorder The paper states that experiencing racism can induce post-traumatic stress disorder. Most people do not draw a link between racism and PTSD.
• Stress Reduction Education Targeting the Mental Health Patients with mental health illnesses such as stress and related disorders need to be taught approaches to reduce the latter.
• Epidemiology of Stress in the United Kingdom This report explores the context and current situation related to the prevalence, morbidity, and epidemiology of stress in the UK.
• Stress in Pregnant Women Due to COVID-19 Pandemic Pregnancy is a particularly crucial time for the mental health of a woman. The high levels of stress have been linked to exposure to the pandemic.
• Stress and Stress Management Discussion It is crucial to distinguish acute and chronic stress and the risk factors associated with them to ensure timely intervention to manage stress and prevent long-term damage.
• Impacts of Stress of Low Income on the Risk of Depression in Children Socioeconomic hardships lead to a decline in the quality of parenting and the development of psychological and behavioral problems in children.
• Physiology of Stress and Its Effects on Aging Process Assessment of the biological factors that influence anxiety and resilience might assist in identifying possible neurobiological systems as targets.
• Post-Traumatic Stress Disorder During and After World War I The paper examines the causes and manifestations of PTSD during and after World War I, despite the absence of this term at that time, and how diagnosis and treatment are made.
• Post-Traumatic Stress Disorder’s Treatment The paper present bibliography which review different psychotherapy interventions that can be applied in treating Post Traumatic Stress Disorder among adults.
• Stress and Anxiety and How to Cope With Them The research utilizes a reverse Stroop experiment to evaluate the mental performance of individuals when subjected to either up-regulation or down-regulation.
• Migration Crisis & Post-Traumatic Stress Disorder Trump’s anti-migration actions have significantly affected the psychological state of the people striving to get protection from the US.
• Post-Traumatic Stress Disorder and Substance Addiction Treatment The paper presents the case study of a client struggling with PTSD and substance addiction, including disposition, suggested treatment protocol, and resources for treatment.
• Psychological Post-Traumatic Stress Disorder Traumatized people are more likely to acquire PTSD, a condition in which the victim’s consciousness is dominated by the recollection of the traumatic incident.
• Ways To Cope Emotions and Stress There are several theories on how people experience emotions that have been put forward throughout the years, all attributing emotions to separate causes.
• Oncology: Caregiving Burden, Stress, and Health Effects The illness selected for this paper is cancer, which is a serious disease that sometimes can also be chronic. Caring for cancer patients is difficult.
• Stress: Causes and Consequences from a Sociological Perspective The sociological analysis of stress and the underlying causes of it, as well as its devastating effects, is required as a tool for vulnerable groups.
• Assessing and Treating Post-Traumatic Stress Disorders The paper discusses the treatment of PTSD and the pharmacokinetics of various antidepressants such as fluoxetine, citalopram, paroxetine, and sertraline.
• Benefits of Stress Management and Obstacles of Implementation Stress management strategies are a focal point for people working in the health industry. They are among the most exposed to high levels of stress.
• Discussion of Stress Response in Human The article examines the topic of stress response in humans, and attempt to find an answer to people having to endure traumatic events.
• Stress and Its Negative Influence on Health Current research explores the negative influences of stress on health, accenting neurological, cardiovascular, and immune systems dangers.
• Stress Management on the Job The paper discusses principles in the corporate culture, which help combat stress among employees to bring more value to the company.
• Stress Management Program for Health Workers The paper proposed to use the stress management program for the health workers based on the Mindfulness-Based Stress Reduction (MBSR) technique.
• Stress at the Workplace: Controlling and Preventing Stress at the workplace is inevitable because of workers’ dynamism. Distress in an employment environment can be related or not linked to the job.
• Preventing Workplace Stress: Effective Methods Effective methods of preventing stress in the workplace will help to avoid unpleasant consequences. This paper aims to discuss such methods.
• Posttraumatic Stress Disorder. Diagnostics Posttraumatic stress disorder (PTSD) is a serious mental health condition that needs treatment due to its potential negative implications.
• Combating Stress: Methods for Combating Stress General stress in student life can be caused by anxiety about the future, heavy learning burden, exams, and other factors. This paper discusses methods for combating stress.
• Personal Management Plans: Managing Stress, Nutrition This paper discusses personal management plans: Managing stress, fitness, nutrition, plans for disease prevention, and getting life in order in preparation for dying.
• Prevalence of Combat Post-traumatic Stress Disorder Among Veterans The paper argues combative nature of military personnel contributes to the Post-traumatic Stress disorder experienced by officers.
• Psychophysiological Aspects of Stress Stress has become a serious issue, especially considering the way of life of an average person in the contemporary world, which elevates different disorders.
• Theories in Epidemiology. Stress and Heart Disease The impact of stress on heart diseases is highly controversial among scientists. Various studies support the hypothesis that stress is highly associated with heart disease.
• Post-traumatic Stress and Growth Post-traumatic growth (PTG) refers to positive changes that a person makes after experiencing an extremely disturbing event.
• Maternal Stress in Pregnancy: Effects on Fetal Development The study seeks to find out if the development of the nervous system of the fetus is closely influenced by the psychological wellbeing of the mother.
• Stress and Somatic Symptoms: Healing Environment In summary, a healing environment is vital for modern people since they live in conditions that subject that to stress daily.
• Post-Traumatic Stress Disorder in Military Militants experience a significant number of traumatic events that subject them to PTSD. The culture of the military plays a significant role in promoting veteran mental wellness.
• Post-Traumatic Stress Disorder in Various Populations In this paper, the authors explore the prevalence of post-traumatic stress disorder among different populations. They compare this prevalence between genders and veterans.
• Anxiety and Stress Affect Pain Relief The study aims to reduce pain and monitor patient response in related areas such as relaxation, anxiety. The role of massage in the treatment of pain has been noted successfully.
• Post-Traumatic Stress Disorder: Pharmacological Treatment Approved medications can help treat PTSD symptoms and improve patient outcomes. SSRIs, such as sertraline, have been shown to reduce anxiety and increase concentration.
• Post Traumatic Stress Disorder: Characteristics Central Nervous System associated disorders represent one of the health issues globally. The description is aimed at highlighting research related to Posttraumatic stress disorder
• A Collaborative Stress Management Initiative for Mothers of Cancer Children The article explored the psychological stress experienced by mothers who have cancerous children. The research is current and relevant to contemporary health issues.
• Stress in Law: Reasons and Solutions The paper identifies the factors that result in stress by law enforcers and proposes ways in which the stress and by extension the negative effects it brings, can be mitigated.
• Post-Traumatic Stress Disorder The purpose of this paper is to discuss PTSD. Also, this paper introduces the assessment and factors associated with PTSD.
• Posttraumatic Stress Disorder: Triggers, Clinical Manifestations, and Therapy Posttraumatic stress disorder (PTSD) is a mental condition that originates from experiencing terrifying events and getting haunted by them long after they happened.
• Stress in Women Before and After Myocardial Infarction The study uses two interviews with women suffering an MI; interviews were taken in two different hospitals with a sample size of twenty and 14 respondents, before and after the MI.
• Mindful Meditation as Reducing College Students Stress The study answers the question of what is the reported effect of mindfulness meditation on reducing stress in teenage college students and its overall effectiveness.
• Investigating Post-Traumatic Stress Disorder Most people experience traumatic events during their lifetime. For the first time, the phenomenon of post-traumatic stress disorder was examined among the participants of the wars
• The Post-Traumatic Stress Disorder Many people suffer from post-traumatic stress disorder, and it is very important to know more about its symptoms and treatment.
• Utilization and Effectiveness of Coping Strategies in Job-Related Stress among Nurses Nursing is a discipline that is constantly evolving and requires professionals to use their skills and evidence-based practices to achieve good outcomes in their responsibilities.
• Incidence of Posttraumatic Stress Disorder After Motor Vehicle Accidents In recent years, a global surge in the number of posttraumatic stress disorder (PTSD) occasioned by motor vehicle accidents has been witnessed in the United States of America.
• “Sources of Stress in Nursing Students” by Pulido This is a critique of the paper titled “Sources of stress in nursing students: a systematic review of quantitative studies” by three University of Jaen scholars.
• Strain-Stress Shielding in the Proximal Tibia of a Stemmed Knee Prosthesis In this paper, we review work that has been done about stress shielding and knee prosthesis, compare them and outline the recommendations given in these papers.
• Trends and Issues in Nursing: Workload Stress Stress at the employment place reduces the competence of the employee. In nursing workplace, stress results in deprived service delivery and might affect the fitness of the patient.
• Reducing Stress in Student Nurses: Article Critique In Galbraith and Brown’s quantitative systematic review, “Assessing the intervention effectiveness for reducing stress in student nurses,” the aim is clearly articulated.
• Issue of Stress in Nursing Practice The issues of stress caused by workplace violence in nursing practice require special consideration because of their direct relation to the quality of health care services.
• My Experiences Handling Stress at High School The most challenging part of implementing my program was self-control. It can be very tempting to “cheat” and reward yourself without making an actual effort.
• Posttraumatic Stress Disorder: Approaches and Symptoms The report presents that several investigations indicate a negative relationship between mindfulness-based approaches and PTSD symptoms acuteness.
• Therapeutic Massage and the Reduction of Overall Stress and Anxiety This paper describes possible biases in conducting a qualitative study of the issue of therapeutic massage and its effect on the human condition.
• Article Summary “Maternal Stress and Sensitivity: Moderating Effect of Positive Affect” The article “Maternal stress and sensitivity: Moderating effect of positive affect” provides insights into the relationship between stress and maternal positive emotions.
• Airport Security Environment and Passenger Stress Most of the measures taken by airport operators to maintain transport security are appropriate and reasonable. Visible signs of safety concerns can cause anxiety to the passenger.
• Research on Stress Levels During Scheduled Sleep Behavior Different studies have revealed that there are several strategies used to reduce stress. Most scholars agree that there is a relationship between sleep and stress.
• The Influence of the Stress on Our Health: How To Cope With Stress To reduce stress and eliminate potential hazards for health, several coping mechanisms have been created—problem-focused coping aims to solve the problem first-hand.
• Janet Tomiyama’s “Stress and Obesity” Summary “Stress and Obesity,” an article by A. Janet Tomiyama, covers the interrelation between the two issues listed in the title and their mutual influence in psychological terms.
• Stress Management: The Holmes and Rahe Stress Scale To stay healthy, stress must be avoided at different levels, and only an integrated approach will allow people to become genuinely confident and calm.
• Posttraumatic Stress Disorder Risk Factors Crisis workers need to understand risk factors associated with PTSD. The disorder may cause serious diseases that are expensive and complex to cure, such as heart diseases.
• Dealing With Procrastination: Stress-Related Techniques Stress is a person’s response to a restructuring. This paper looks at stress from the angle of procrastination and analyze the techniques one can use to deal with this stressor.
• Stress and Its Influence Employees’ Well-Being The essay seeks to discuss the empirical evidence as for correlation between job stress and employees’ well-being. Questions of importance of such experiments are highlighted.
• How Depression and Stress in College Have Helped Me Be a Better and Stronger Person?
• How Are Effective Non-monetary Incentives in Relieving Stress?
• How Does Stress Affect Our Health?
• What Are the Causes of Stress at Work?
• How Differently Men and Women Cope With Stress at Work?
• How Does Stress Affect the Immune System?
• What is Post-traumatic Stress Disorder?
• What Triggers Stress and the Importance of Reducing It?
• What Works Stress Management?
• What Are the Health and Emotional Implications of Stress?
• How Different Approaches and Power of Leadership Manage Organizational Stress?
• What Are the Best Treatments for the Posttraumatic Stress Disorders in Veterans?
• How Does Stress Affect Child Development?
• How Ethnic Identity Mediates Acculturation Stress Depending?
• What Are the Causes of School-Related Stress in Student-Athletes?
• How Exercise Helps Reduce Stress?
• How Does Stress Affect the Human Body?
• How Does Burn Out Differ From Stress?
• What Are the Causes and Effects of Students’ Stress?
• What Are the Negative Effects of Stress?
• How Does Blood Pressure Relate to the Level of Stress?
• How Does Stress Affect One‘s Health?
• How Does Stress Make Students Struggle?
• What Are the Causes of Stress for Teenagers?
• How Does Stress Affect Appetite?
• How Does Chronic Stress Affect the Body?
• How Does Stress Affect College Students?
• How Does Stress Help Facilitate Potential Positive?
• How Does the Stress Affect Our Lives?
• How Does Stress Affect a Student’s Life?
• Posttraumatic Stress Disorder Diagnostic Categorization
• Stress Management: Personal Stress Techniques
• Analysis of Pre-Conditions and Ways for Reducing the Stress
• Stress Effects and Management Report
• Stress Has Become One of the Most Serious Health Issues
• Stress Consequences, Causes, and Further Actions
• Stress and Its Effects at the Workplace and Home
• Combat Fatigue or Post-Traumatic Stress Disorder in Soldiers
• Post Traumatic Stress Disorder Symptoms and Causes
• Posttraumatic Stress Disorder in Combat Veterans
• Implications of Educational Attainment on Stress Level in Job
• Combat Stress and Operational Stress Management
• Impact of Stress on Performance
• Post-Traumatic Stress Disorder in Children
• Strategies of Preventing Stress
• Post-Traumatic Stress Disorder in Children After Tsunami
• Psychological Stress and Nicotine Intake
• Relationship Between Critical Thinking, Problem-Solving, Decision-Making, and Stress Management in Nursing
• “Depression and Ways of Coping With Stress” by Orzechowska et al.
• Relationship Between Stress and Nicotine Intake in Middle Age Adults
• Stress Reduction Programs for Pregnant Women
• Breathe: Stress Management for Nurses Program
• Nursing Stress Solutions: Benefits and Support
• Motivation, Job Satisfaction, Involvement, Stress
• Posttraumatic Stress Disorder in Military Veterans
• Post-Traumatic Stress Disorder and Life Quality
• Posttraumatic Stress Disorder: Diagnosis and Tratment
• Individuals With Post-Traumatic Stress Disorder
• Training, Stress and Performance: Study Findings
• Holmes & Rahe Stress Inventory and Management
• Strategies in Stress Management
• Stress-Reducing Measures and Activities
• New Life and Stress Factors at High School
• Work Stress and Burnout Among Nurses
• Breast Cancer and Stress Heightening
• The Stress-Buffering Hypothesis Test in a Mexican Sample
• Stress Control Measures to Prevent Nursing Burnout
• The Problem of Nursing Stress
• Shortage-Related Stress in Nursing Workforce
• Posttraumatic Stress Disorder: Definition and Diagnosis
• Humour and Stress in Male and Female Students
• Stress Migraine in Women After Menopause
• Stress Reduction in Healthcare Students
• Work-Related Stress Management in Professional Nurses
• “Job Stress and Burnout in Hospital Employees” by Chou et al.
• Posttraumatic Stress Disorder and Substance Use
• Ontario Post Traumatic Stress Legislation for Employees
• Emotion Perception and Gender Factor in Stress
• Stress as a Fundamental Concept for Nursing
• Stress Control Strategies for Nurses
• Post Traumatic Stress Disorder: Systemic Psychotherapy
• Post Traumatic Stress Disorder Diagnostics
• Combat-Related Posttraumatic Stress Disorder
• The Treatment of Posttraumatic Stress Disorder
• Anti-Stress Workplace Interventions for Nurses
• Post-Traumatic Stress Disorder: Group Therapy
• Stress-Coping Strategies in Nurses
• Posttraumatic Stress Disorder and Treatment Centers
• Post Traumatic Stress Disorder: Case Analysis
• Stress Influence in Emergency Nursing
• Stress Level and Work in Team
• Workplace Stress Control Among Nurses
• “Post-Traumatic Stress Disorder” by Bisson et al.
• Women’s Stress Caused by Social Networks
• Veterans’ Post Traumatic Stress Disorder: How a Game Can Help?
• Mitigate Stress Exercise Program at the Work
• Handling Cultural Stress in the United Arab Emirates
• The Tibetan Culture Views on Stress Management
• Stress Impacts on Psychological and Physiological Health
• Social Workers’ Benefits from Stress Management
• Psychological Therapy of Post-Traumatic Stress Disorder
• Posttraumatic Stress Disorder Concept
• Psychological Treatment: Posttraumatic Stress Disorder
• What Is Post-Traumatic Stress Disorder?
• Post-Traumatic Stress Disorder: Cognitive Therapy

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Coping with Stress

Many of us are facing challenges that can be stressful and overwhelming. Learning to cope with stress in a healthy way will help you, the people you care about, and those around you become more resilient.

Stress can cause the following:

• Feelings of fear, anger, sadness, worry, numbness, or frustration.
• Changes in appetite, energy, desires, and interests.
• Trouble concentrating and making decisions.
• Nightmares or problems sleeping.
• Physical reactions, such as headaches, body pains, stomach problems, or skin rashes.
• Worsening of chronic health problems and mental health conditions.
• Increased use of  alcohol , illegal drugs (like heroin , cocaine , or methamphetamine ), and misuse of prescription drugs (like opioids).
• Healthy Ways to Cope with Stress
• If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org
• Disaster Distress Helpline : CALL or TEXT 1-800-985-5990 (press 2 for Spanish)

Here are some ways you can manage stress, anxiety, grief, or worry:

• Take breaks from news stories, including those on social media. It’s good to be informed, but constant information about negative events can be upsetting. Consider limiting news to just a couple times a day and disconnecting from phone, TV, and computer screens for a while.
• Eat healthy. Have fruits and vegetables, lean protein, whole grains, and low-fat or no-fat dairy. Limit foods with unhealthy fats, salt, and added sugars. See Healthy Eating Tips .
• Get enough sleep.  Go to bed and wake up at the same time each day to help you sleep better . Adults need 7 or more hours per night.
• Move more and sit less. Every little bit of physical activity helps. Start small and build up to 2 ½ hours a week. You can break it into smaller amounts such as 20 to 30 minutes a day.
• Limit alcohol  intake. Choose not to drink, or drink in moderation on days you drink alcohol. Moderation means having 2 drinks or less a day for men or 1 drink or less for women. Find out more at Drink Less, Be Your Best .
• Avoid using illegal drugs or prescription drugs in ways other than prescribed. Don’t take someone else’s prescription. Substance use treatment is available, and recovery starts with asking for help.
• Avoid smoking , vaping, and the use of other tobacco products. People can and do quit smoking for good.
• Continue with regular health appointments, tests, screenings, and vaccinations.
• Take deep breaths, stretch, or meditate .
• Try to do some other activities you enjoy.
• Talk with people you trust about your concerns and how you are feeling.
• Connect with your community-based or faith-based organizations.

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• How stress affects your health. American Psychological Association. https://www.apa.org/topics/stress/health. Accessed Dec. 8, 2021.
• Manage stress. MyHealthfinder. https://health.gov/myhealthfinder/topics/health-conditions/heart-health/manage-stress. Accessed Dec. 6, 2021.
• What is stress management? American Heart Association. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/what-is-stress-management. Accessed Dec. 7, 2021.
• Managing stress. National Alliance on Mental Illness. https://www.nami.org/Your-Journey/Individuals-with-Mental-Illness/Taking-Care-of-Your-Body/Managing-Stress. Accessed Dec. 8, 2021.
• Stress. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/stress. Accessed Dec. 6, 2021.
• AskMayoExpert. Stress management and resiliency (adult). Mayo Clinic; 2021.
• Stress and your health. U.S. Department of Health & Human Services. https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health. Accessed Dec. 9, 2021.
• Seaward BL. Essentials of Managing Stress. 5th ed. Jones & Bartlett Learning; 2021.

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• v.8(Spec Iss 4); 2015

A review of the effectiveness of stress management skills training on academic vitality and psychological well-being of college students

P alborzkouh.

* Exceptional Children Psychology, Islamic Azad University, Central Tehran Branch, Iran

** General Psychology, Islamic Azad University, South Tehran Branch, Iran

*** General Psychology, Humanities and Social Sciences Faculty, Paradise University, Gillan Branch, Iran

**** General Psychology, Islamic Azad University, Science and Research Branch, Tehran, Iran

F Shahgholy Ghahfarokhi

***** Clinical Psychology, Islamic Azad University, Science and Research Branch Branch, Isfahan, Iran

Objective: Carrying out the appropriate psychological interventions to improve vitality and mental well-being is critical. The study was carried out to review the effectiveness of stress management training on the academic life and mental well-being of the students of Shahed University.

Methodology: The method used was quasi-experimental with a pretest-posttest plan and control group. Therefore, a total of 40 students of Shahed University of Tehran were selected by a convenience sampling method and were organized into two groups: experimental and control group. Both groups were pretested by using an academic vitality inventory and an 84-question psychological well-being inventory. Then, the experimental group received stress management skills training for ten sessions, and the control group did not receive any intervention. Next, both groups were post-tested, and the data were analyzed with SPSS-21 software by using descriptive and inferential statistical methods.

Findings: The findings showed that the stress management skills training significantly contributed to promoting the academic vitality and psychological well-being of students (p < 0.001).

Conclusions: It was concluded from this research that teaching the methods for dealing with stress was an effective strategy to help students exposed to high stress and pressure, and this was due to its high efficiency, especially when it was held in groups, had a small cost, and it was accepted by the individuals.

Introduction

Challenges during education create sources of stress for students, and put their health at risk, in a way that affects their learning abilities [ 1 ]. Therefore, paying attention to the factors that could have a positive impact on the agreeableness and could increase the positive psychological states, and as a result, the physical and psychological health of the students was of great importance.

Among the important factors that affect people’s ability to adapt to the stresses of studying era is academic vitality [ 2 ]. Academic vitality means an adaptive response to various challenges and barriers experienced during education [ 3 ]. When a person does things spontaneously, does not feel not only frustrated and tired, but also constantly feels the strength and increased energy, and overall has a sense of inner vitality [ 2 ]. Therefore, the academic life has a relationship with the individual’s adaptation to the various situations of the academic period, feelings of self-efficacy and empowerment in the face of challenges, experiencing less anxiety and depression, a sense of responsibility in dealing with the academic tasks and better academic success [ 3 ]. Despite the high importance of academic vitality in the successful confrontation with the challenging academic period, the literature review of the studies managed in Iran showed that few studies were performed on the factors promoting this important variable. Therefore, an attempt to address this research gap increased the need for the current study.

Another important positive psychological state in students is the psychological well-being. The psychological well-being factor is defined as a person’s real talents growth and has six components that are the purpose in life, positive relations with others, personal growth, self-acceptance, autonomy, and environmental mastery [ 4 ]. The purpose in life means having a purpose and direction in life and pursuing them [ 5 ]. Positive relations with the others mean having warm, satisfactory relations along with confidence and empathy [ 6 ]. Personal growth means having a sense of continuous growth and the capacity for it and having an increased sense of efficacy and wisdom [ 4 ]. Self-acceptance means having a positive attitude towards oneself and accepting the various aspects of oneself [ 6 ]. Autonomy means the feeling of self-determination, independence, and self-assessment against personal criteria [ 4 ]. Moreover, environmental mastery means a sense of competence and the ability to manage the complex environment around [ 5 ].

However, one of the most significant parts affecting the psychological health and well-being of individuals is life skills training [ 7 ]. Life skills’ training is critical for students, in a way that on this basis, many universities have started to teach life skills and stress management skills to improve the physical and psychological health of their students in the recent years [ 8 ]. The main objective of the World Health Organization regarding the creation of a life skills plan is in the field of psychological health. Therefore, different societies throughout the world try to promote the implementation and evaluation of the programs training in life skills. It focuses on the growth of mental abilities such as problem-solving, coping with emotions, self-awareness, social harmony, and stress management among children, teenagers, and even adults [ 9 ]. From the life skills, training in stress management skills is critical, because students need to deal effectively with stressful issues and factors. Accordingly, it was thought that teaching stress management skills is very efficient in improving the students’ positive psychological states, in particular, their vitality and mental well-being. Therefore, this study examined the effectiveness of the stress management skills training on the academic life and psychological well-being among Shahed University students.

Methodology

The study was quasi-experimental with a pretest-posttest. The analytical community of the study included all the students of Shahed University of Tehran in the fall of 2015, who were selected with a convenience method. For the calculation of the sample size, the appropriate sample size in experimental studies was of 15 people for each group [ 10 ]. At first, the sample size of 15 individuals was selected for each group. Then, to increase the statistical power and to manage the possible decrease in the number of participants, the sample size of 20 individuals (n = 20) was considered for each group. The sampling was voluntary non-random from among all the students studying at Shahed University. The inclusion criteria included an informed consent and the willingness to participate in the research, the ability to take part in the sessions and to collaborate in carrying out assignments, willingness to cooperate in completing the instruments, and the age range of 18 to 35 years. The exclusion criteria included the lack of desire to participate in the sessions and the absence to more than three courses in the preparation method, the lack of the ability to participate in the sessions, lack of cooperation in carrying out assignments, and receiving any training or psychological therapy that was not part of the program of this research.

The procedure of the study was that from all the students studying at Shahed University, a number was non-randomly and voluntarily selected, and if they met the inclusion criteria, they were randomly assigned to two groups: experimental and control. At the beginning and before starting the study, an informed consent was obtained from all of them to uphold moral considerations, through informing them of the aim of the study and the impact of such studies in improving their psychological status. Then, all the information of the participants were collected, and they were assured that the information would remain confidential by the researcher. Then, the experimental group received group stress management training for ten sessions, and the control group did not receive any intervention. In the end, both groups were post-tested. The protocol of stress management training sessions is presented in Table 1 .

Protocol of stress management skills training sessions

The instruments used in the study included a demographic sample page, an academic vitality questionnaire, and a psychological well-being scale (PWBS-18).

Demographic sample page: The demographic sample page included age, gender, educational level, and marital status. The sample page was prepared and evaluated by the researchers of the study.

Academic vitality questionnaire: This questionnaire was developed by Dehqanizadeh MH, Hosseinchari M (2012) [ 3 ], based on the academic vitality scale of Martin AJ, Marsh HW (2006) [ 15 ], which had four items. After various implementations of the items of the questionnaire, the final version was rewritten, and the result was that the revised version had ten items. Then the items above were again examined in a preliminary study on a sample including 186 high school students, who were chosen by using a cluster random sampling, and their psychometric properties were examined. The results of the examination showed that the obtained Cronbach’s alpha coefficient, by removing [ 3 ] item number 8, was 0.80 and the retest coefficient was 0.73. Also, the range of correlation of the elements with the total score was between 0.51 and 0.68. These results indicated that the items had a satisfactory internal consistency and stability.

Psychological well-being scale (SPWB): Riffe’s mental well-being scale [ 11 ] was made up of 84 questions in Likert’s 7-degree scale (from “strongly disagree” to “agree strongly”). It was a self-report questionnaire, which measured six components of the psychological well-being, including purpose in life, positive relations with others, personal growth, self-acceptance, autonomy, and environmental mastery. The internal consistency coefficients for the components of this questionnaire were obtained from 0.83 to 0.91. In Mohammadpour and Joshanloo research (2014) [ 6 ], the reliability coefficient of this scale with Cronbach’s alpha method for the psychological well-being scale obtained was 0.81. Also, for the subscales of the test including self-compliance, environmental mastery, personal growth and development, link with others, the goal in life, and self-acceptance were obtained at 0.60, 0.64, 0.54, 0.58, 0.65, and 0.61, respectively. A study performed by Kafka and Kozma (2002) was conducted to verify the validity of the items of the Riffe’s psychological well-being scale. The findings showed that there was a high correlation between this scale and the subjective well-being scale (SWB) and the satisfaction with life scale (SWLS). In the present study, the reliability coefficient with Cronbach’s alpha method for the psychological well-being scale obtained was 0.81. Also, for the subscales of the test, including self-compliance, environmental mastery, personal growth and development, relations with others, the goal in life, and self-acceptance were obtained at 0.60, 0.64, 0.54, 0.58, 0.65, and 0.61, respectively.

The SPSS-20 software was used for data analysis. The statistical method used for the data analysis of the research on the level of descriptive statistics was mean, standard deviation, frequency, and frequency percentage indexes, and on the inferential statistics, univariate and multivariate analysis of covariance model were used.

Findings of the research

The demographic properties of the sample present in the study are presented in Table 2 .

Demographic characteristics of the subjects

As presented in Table 1 , the largest frequency of participation belonged to the participants in the age range of 21 to 25 with 14 individuals (35%) and the lowest frequency of individuals in the range of 18 to 20 years, with six individuals (15%). In addition, the mean age of the participants was 24.85, and the standard deviation was 4.41. The other information about the demographic properties of the present sample is provided in Table 2

As shown in Table 3 , the mean scores of purpose in life, positive relations with others, personal growth, self-acceptance, autonomy, environmental mastery, total score of psychological well-being, and academic vitality of posttest were increased in the test group as associated with the control group.

Descriptive stats of academic vitality and psychological well-being scores of the two groups divided by the pretest and posttest

As shown in Table 4 , the null hypothesis of the equality of variances of the two groups in the academic vitality and psychological well-being with all its components was confirmed. It meant that the variances of the two clusters in the population were equal and had no significant difference for the academic vitality and the psychological well-being variable with all its components. Thus, given the compliance with the Levene assumption, the analysis of covariance of the results of the hypothesis of the research were permitted.

Results of Levene test for the examination of the consistency of variances of academic vitality and psychological well-being variables with its components in the posttest stage

As shown in Table 5 , the significance level of all the tests (p < 0.001) indicated that there was a significant difference between the two groups at least in one of the dependent variables (academic vitality and psychological well-being with its components). And, according to the eta square, 0.89 percent of the differences observed among individuals were associated with the effect of the independent variable, which was the intervention method (stress management skills training). On the other hand, given that the statistical power was 0.95, which was higher than 0.80, the sample size was acceptable for the research. The results related to significant differences in any of the dependent variables are listed below.

Results of multivariate analysis of covariance on the scores of posttest with the control of pretest in the academic vitality and psychological well-being variable with its components

According to Table 6 , the significance level was p < 0.001, the hypothesis of the difference between the academic vitality and the psychological well-being with its components in the two groups was confirmed. It stated that 0.54, 0.25, 0.52, 0.64, 0.60, 0.59, 0.45 and 0.81 percent change in the academic vitality, individuals’ purpose in life, positive relations with others, personal growth, self-acceptance, autonomy, environmental mastery, and psychological well-being scores were due to the independent variable (stress management skills training). Therefore, it could be said that stress management skills training increased the academic vitality and the psychological well-being and all of its components.

The results of multivariate analysis of covariance to assess the impact of stress management skills training on the level of psychological well-being and its components in the posttest stage

Discussion and conclusions

Given the aim of this study, which was to examine the effectiveness of stress management skills training on the academic vitality and psychological well-being of the students of Shahed University, the results of the univariate and multivariate analysis of covariance showed that stress management skills training had a significant impact on increasing the academic vitality and psychological well-being. The findings indicated that the stress management skills training had a major impact on increasing the academic life. It was consistent with different studies of Habibi M (2015), Pakdaman A, Ganji K, Ahmadzadeh M (2012), Shirbim Z, Sudani M, Shafi-Abadi A (2008) [ 12 - 14 ].

In explaining their similar finding, Pakdaman A, Ganji K, Ahmadzadeh M (2012) [ 13 ] also stated that life skills training helped in the improvement of the academic conditions of the subjects. In addition, this was because of this training, with growing different skills of the students, helping the students know their strengths and weaknesses, and overall, help the individuals move from weaknesses and skill deficits to capable and strong skills. Therefore, this could provide the students with better educational conditions [ 14 ]. In explaining their similar finding, Shafi-Abadi (2008) stated that teaching life skills, including stress management skills, are one of the ways to improve the mental health of the individuals of the community and to prevent harms. In fact, these teachings protected the health and mental hygiene of the society and protected it against diseases, disabilities, and disturbances in human relations. As a result, the feeling of security and solidarity increased among the members of the society, and then their senses of happiness, vitality, and health increased.

The findings showed that stress management skills’ training has a significant impact on the psychological well-being. It was consistent with the multiple studies of Qadiri-Bahramabadi F, Mikaeli-Manee F (2015), Qanbari N, Habibi M, Shams-Aldini S (2013), Alavi-Arjmand N, Kashaninia Z, Hosseini MA, Reza-Soltani P (2012), Chubforushzadeh A, Kalantari M, Molavi H (2009) [ 16 - 19 ].

In explaining their similar findings, Qadiri-Bahramabadi F, Mikaeli-Manee F (2015) [ 16 ] stated that facing numerous stresses required teaching and learning of appropriate stress management skills. In other words, during stress, individuals must know the necessary coping skills to reduce the effects of stress, and if the pressure was managed and the effective coping skills were applied, the person would be able to get along better with the needs and challenges of his/ her life. Therefore, the intervention of stress management led to the formation of good feelings about oneself, as well as a positive performance in the stable world. It created interest and motivation in people’s lives as well as increasing the self-confidence of the individuals. As a result, it increased the psychological well-being.

In explaining their similar finding, Qanbari N, Habibi M, Shams-Aldini S (2013) [ 17 ] stated that with the help of multiple strategies to manage stress such as relaxation, and muscular relaxation, stress and anxiety could be reduced. The individuals identified the somatic symptoms, and with mastering the ways to acquire relaxation, which was inconsistent with stress, reduced their anxiety and unpleasant feelings, thus increasing the psychological well-being. Also, in explaining their similar finding, Chubforushzadeh A, Kalantari M, Molavi H (2009) [ 19 ], stated that stress management treatments make multiple changes in the individual’s beliefs, feelings, and behaviors. Therefore, improving the individual’s evaluations and coping skills, and the provided practices to integrate the learned separations with real life situations could lead to a decrease in the perceived stress and an increase in the psychological well-being.

Acknowledgement

The authors would like to thank the venerable authorities of Shahed University of Tehran for their assistance. Also, the authors would like to thank all the participants in the study.

ORIGINAL RESEARCH article

Self-employed and stressed out the impact of stress and stress management on entrepreneurs’ mental health and performance.

• 1 Faculty of Health Psychology, SRH Distance Learning University, Riedlingen, Germany
• 2 Institute of Digital Engineering, Technical University of Applied Sciences Würzburg-Schweinfurt, Schweinfurt, Germany

Introduction: Entrepreneurs play a central role in economic and social stability, yet the start-up rate in Germany has declined in recent years, possibly due to the stress associated with entrepreneurial endeavors. Stressors such as financial uncertainty and time pressure are prevalent among entrepreneurs and negatively affect their psychological well-being. However, research on stress management strategies among self-employed individuals remains limited.

Methods: This pilot study conducted a quantitative analysis with 117 self-employed participants in Germany. The study focused on typical entrepreneurial work demands and selected stress coping mechanisms.

Results: The analysis revealed a significant correlation between quantitative demands and mental exhaustion. Furthermore, a high positive correlation between presenteeism and workload suggests that presenteeism may partially explain the variance in workload. These findings underscore how high job demands can lead to self-endangering behaviors that are detrimental to mental health.

Discussion: Although no significant moderating effect of proactive coping on the relationship between job demands and mental exhaustion was observed, significant negative correlations between proactive coping and both job demands and mental exhaustion suggest a potential protective role of proactive coping against work-related stress. This study highlights the importance of understanding stress coping strategies among self-employed individuals and their impact on entrepreneurial success and mental well-being. Further research in this area is warranted to develop effective interventions to support the well-being and productivity of self-employed individuals in Germany.

1 Introduction

Numerous studies emphasize entrepreneurs’ significant contribution to economic growth and social stability ( Stoica et al., 2020 ; Fischer et al., 2021 ; Gomes et al., 2023 ). According to Spinelli and Adams (2014) , entrepreneurs are characterized as experienced strategists with a broad mindset, focusing their decision-making processes on the implementation of visions and concepts. Entrepreneurship entails recognizing opportunities and possessing the determination, adaptability, and risk-taking capacity to create value and promote social progress ( Spinelli and Adams, 2014 ; Fischer et al., 2021 ). In Germany, federal and state governments respond with funding programs aimed at providing targeted support for company foundations and startups ( Fischer et al., 2021 ). Additionally, the number of private-sector support facilities, such as incubator and accelerator programs, co-working spaces, and maker labs, is increasing ( Zinke et al., 2018 , pp. 33–95; Fischer et al., 2021 ). However, despite the numerous support services, the startup rate in Germany has been steadily declining since 2012 ( Bonin et al., 2022 , p. 16; Metzger, 2022 , p. 1). In the first quarter of 2023, the number of self-employed individuals in Germany was approximately 3.9 million compared to 41.7 million employees, representing around 8.5% of all employees in Germany. This reflects a decrease of 0.8% in the number of self-employed individuals compared to the previous year ( Federal Statistical Office, 2023b ). One possible explanation for the low proportion of entrepreneurs in Germany is the association of entrepreneurial activity with high levels of professional stress ( Kieschke and Schaarschmidt, 2003 , p. 108; Stephan, 2018 , p. 290).

Entrepreneurs are often exposed to higher levels of stress compared to other occupational groups, which leads to negative health effects ( White and Gupta, 2020 ; Lee et al., 2023 ; Wang et al., 2023 , p. 81). The work demands faced by the self-employed have been extensively studied in the literature in terms of stress levels ( White and Gupta, 2020 ; Lee et al., 2023 ; Wang et al., 2023 ). Effectively managing the development and management of stress in the self-employed is therefore a critical success factor that impacts not only the health of the entrepreneur, but also the performance and prosperity of the business ( Wach et al., 2021 ). In recent years, researchers have increasingly focused on the specific stressors faced by the self-employed ( Wach et al., 2021 ; Lee et al., 2023 ; Wang et al., 2023 ). Wach et al. (2021) emphasize that the well-being of entrepreneurs is increasingly taking center stage as it directly correlates with business performance and serves as a measure of entrepreneurial success. Therefore, it is imperative to explore strategies that enable entrepreneurs to maintain or enhance their well-being during a demanding workload ( Wach et al., 2021 ; Wang et al., 2023 ).

High financial and economic uncertainty as well as considerable time and deadline pressure are often cited in the literature as primary stressors in entrepreneurial ventures ( Kottwitz et al., 2019 ; Lek et al., 2020 ; White and Gupta, 2020 ). Especially in times of financial uncertainty, entrepreneurs are confronted with increased expectations of flexibility, which can have a negative impact on their mental well-being. For example, they must respond flexibly to orders to ensure financial stability, even if their time resources are limited ( Kottwitz et al., 2019 ). Entrepreneurs must also respond skillfully to rapid economic fluctuations ( Fischer et al., 2021 ). In addition, high workload is repeatedly mentioned in the literature as a stressful aspect of the entrepreneurial environment, with workload meaning an overwhelming amount of tasks, often accompanied by long working hours, which has a negative impact on mental health ( Stephan, 2018 ; Wach et al., 2021 ).

Stress can significantly affect job satisfaction, performance and commitment to the organization ( Eager et al., 2015 , p. 254; Wach et al., 2021 ). The mental health of entrepreneurs is a critical factor for the sustainable preservation of companies ( Eager et al., 2015 , p. 254; Lee et al., 2023 ). Against this backdrop, increasing attention is being paid to the stress management skills of entrepreneurs. The way in which entrepreneurs deal with stressful working conditions can be crucial for maintaining their health and thus for the sustainable success of the company. Conversely, maladaptive coping mechanisms can jeopardize the health of entrepreneurs and thus the company ( Kieschke and Schaarschmidt, 2003 , p. 109; Neck et al., 2013 , p. 475). Therefore, this study aims to investigate the relationship between workloads, coping strategies and the mental well-being of self-employed workers. The research is guided by the following questions:

RQ1 : To what extent does work stress affect the mental health of the self-employed?

RQ2 : To what extent do health-endangering coping strategies affect the relationship between workload and well-being?

RQ3 : To what extent do health-promoting strategies affect the relationship between workload and well-being?

This paper presents the results of a quantitative pilot study conducted in the context of an online network with 117 participants. The sample represents a simple, non-probabilistic self-selection designed to reflect the diversity of the self-employed in Germany. Our study focuses on typical entrepreneurial work demands, including cognitive and quantitative aspects, as well as selected stress coping strategies such as work extension, presenteeism, proactive coping and reframing, and examines their influence on the mental exhaustion experienced by the self-employed respondents. While our assessment is not exhaustive, it provides valuable insights into the use of self-threat coping strategies, proactive coping and emotional coping through positive reframing. The study therefore contributes to the entrepreneurship literature by examining self-employed individuals’ stress coping mechanisms and highlighting how quantitative demands play a significant role in mental exhaustion, as well as how presenteeism mediates work stress. Furthermore, we emphasize the importance of understanding stress coping strategies for entrepreneurial success and psychological well-being within the current entrepreneurship research landscape (e.g., Lee et al., 2023 ; Wang et al., 2023 ).

The article is divided into five sections. After the introduction (Section 1), Section 2 (Theoretical background) explains the empirical studies and theoretical models on which our hypotheses are based. Section 3 (Methods) describes the detailed research design, including a description of the sample and the analytical approach. The results of our hypothesis testing are described in Section 4 (Results) and then discussed and contrasted with the underlying theories in Section 4 (Discussion). Finally, Section 5 (Conclusion) summarizes the results and limitations of our study, while highlighting avenues for future research.

2 Theoretical framework

2.1 job demand-resources model.

The Job Demand-Resources (JD-R) according to Bakker and Demerouti (2017) is a model to explain the development of burnout or mental exhaustion and work. Based on the stress–strain model and work design theories ( Demerouti and Nachreiner, 2019 ; Wang et al., 2023 ), the JD-R model integrates these theoretical frameworks. The stress–strain model describes the interplay between work demands (stressors) and stress reactions (strain), while work design theories clarify the relationship between work resources and work motivation. By bringing these perspectives together, the JD-R model comprehensively clarifies the effects and relationships of work demands and resources on burnout and work engagement ( Demerouti and Nachreiner, 2019 , p. 120; Wang et al., 2023 ). The model is based on two fundamental premises: First, burnout risk factors can be categorized into two main groups: job demands and job resources. Second, these categories, work demands and work resources, can trigger two different psychological mechanisms.

The authors define work demands as occupational activities that are typically associated with persistent physical and/or psychological stress and specific physiological and/or psychological costs caused by physical, psychological, social and organizational factors ( Demerouti and Nachreiner, 2019 , p. 121). Examples include time pressure or high cognitive demands ( Demerouti and Nachreiner, 2019 , p. 121). Work demands have been identified as the most important predictors of mental exhaustion ( Bakker and Demerouti, 2017 , p. 274). Work resources are understood as all physical, psychological, social and organizational factors that support a person in achieving their goals, dealing appropriately with work demands and stressors and serving personal development ( Schuster et al., 2011 , p. 51; Demerouti and Nachreiner, 2019 , p. 121).

In the first process, constantly high work demands lead to mental exhaustion in the long term ( Demerouti and Nachreiner, 2019 , p. 122). In the second process, a lack of work resources leads to frustration and subsequently to a decline in motivation and work commitment ( Bakker et al., 2004 , pp. 87–88; Demerouti and Nachreiner, 2019 , p. 122). The effect of these two processes has been empirically confirmed in several studies ( Bakker and Demerouti, 2007 , p. 317). In addition, a third effect has been identified and empirically confirmed: Work resources fulfill a buffering effect between work demands and mental exhaustion ( Bakker et al., 2004 , pp. 88–98; Bakker and Demerouti, 2007 , p. 314; Demerouti and Nachreiner, 2019 , p. 124). The model can be represented graphically as follows:

Wrzesniewski and Dutton (2001) and Xanthopoulou et al. (2007) have considerably extended the JD-R model by including personal resources and job crafting. Xanthopoulou et al. (2007) included personal resources such as self-efficacy, organizational self-esteem and optimism in the model and examined their moderating and mediating roles. Although the moderating effect could not be confirmed, personal factors were found to mediate between work resources and work engagement. In particular, personal resources were found to play an active-preventive role by activating personal resources to reduce mental exhaustion. This underlines the importance of personal resources alongside work demands and resources in the JD-R model. Job crafting, as proposed by Wrzesniewski and Dutton (2001) , represents a proactive, self-initiated perspective on changing working conditions. It involves various changes that individuals make to their tasks, cognitive attitudes and working relationships. Job crafting is relevant to this study as it suggests coping strategies such as proactive coping and reframing of situations as intrapsychic resources that mitigate the detrimental effects of high work demands on mental exhaustion.

For this study, the JD-R model is of central importance to the empirical investigation. With its valid empirical foundations and extensions, in particular job crafting, it offers insights into the interaction between resource-oriented coping strategies, job demands and mental health.

2.2 Stress levels among self-employed persons

The International Classification of Occupations (ISCO) is a globally recognized standard for categorizing types of employment ( Schüller and Wingerter, 2019 ). The ISCO divides the self-employed into different groups: those with employees, such as managing proprietors and sole proprietors with staff; those without employees, also known as solo self-employed, which includes managing proprietors and sole proprietors without staff; and dependent self-employed, who work in their own business to generate profits but are heavily dependent on a commercial contractor. Furthermore, the distinction between consumer and entrepreneur is crucial and is regulated by the German Civil Code, which defines an entrepreneur as a natural or legal person who acts independently in the exercise of his or her trade, business or profession, with no distinction between self-employed persons and entrepreneurs, which is why the terms entrepreneur and self-employed person are used interchangeably in this study.

A comparative study by Martin (2013) between the self-employed and employees found that only around 5% of the employees surveyed work more than 10 h a day on more than 10 days a month, while this proportion is 27% for entrepreneurs ( Martin, 2013 ). A high workload is mainly caused by customers postponing deadlines, delayed planning or buffer times when order volumes are low ( Clasen, 2012 , p. 99; Kottwitz et al., 2019 , p. 132). In addition, the requirements associated with the high workload are diverse, highly demanding and complex ( Kottwitz et al., 2019 , p. 132). Entrepreneurs are also exposed to high competitive pressure ( Oren, 2012 , p. 168; Kottwitz et al., 2019 , p. 140). In addition, entrepreneurs experience considerable pressure to take responsibility, as they often bear sole responsibility for far-reaching decisions with high risk and limited resources ( White and Gupta, 2020 , p. 81). Another stressor in entrepreneurial self-employment is role strain ( Kottwitz et al., 2019 , p. 143; White and Gupta, 2020 ; Vandor and Meyer, 2021 ). It is not only the demands of the various professional roles that cause stress – entrepreneurs are simultaneously salespeople, networkers, managers, controllers, etc. – but also the role conflict between work and family or partnership, especially for female entrepreneurs ( Schonfeld and Mazzola, 2015 , p. 506; Kottwitz et al., 2019 , p. 143). In addition, social isolation is particularly stressful for solo self-employed workers ( Schonfeld and Mazzola, 2015 , p. 506; Kottwitz et al., 2019 , p. 134). Furthermore, stressors in connection with customers, suppliers or other interest groups should not be underestimated ( Kottwitz et al., 2019 , p. 134).

When stress and strain become chronic, long-term health consequences can arise ( Faltermaier, 2016 , p. 117; Semmer and Zapf, 2018 , pp. 25–26). Long-term effects of stress are particularly related to the functionality of stress management strategies and the ability to relax. If attempts to cope fail too often and/or the necessary relaxation does not occur after stressful events, this can lead to excessive demands and long-term stress-related damage ( Semmer and Zapf, 2018 , p. 26). Health-related stress consequences can be divided into physiological-somatic, psychological (cognitive-emotional) and behavioral consequences ( Busch et al., 2009 , pp. 22–23). The physiological or somatic consequences of stress include psychosomatic complaints such as muscle tension leading to back pain or headaches, cardiovascular problems, damage to the sensory organs (tinnitus, hearing loss), digestive problems or an increased sensation of pain ( Kaluza, 2015 , pp. 31–33; Faltermaier, 2016 , p. 152). On a psychological level, chronic stress can lead to a reduction in cognitive performance, psychological impairments such as loss of self-esteem and mental illnesses such as depression, anxiety and burnout ( Kaluza, 2015 , pp. 31–33; Schaper, 2019 , p. 588). Burnout is a state of complete mental, physical and emotional exhaustion that is accompanied by alienation and disenchantment with work ( Burisch, 2014 , p. 19; Schaper, 2019 , p. 589).

In addition to the stress factors, however, self-employment also harbors some resources. The self-employed often exhibit a high level of job satisfaction, as they experience a higher degree of autonomy, competence, control, and self-realization ( Clasen, 2012 , p. 100; Stephan, 2018 , pp. 290–293; Kottwitz et al., 2019 , p. 120). The use of one’s own skills in entrepreneurial self-employment is often associated with a high sense of professional self-efficacy, which can act as an important pro-tective factor against stress ( Kaluza, 2015 , pp. 55–56). In addition, the experience of coherence and meaning in daily work can serve as an important protective factor against stress and health impairments ( Kaluza, 2015 , p. 56). Furthermore, entrepreneurs perceive their responsibility and complex tasks as intrinsically motivating to a certain extent ( Martin, 2013 , p. 10), while self-employment offers numerous learning and development opportunities ( Clasen, 2012 , p. 100).

The following section shows the extent to which these resources have a positive impact on the self-employed when dealing with stressors.

2.3 Stress management for the self-employed

The way in which the self-employed deal with the high demands of everyday working life (so-called coping) is decisive for whether health problems occur ( Kieschke and Schaarschmidt, 2003 , p. 109; Stephan, 2018 , p. 301; White and Gupta, 2020 , p. 87). A study by Oren (2012) compared the coping strategies of the self-employed and employees in the United States of America ( Oren, 2012 , pp. 164–165). The study concluded that the self-employed often use active coping strategies such as direct confrontation with the problem, while employees more often choose an avoidance strategy ( Oren, 2012 , p. 168). In a qualitative study by Schonfeld and Mazzola (2015) on self-employed people in the cultural and creative industries, the authors came to similar conclusions. The self-employed people surveyed used active-problem-oriented coping strategies (67:23) significantly more often than emotion-oriented coping strategies when dealing with stress ( Schonfeld and Mazzola, 2015 , p. 508). Schneider (2011) was able to identify the following problem-oriented coping strategies among entrepreneurs in a qualitative study: Cause and error analysis, active coping by immediately dealing with possible solutions, prioritization and structuring, planning and obtaining external support ( Schneider, 2011 , pp. 73–77).

An emotion-focused stress management strategy that is mentioned in research in connection with entrepreneurship is so-called “self-management.” By self-management, Neck et al. (2013) mean a process of influencing one’s thoughts, beliefs and patterns in a self-motivating way that is necessary for good performance ( Neck et al., 2013 , pp. 469–473). Self-leadership or “positive self-instruction” by the entrepreneur is a strategy to better manage workloads and improve organizational performance ( Oren, 2012 ; Neck et al., 2013 , p. 475; Schenk, 2017 , pp. 59–62). White and Gupta also emphasize that among the company-specific coping strategies there are also those that reduce rather than increase well-being ( White and Gupta, 2020 , p. 83). Kieschke and Schaarschmidt (2003) , who were able to identify various risk groups among entrepreneurs, also come to this conclusion. A large proportion of the entrepreneurs surveyed in their study exhibited risk pattern A, which is associated with excessive commitment as a coping strategy ( Kieschke and Schaarschmidt, 2003 , pp. 109–110). Work intensification or “self-exploitation” is also mentioned by Clasen and Kottwitz as a relevant characteristic of entrepreneurs ( Clasen, 2012 , p. 100; Kottwitz et al., 2019 , p. 163). Work intensification as a dysfunctional coping strategy is explained by Krause et al. (2014) with the term “self-endangerment.” The authors define self-endangerment as “actions that serve the active and problem-oriented coping of work-related stressors, but have negative effects on health [...]” ( Krause et al., 2014 , p. 49).

The concept of coping is the main subject of the empirical studies in this thesis. The work is primarily based on the findings presented above on the influence of coping on (mental) health. Coping strategies that are more likely to be assigned to the dysfunctional spectrum and coping strategies that are more likely to be assigned to the functional spectrum are examined for their health-effective influence on the stress level of the self-employed.

2.4 Hypotheses and theoretical model

Related studies show that the self-employed primarily perceive the high quantitative workload and time pressure as well as high cognitive demands such as great (decision-making) responsibility, high flexibility requirements and diverse and complex tasks as stressors ( Kottwitz et al., 2019 , p. 132; Lek et al., 2020 , p. 502; White and Gupta, 2020 , p. 81). Based on the job demand resource model and the transactional stress theory ( Lazarus, 1995 , pp. 212–215; Demerouti and Nachreiner, 2019 , p. 121), it is assumed that high job demands, which are perceived as stressors, affect the health of self-employed workers. In this study, mental health is operationalized by the degree of mental strain. Existing research suggests that self-employed people perceive high workload, time pressure and cognitive demands such as high decision-making responsibility, flexibility requirements and multiple tasks as stressors. Therefore, this study considers quantitative and cognitive work demands as predictors of mental health (H1 1 ), controlling for perceived autonomy in the work environment, which may serve as a protective factor for the mental health of the self-employed. Perceived autonomy in everyday working life, which can be a protective factor for the mental health of the self-employed, is controlled for.

The literature review also shows that the health-related consequences of stress are influenced by the coping strategies used (e.g., Lazarus, 1966 , p. 216; Skinner et al., 2003 , p. 231; Carver and Connor-Smith, 2010 ; Perrez et al., 2011 , p. 284). Coping strategies can be either health-promoting or health-damaging ( Skinner et al., 2003 , p. 231; Mülder et al., 2021 ). For this study, the concept of self-endangerment is assumed to be a health-damaging coping strategy ( Krause et al., 2014 ). The aspects of work prolongation and presenteeism were examined as self-endangering ways of working with regard to their effect on the relationship between work demands and health. For these, the assumption of a mediation effect postulated by Krause et al. (2014) was tested (H1 2 , H1 3 ).

It is assumed that health burdens are more likely to be intensified by excessive work or working despite illness and that a negative influence on mental health can be measured by exceeding physical and cognitive limits similar to type A behavior ( Lazarus and Folkman, 1984 , pp. 215–216; Krause et al., 2014 , pp. 51–54). The health-promoting coping strategies examined in this study are positive reinterpretation and proactive coping, which are also frequently used by the self-employed ( Oren, 2012 ; Neck et al., 2013 , p. 475; Schenk, 2017 ). They are functional coping strategies that actively and constructively deal with the stressor and/or their own stress response ( Skinner et al., 2003 , p. 231; Kaluza, 2015 , p. 66). Moderation effects should be tested for positive reinterpretation and proactive coping (H 4 , H1 5 ).

Therefore, the following five hypotheses were derived and tested inferentially:

H1 1 : Work demands significantly influence mental exhaustion. The higher the perceived work demands, the higher the subjectively perceived mental exhaustion.

H1 2 : The amount of work significantly influences the relationship between work demands and mental exhaustion. The relationship between work demands and mental exhaustion is explained or mediated by the amount of work.

H1 3 : Presenteeism has a significant influence on the relationship between work demands and mental exhaustion. The relationship between work demands and mental exhaustion is explained or mediated by presenteeism.

H1 4 : Positive reframing of the stressful situation significantly influences the relationship between work demands and mental exhaustion. Positive reframing moderates the relationship between work demands and mental exhaustion to the extent that a high level of positive reframing reduces the relationship.

H1 5 : Proactive coping significantly influences the relationship between work demands and mental exhaustion. Proactive coping moderates the relationship between work demands and mental exhaustion to the extent that a high level of proactive coping reduces the relationship.

The hypotheses are also presented in the research model ( Figure 1 ), which states that high job demands perceived as stressors affect the mental health of the self-employed, expressed here by the degree of mental exhaustion. This study examines the influence of coping strategies on the health effects of stress, focusing on self-endangerment as a maladaptive coping strategy among the self-employed. In particular, work extension and presenteeism are examined as potential mediators between work demands and health, as they have a negative impact on mental health. In addition, functional coping strategies such as positive reinterpretation and proactive coping are examined for their health-promoting effects in this group. Moderation effects of these strategies are also examined. The following chapter outlines the methodological approach of our study.

Figure 1 . Theoretical framework. Own figure.

3.1 Research design

The research work is explanatory, i.e., it has a theory-and hypothesis-testing character ( Döring and Bortz, 2016 , pp. 192–193). In this pilot study, the theoretically derived research model was tested for the target group of self-employed persons. A quantitative, hypothesis-testing research design was chosen to test the hypotheses ( Döring and Bortz, 2016 , pp. 184–185). The data was collected using a fully standardized online questionnaire in a non-probabilistic cross-sectional convenience study among self-employed persons in Germany ( Döring and Bortz, 2016 , p. 294). The questionnaire was created using the web-based online survey software TIVIAN and made available to the participants via a corresponding link. The survey was open for participation from July 2023 to August 2023. Before the survey began, a qualitative pre-test was conducted with 7 people. The estimated completion time was approx. 10 min, based on the experience from the pretest, and was communicated to the participants in advance. In addition, all participants were informed in advance about confidentiality, anonymity and data protection regulations and had to agree to the data protection regulations.

The chosen method of data collection through an online survey harbors both opportunities and risks, which will be critically examined here. For example, only people with Internet access and a presence in the forums relevant for participant recruitment can be reached digitally. The latter poses the problem of self-selection bias. This means that the sample cannot be determined probabilistically by random selection or systematic sampling, but that the participants assign themselves to the sample ( Döring and Bortz, 2016 , p. 415). However, a major advantage of the online survey is its high efficiency ( Döring and Bortz, 2016 , p. 414). An online survey was chosen for this study due to its efficiency advantage. The link to the survey was primarily distributed via the online business network “LinkedIn,” with additional support from various organizations for dissemination. Statistical analysis was conducted using IBM SPSS, with the mediation and moderation hypotheses tested using ( Hayes, 2013 ) PROCESS macro, which uses bootstrapping.

3.2 Variables

For the measurement of latent variables, validated instruments were selected according to criteria such as test quality, availability of German scales and realistic survey time. In the following section, these instruments and their test quality criteria are presented, with a focus on internal consistency and construct validity. Reliability measures (test–retest reliability r_tt; Cronbach’s alpha α) above 0.70 are considered acceptable, while correlations with r  = 0.10, 0.30 and 0.50 are interpreted as small, moderate and large, respectively, ( Nunnally, 1967 , 1978 ; Cohen, 1988 ). The following variable schedule contains the scales used, see Table 1 .

Table 1 . Dimensions and indicators.

3.2.1 Copenhagen psychosocial questionnaire

All scales used were adapted to the purpose of the study and tested. Perceived workload was assessed using the “Quantitative demands” and “Cognitive demands” scales of the Copenhagen Psychosocial Stress Questionnaire (COPSOQ) in its German version. The original Danish version was further developed to measure psychosocial workload. The COPSOQ is used both as a screening instrument in practice and for research and evaluation purposes in science ( Nübling et al., 2005 , p. 12). It consists largely of measurement instruments that have already been tested and validated ( Nübling et al., 2005 , p. 13).

3.2.2 Copenhagen burnout inventar

In the original study with a sample size of N  = 1898, a high internal reliability of α > 0.87 was achieved for the personal burnout scale ( Kristensen et al., 2005 , p. 200). Similarly, in the German translation of the COPSOQ by Nübling et al. (2005) , a high reliability of α  > 0.90 was achieved for the personal burnout scale with six items. Construct validity was tested in the original study using the SF-36 Health Survey. As expected, high correlations were found between the “Vitality” and “Mental Health” scales of the SF-36 and the personal burnout scale ( r  = 0.75; r  = 0.67) ( Kristensen et al., 2005 , p. 202). In the German study on the translation of the COPSOQ, the personal burnout scale showed high correlations in the expected direction compared to similar outcome constructs such as job satisfaction ( Nübling et al., 2005 , p. 56). It can therefore be assumed that the scale has high construct validity.

3.2.3 Stress and coping inventory

The scales for the latent variables of proactive coping and positive reframing as health-promoting coping strategies were taken from the Stress and Coping Inventory (SCI) by Satow (2012) . The SCI assesses five coping strategies, including positive thinking and proactive coping, using a self-assessment questionnaire ( Satow, 2012 , p. 6). The SCI was selected for this study because it offers a comprehensive scale, high-quality documentation and free availability.

3.2.4 Instrument for measuring self-harm

The variables for the coping strategies of extended working hours and presenteeism were taken from the instrument for recording self-harm by Krause et al. (2014) . The scales on working time extension and presenteeism are two of eight facets of self-harm that were identified in a qualitative preliminary study ( Krause et al., 2014 , p. 52). Extending one’s own working hours primarily refers to the time limit on work, while presenteeism is understood to mean working despite illness or foregoing regeneration during illness ( Krause et al., 2014 , pp. 52–53).

3.2.5 Scale for basic needs satisfaction in the workplace

The control variable autonomy was measured using the autonomy scale from the measurement instrument “Scale for basic needs satisfaction in the workplace” ( Koch and Zunk, 2021 , pp. 13–14). Construction and response format. The German-language scale on autonomy comprises 6 items, which have a 5-point Likert scale in the German-language translation ( Koch and Zunk, 2021 , pp. 20–21).

The sample consisted of 117 participants drawn from the population of self-employed people in Germany ( Döring and Bortz, 2016 ). Following the ICSE, we define an entrepreneur or self-employed person as a natural or legal person who acts independently in the exercise of their commercial or professional activity, which includes both self-employed persons and persons with employees, as defined in the German Civil Code (see section 2.2). According to the Federal Statistical Office, there were around 3.887 million self-employed persons in Germany in the first quarter of 2023 ( Federal Statistical Office, 2023a ; Federal Statistical Office, 2023b ). Of the 839 people who accessed the survey link, 130 completed the questionnaire, which corresponds to a completion rate of 15.49%.

After data cleansing, the data set comprised 117 participants ( n  = 117). Two filter variables were used at the beginning of the questionnaire to refine the sample. Thirteen participants who stated that they were not employed or not self-employed were excluded from the sample. Of the 117 participants, 58 (49.6%) reported being male, 59 (50.4%) reported being female, and no participants described themselves as non-binary. Fifty-nine participants (50.4%) reported having employees, while 58 (49.6%) were solo self-employed. The average age of participants was 42.26 years ( M  = 42.26, SD = 11.10), with the youngest participant being 21 years old and the oldest 66 years old. Half of the participants were under 40 years old, and 25% were younger than 33.5 years. On average, participants had 11.95 years of self-employment experience ( M  = 11.95, SD = 10.61), with three individuals having 40 years of self-employment experience. Further demographic information can be found in Table 2 .

Table 2 . Demographic data ( n  = 117).

3.4 Data analysis

The statistical analysis was carried out using the statistical program IBM SPSS. The SPSS macro procedure by Hayes (2013) , which is based on bootstrapping, was used to test the mediator and moderator hypotheses. The statistical methods of linear regression, moderation and mediation, which are briefly explained below, were used to empirically test the hypotheses described.

3.4.1 Linear regression

Hypothesis H1 1 postulates a negatively directed, semi-partial association hypothesis ( Döring and Bortz, 2016 , pp. 146, 666–667, 679). Association hypotheses can be divided into bivariate, partial and multiple association hypotheses ( Döring and Bortz, 2016 , p. 678). A bivariate association hypothesis examines the relationship between two variables: an independent predictor variable and a dependent criterion variable ( Döring and Bortz, 2016 , pp. 146, 678). In the case of a partial association hypothesis, the influence of a control variable on the criterion variable is also eliminated (semi-partial correlation) ( Döring and Bortz, 2016 , p. 678). A multiple association hypothesis also examines relationships between a criterion and several predictors ( Döring and Bortz, 2016 , pp. 146, 678). Association hypotheses such as H1 1 are tested using linear regression analysis. Linear regression aims to predict the development of an outcome variable (criterion) under the influence of one or more independent variables (predictors) ( Leonhart, 2013 , pp. 311–312, 338).

3.4.2 Moderation

In (multiple) linear regression, the focus of the analysis is on the individual predictors of a regression model and their effects on the criterion. It is also possible to analyze interaction effects of variables on an existing relationship. The interaction effect is also referred to as moderation ( Field, 2013 , p. 395; Hayes, 2013 , pp. 208–209; Bühner and Ziegler, 2017 , pp. 769–770). Hypotheses H1 4 and H1 5 represent moderation hypotheses.

3.4.3 Mediation

Hypotheses H1 2 and H1 3 represent mediation hypotheses. Mediation occurs when the relationship between predictor and criterion is influenced by an intervening third variable (mediator M) ( Hayes, 2013 , pp. 86–87; Bühner and Ziegler, 2017 , p. 760). In contrast to the moderator variable, which influences the extent of the relationship between X and Y, the mediator variable establishes the relationship between X and Y ( Bühner and Ziegler, 2017 , p. 760).

4.1 Descriptive values

In research practice, Cronbach’s α is usually used as a coefficient to determine reliability. Values of at least 0.70 are considered sufficient, values of 0.80 are recommended and values above 0.90 are considered high [ Nunnally, 1967 , 1978 , cited in Gäde et al. (2020) , p. 331; Janssen and Laatz, 2017 , p. 611]. As validated and reliable measurement instruments were used to operationalize the variables, albeit with adapted response formats. Reliability analyzes revealed acceptable to very good reliability values for all scales despite the modified response format (Cronbach’s α between 0.72 and 0.92), which indicates good study quality. For none of the scales was there a clear improvement in Cronbach’s α due to the exclusion of one or more items, so that no items were excluded from the analysis.

Table 3 provides an overview of the descriptive values of our analysis. For the scales describing job requirements, the mean value for quantitative requirements was 3.77 (standard deviation SD = 0.98) and for cognitive requirements 4.74 (SD = 0.644). The level of cognitive requirements was therefore higher on average than that of quantitative requirements. The overall index of requirements had a mean value of 4.29 (SD = 0.64). In the case of quantitative requirements, 44.4% of respondents stated that they were often to always confronted with these requirements, while the percentage for cognitive requirements was 88.0%. On the scales for health-promoting stress management, the scale for positive reinterpretation/reframing had a mean value of 3.86 (SD = 0.92) and the scale for proactive coping had a mean value of 3.97 (SD = 1.00). On a scale of 1–6, these values correspond to moderately pronounced tendencies. In the scales on health-damaging stress management, the scale on work prolongation had a mean value of 3.69 (SD = 0.98), and the scale on presenteeism had a mean value of 2.45 (SD = 1.35). 28.2% of respondents stated that they rarely or never extend their working hours, while 71.8% stated that they rarely or never work when they are ill. The extent of extended working hours was therefore moderate, while the extent of presenteeism was relatively low. The scale for mental exhaustion resulted in a mean value of M  = 3.22 (SD = 0.96) in the medium range. 16.2% of respondents stated that they were often to always mentally exhausted. The control variable autonomy showed a relatively high level with a mean value of 4.56 (SD = 0.70).

Table 3 . Scale means, standard deviations, and Cronbach’s α of the variables ( n  = 117).

The data show that only 16.2% of participants stated that they were often to always mentally exhausted. This contrasts with the findings of Clasen (2012) , according to which one in five freelancers suffered from severe mental stress. However, the cognitive demands were particularly high: 88.0% were often to always confronted with them. Autonomy, which is inversely correlated with both quantitative demands ( r  = −0.44, p  < 0.001) and mental exhaustion ( r  = −0.45, p  < 0.001), proved to be a significant protective factor for the mental well-being of freelancers ( Clasen, 2012 , p. 100; Oren, 2012 , p. 164). Proactive coping was rated moderately high ( M  = 3.97, SD = 1.00), while presenteeism was low ( M  = 2.45, SD = 1.35), possibly due to an increased awareness of the negative effects during the Covid-19 pandemic. Nevertheless, the responses could be influenced by social desirability after the pandemic. A weak but significant positive correlation was found between presenteeism and work experience ( r  = 0.20, p  = 0.030), which raises the question of why long-standing self-employed workers might overlook health concerns compared to new entrants. This tendency could be due to the increasing responsibility and greater consequences of absenteeism with longer periods of self-employment.

4.2 Hypothesis tests overview

All hypotheses were tested with a significance level of at least α < 0.05. The analyses are all based on a 95% confidence interval (CI). A summary of the hypothesis tests can be found in Table 4 .

Table 4 . Results of the hypothesis tests.

4.2.1 Hypothesis H1 1

In H1 1 , multiple linear regression was used to test the extent to which the individual requirement components quantitative requirements and cognitive requirements influence mental exhaustion. The influence of the control variable autonomy on mental exhaustion was controlled. A hierarchical regression was calculated. In the first stage, the control variable autonomy was included in the model (model 1); in the second stage, the predictors quantitative demands and cognitive demands were also included (model 2). Table 5 shows all relevant coefficients and measured values for hypothesis testing. A highly significant influence on mental exhaustion was found for the predictor variable quantitative demands after inclusion of all variables (model 2) ( B  = 0.38, β = 0.39, p  < 0.001). For the predictor variable cognitive demands, there was no significant influence on mental exhaustion after including all variables (model 2) ( B  = −0.03, β  = −0.02, p  = 0.782). Model 2 was highly significant and explained 33% of the variance in mental exhaustion ( R 2  = 0.33, corrected R 2  = 0.31, F (3, 113) = 18.16, p  < 0.001). After including the predictors cognitive and quantitative demands in model 2, a further 12% of the variance in mental exhaustion could be significantly explained by the control variable autonomy compared to model 1 (Δ R 2  = 0.12, Δ F  = 10, p  < 0.001). If the autonomy variable is controlled, the cognitive and quantitative demands can still explain 12% of the variance in the mental exhaustion criterion.

Table 5 . Regression models with predictors quantitative and cognitive demands, control variable autonomy, and criterion mental exhaustion ( n  = 117).

4.2.2 Hypothesis H1 2

Hypothesis H1 2 assumes a mediating relationship in which the expansion of work explains the relationship between general work demands and mental exhaustion. In testing this hypothesis, the influence of autonomy was also controlled for, see Table 6 . The mediator analysis, conducted using the SPSS macro PROCESS version 4.2 by Andrew Hayes, revealed a significant overall effect of job demands on mental exhaustion ( B  = 0.44, β  = 0.30, p  = 0.01). The overall effect of job demands significantly predicted work prolongation ( B = 0.79, β = 0.52, p  < 0.001), which in turn significantly predicted mental exhaustion ( B = 0.30, β = 0.30 p  = 0.001). The indirect effect (axb) of general job demands on mental exhaustion due to job enlargement was significant ( B  = 0.23, 95% CI = [0.0866, 0.3944], β = 0.16, 95% CI = [0.0570, 0.2616]). After including the mediator in the model, the direct effect of total work demands on psychological exhaustion was no longer significant ( B = 0.21, β = 0.14, p  = 0.144). Thus, H0 2 is rejected, while H1 2 is accepted.

Table 6 . Regression coefficients B, standard errors, and t -values for the mediator model for H1 2 .

4.2.3 Hypothesis H1 3

Hypothesis H1 3 suggests that presenteeism mediates the relationship between general job demands and mental exhaustion ( Hayes, 2013 , pp. 86–87; Bühner and Ziegler, 2017 , p. 760). When testing the hypothesis, the influence of autonomy was controlled. The mediating effect was calculated with SPSS Macro PROCESS by Hayes, whereby the entire model took the autonomy variable into account. A significant overall effect was found between general job demands and psychological exhaustion ( B = 0.44, β = 0.30, p  < 0.001). A significant direct effect of general job demands on presenteeism ( B = 0.71, β = 0.34, p  = 0.001) and of presenteeism on mental exhaustion ( B = 0.23, β = 0.32, p  = 0.001) was observed. The indirect effect of general job demands on mental exhaustion (controlled for autonomy) by presenteeism was significant ( B = 0.16, 95% CI = [0.0478, 0.3069], β = 0.11, 95% CI = [0.0316, 0.2024]). Even after including the mediator, the direct effect of general job demands on mental exhaustion (controlled for autonomy) remained significant at a 5% level ( B = 0.28, β = 0.19, p  = 0.031), indicating partial mediation.

H1 3 is accepted, and H0 3 is rejected. The regression coefficients, standard errors, and t-values for the model are shown in Table 7 .

Table 7 . Regression coefficients B, standard errors, and t -values for the mediator model for H1 3 .

4.2.4 Hypothesis H1 4

Hypothesis H1 4 examines interaction effects and functions as a moderator hypothesis. It tests the effects of positive reframing on the relationship between general job demands and mental exhaustion, controlling for autonomy variables. Table 8 contains the results of the regression analysis, which examines the moderation effect of positive reframing on the relationship between general job demands and mental exhaustion. After including the product term Z in the regression model, no significant interaction effect of positive reframing (centered) on the relationship between general job demands (centered) and mental exhaustion, controlling for the autonomy variable (centered), was found ( B  = −0.21, β = −0.12, p  = 0.131). H0 4 is accepted, and H1 4 is not confirmed.

Table 8 . Results of the regression analysis examining the moderation effect of positive reframing on the relationship between overall job demands index and mental exhaustion ( n  = 117).

In addition, significant positive effects of the predictor overall job demands (centered) and negative effects of the moderator reframing (centered) were observed in both models. Overall job demands (centered) had a significant positive effect on mental exhaustion ( B  = 0.47, β = 0.32, p  < 0.001 or B  = 0.48, β = 0.32, p  < 0.001). The reframing moderator (centered) had a significant negative effect on mental exhaustion at the 5% level in both models ( B  = −0.18, β = 0.17, p  = 0.034 or B  = −0.18, β = −0.18, p  = 0.026 Model 1, which included general job demands, reframing, and autonomy (each centered), significantly explained 31% of the variance in mental exhaustion ( R 2  = 0.31, adjusted R 2  = 0.27, F (3, 113) = 16.85, p  < 0.001) = 16.85, p  < 0.001). The inclusion of the product term Z in the model did not lead to a significant change in the explanation of variance (Δ R 2  = 0.01, Δ F  = 2.31, p  = 0.131).

4.2.5 Hypothesis H1 5

Hypothesis H1 5 , also a moderator hypothesis, tests the effect of proactive coping (ProCop) on the relationship between general work demands and mental exhaustion, controlling for the autonomy variables. The results in Table 9 show the results of the regression analysis examining the modulation effect of proactive coping on the relationship between general work demands and mental exhaustion. After including the product term Z in the regression model, no significant interaction effect of proactive coping (centered) on the relationship between general work demands (centered) and mental exhaustion, controlling for the autonomy variable (centered), was found ( B  = −0.01, β  = −0.00, p  = 0.968). H0 5 is accepted, and H1 5 is not confirmed.

Table 9 . Results of the regression analysis examining the moderation effect of proactive coping on the relationship between overall job demands index and mental exhaustion ( n  = 117).

In addition, significant positive effects of the predictor general work demands (centered) and negative effects of the moderator proactive coping (centered) were observed in both models. The general work demands (centered) had a significant positive effect on mental exhaustion ( B  = 0.40, β = 0.27, p  = 0.002 and B  = 0.40, β = 0.27, p  = 0.002). The proactive coping moderator (centered) had a significant negative effect on mental exhaustion at the 5% level in both models ( B  = −0.17, β = 0.18, p  = 0.033 or B  = −0.17, β = 0.18, p  = 0.040). Model 1, which includes general work demands, proactive coping and autonomy (each centered), significantly explained 31% of the variance in mental exhaustion ( R 2  = 0.31, adjusted R 2  = 0.29, F (3, 113) = 16.89, p  < 0.001). The inclusion of the product term Z in the model did not lead to a significant change in the variance explanation (Δ R 2  = 0.00, Δ F  = 0.00, p  = 0.968).

5 Discussion

The first research question, which is derived from the JD-R model, investigated the effects of specific work demands on the mental health of self-employed people, measured in terms of subjectively perceived mental exhaustion. After rejecting the null hypothesis, which postulated no relationship between work demands and mental exhaustion, the alternative hypothesis was confirmed, which showed a statistically significant influence of work demands on mental exhaustion ( B  = 0.44, β = 0.30, p  = 0.001). The analysis showed that quantitative demands had a highly significant impact on mental exhaustion ( B  = 0.38, β = 0.39, p  < 0.001), with the inclusion of this variable explaining an additional 12% of the variance in mental exhaustion. These results are consistent with recent studies that identify long working hours and time pressure as detrimental conditions for the mental health of the self-employed. Conversely, this study found no effects of cognitive demands such as high responsibility or flexibility requirements on mental exhaustion. Cognitive demands can activate other protective factors that positively influence mental health ( Clasen, 2012 ; Martin, 2013 ; Kaluza, 2015 ).

The second research question investigated how self-endangering coping strategies such as work prolongation and presenteeism influence the relationship between work demands and mental health. Both mediator hypotheses (H1 2 and H1 3 ) were confirmed, with work extension fully mediating the relationship and presenteeism partially mediating it. The results indicate that high job demands can lead to self-endangering behaviors that impair mental health. These results confirm similar studies in Switzerland and underline the importance of self-harm coping strategies for the self-employed and entrepreneurs (see Dorsemagen et al., 2012 ; Krause et al., 2012 , pp. 198–199; Krause et al., 2014 , p. 51).

The third research question investigated the health-promoting effect of coping strategies such as positive reframing and proactive coping. The hypotheses regarding moderating effects (H1 4 and H1 5 ) could not be confirmed. Neither positive reframing nor proactive coping showed a significant moderating effect on the relationship between work demands and mental exhaustion. The discrepancy in the definition of the reframing coping strategy and in the measurement instruments may affect the comparability of the study results. However, significant negative correlations were found between proactive coping and work demands and mental exhaustion. These results confirm previous studies and suggest that proactive coping primarily reduces work demands and thus contributes to lower mental exhaustion.

The results are in line with the assumptions of the JD-R model by Bakker and Demerouti, which have already been empirically confirmed in several studies ( Bakker et al., 2004 ; Bakker and Demerouti, 2007 , pp. 315–317). When analyzing the individual components of work demands (cognitive and quantitative demands), a highly significant influence of quantitative demands on mental exhaustion was found ( B  = 0.38, β = 0.39, p  < 0.001). After including the variable quantitative demands, a highly significant 12% more variance in mental exhaustion could be explained. This is in line with recent studies that have identified a high workload and the associated long working hours and time pressure as harmful conditions for the mental and physical health of the self-employed (e.g., Stephan, 2018 ; Kottwitz et al., 2019 , p. 120; Lek et al., 2020 , pp. 502–503).

In contrast to current research, however, no influence of cognitive demands such as high responsibility or flexibility requirements on mental exhaustion was found in this study ( B  = −0.03, β  = −0.02, p  = 0.78; e.g., Kottwitz et al., 2019 , pp. 132–133; Lek et al., 2020 , p. 502; White and Gupta, 2020 , pp. 80–81). One possible explanation for this could be that cognitive demands such as high responsibility, pressure to innovate or flexibility in turn activate other protective factors such as high self-efficacy, intrinsic motivation or meaningfulness of work, which have a positive effect on mental health ( Clasen, 2012 , pp. 99–10; Martin, 2013 , p. 10; Kaluza, 2015 , pp. 55–56). In addition, with regard to the person-environment fit model (P-E fit model), it can be hypothesized that the self-employed respondents have relevant personality traits, goals and values that correspond to the cognitive requirements of self-employment ( Oren, 2012 , p. 168).

The role of the control variable autonomy in the model was also interesting. Autonomy was highly significant in explaining 21% of the variance in mental exhaustion and had a negative effect on mental exhaustion ( B  = −0.62, β = −0.45, p  < 0.001). In line with existing research findings, it can be concluded that autonomy is an important resource for the self-employed and a protective factor for the mental health of the self-employed (e.g., Oren, 2012 , p. 164; Stephan, 2018 , p. 293; Kottwitz et al., 2019 , p. 120).

The two mediator hypotheses (H1 2 and H1 3 ) were also confirmed: Both work duration and presenteeism showed a mediating effect between work demands and mental exhaustion among the self-employed respondents in this study. The results show that high work demands can lead to self-endangering behavior among the self-employed respondents, which in turn impairs their mental health. Self-endangering coping strategies are therefore of great importance in the context of self-employment and entrepreneurship and, as assumed in the research model of this study, can certainly be described as harmful to health. Self-endangering behaviors, as described in risk pattern A by Kieschke and Schaarschmidt (2003) , are widespread among business founders according to their findings. These behaviors therefore appear to be a critical factor for the mental health of the self-employed ( Kieschke and Schaarschmidt, 2003 , p. 110). It is reasonable to conclude that many entrepreneurs tend toward a type A risk behavior pattern that is associated with self-endangering behavior, which in turn leads to mental exhaustion in connection with the high demands of self-employment.

Moderating effects were assumed in the hypotheses (H1 4 and H1 5 ). However, both moderator hypotheses could not be confirmed. Contrary to the hypotheses of Neck et al. (2013) , no significant moderator effect of the coping strategy positive reinterpretation/reframing on the relationship between work demands and mental exhaustion was found (product term Z: B  = −0.21, β  = −0.12, p  = 0.131) ( Neck et al., 2013 , pp. 469–474). No significant moderating effect was found for the coping strategy proactive coping on the relationship between work demands and mental exhaustion (product term Z: B  = −0.01, β  = −0.00, p  = 0.968). However, significant negative correlations were found between proactive coping and demands ( r  = −0.22, p  = 0.016) and between proactive coping and mental exhaustion ( r  = −0.31, p  = 0.001).

The results of our pilot study thus confirm previous research: a negative correlation between proactive coping and mental exhaustion has already been demonstrated in several studies ( Ângelo and Chambel, 2014 , p. 205). Here, too, it can be argued at this point that proactive coping reduces the demands of advance, which in turn contributes to lower mental exhaustion. In addition, a significant correlation was also found between proactive coping and autonomy ( r  = 0.23, p  = 0.015). This expression may support Oren’s (2012) assumption that proactive coping is more likely to be used in autonomous work environments, as it is more helpful there than in work environments where the employee has less control over the organization of their work ( Oren, 2012 , p. 168). However, it can also be the other way around if the employer creates scope for autonomous action through careful planning and early processing of potential stressors.

5.1 Research limitations

A quantitative study design with a small sample was used in this study. It is therefore necessary to critically reflect on the data collection and analysis with regard to the following aspects: Sample size and representativeness, validity criteria of the instruments used and scope of the study. One incomprehensible criticism concerns the representativeness of the sample, which was not probabilistic and self-selected ( Döring and Bortz, 2016 ). The survey was distributed online and offline through various channels and regional networks, which allowed for voluntary participation. This method limited the sample to people with access to these networks and a basic interest in the topic, which may have led to an underrepresentation of skeptical groups ( Döring and Bortz, 2016 ). It was therefore not possible to form a representative sample that reflects the characteristics of the population. Furthermore, due to the cross-sectional design of the study, no causal relationships can be derived, meaning that the assumed directions of the associations cannot be empirically tested. However, these assumed relationships were logically derived from theory, which is a strength of this study. In addition, some socio-demographic and occupational characteristics were evenly distributed, which mitigated biases due to gender or employment status. However, the study lacked industry-specific data, which could lead to bias. Therefore, this study is a pilot study that requires further research (see below).

Another limitation concerns the limited extent to which the construct of coping was statistically analyzed. Coping is a complex, multidimensional construct with different styles and strategies. Due to time and resource constraints, only four main coping strategies were examined. However, this study does not claim to comprehensively capture the coping behavior of the self-employed. Validated instruments in the literature provide comprehensive assessments of coping styles, but their high number of items would have been impractical for this study. By taking these considerations into account, the study remains transparent and highlights areas for improvement and further research.

5.2 Further research

The results of this study suggest several avenues for further research. In addition to examining specific assumptions, such as the mediating effect of proactive coping strategies, there is a need for an expanded research model. As mentioned earlier, the coping constructs were not fully explored in this study. Therefore, future studies should comprehensively investigate the coping strategies of self-employed individuals using existing measurement instruments. Qualitative research designs could also provide insights into the nuanced coping strategies of the self-employed. In addition, it is recommended to include aspects of entrepreneurial personality in the research model. Personal factors are closely related to the choice of coping strategies, and understanding how entrepreneurial characteristics influence coping strategies and consequently mental health is a valuable research approach. In addition, examining the dual pathways of the JD-R model— specifically the relationship between occupational resources, engagement and psychological exhaustion in the self-employed — could provide valuable insights into entrepreneurial success. In addition, future research should consider a broader range of stressors within a single model and examine industry classifications to identify vulnerable groups in need of special support.

In terms of practical implications, the findings suggest various strategies for entrepreneurship centers and public or private programs to promote entrepreneurship. These institutions could implement psychoeducational programs and stress management workshops to provide entrepreneurs with effective coping strategies for the demands of self-employment. Educating entrepreneurs about the health risks associated with self-endangering behavior is also critical. Offering voluntary risk assessments or aptitude diagnoses as part of entrepreneurial coaching can help individuals make informed career decisions or seek appropriate support from the outset. In addition, tailored mental health support services should be offered to prevent incapacity and ensure business continuity. In the context of solo self-employment, it could be beneficial to incentivize client companies to prioritize the health of their contractors. For example, client companies could offer their contractors the opportunity to participate in their company health programs.

6 Conclusion

In this study, we provide an insight into the stress factors that entrepreneurs face and the coping strategies they use to deal with them. It has been confirmed that self-endangering coping behavior (work prolongation and presenteeism) has a negative impact on mental health. In self-employed workers, proactive coping did not mitigate the link between work demands and mental exhaustion. Based on the key questions of this study, it becomes clear that high job demands in entrepreneurial or self-employed activities can indeed have critical effects on the mental health of self-employed people. Quantitative demands such as time pressure and workload are particularly relevant. In addition, the use of stress management strategies by the self-employed plays an important role in this context. Although it was not possible to collect comprehensive data on stress management strategies in this study, it was possible to gain important insights into the use of self-threatening coping strategies, proactive coping and emotional coping through positive reframing. Self-endangering behaviors had a detrimental effect on health, while proactive coping showed a health-promoting influence. Positive reframing or the reinterpretation of stressful situations had little to no influence in this study. In order to harness the potential of entrepreneurship for the economy and society, support for the self-employed with regard to their health promotion, as shown in this and similar studies, would be of crucial importance.

The results of the study point to several areas of interest for future research. In addition to testing certain assumptions, such as the mediating effect of proactive coping strategies, an extension of the research model is suggested. It should be noted that the coping construct was not fully captured in this study. Future studies could therefore investigate the stress coping strategies of the self-employed more thoroughly using established measurement instruments. Qualitative study designs could provide a detailed picture of the stress coping strategies of the self-employed.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Author contributions

SK: Conceptualization, Formal analysis, Methodology, Visualization, Writing – original draft. SF: Writing – original draft, Writing – review & editing. JS: Resources, Supervision, Writing – review & editing.

Supported by the publication fund of the Technical University of Applied Sciences Würzburg-Schweinfurt.

Acknowledgments

The authors would like to thank all study participants who voluntarily took part in the empirical survey and thus gave us an insight into the current situation.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: stress, stress management, coping, mental health, self-employment, entrepreneurship

Citation: Kiefl S, Fischer S and Schmitt J (2024) Self-employed and stressed out? The impact of stress and stress management on entrepreneurs’ mental health and performance. Front. Psychol . 15:1365489. doi: 10.3389/fpsyg.2024.1365489

Received: 05 January 2024; Accepted: 05 March 2024; Published: 04 April 2024.

Reviewed by:

Copyright © 2024 Kiefl, Fischer and Schmitt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Sophie Fischer, [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

117 Stress Management Essay Topic Ideas & Examples

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• Stress Management for Patients With Arthritis The study’s primary objectives were to substantiate the hypothesis of the relation between RA activity and stress and find the evidence for the basis of further decisions.
• Stress Management Skills of Student-Athletes Their responses will then be categorized as “low perceived stress,” “moderate perceived stress,” and “high perceived stress”. The students will then be qualified as possessing superior, above-average, average, or below-average stress management skills.
• Stress Management in the Adulthood To effectively handle stress, an individual must be able to recognize the symptoms of stress and understand the possible cause which is easy as stress changes an individual’s happiness level, health, and behavior.
• Stress Management Strategies in Applied Psychology It is possible to note that the development of applied psychology was a natural stage of the evolution of psychology as a field of study.
• Stress Management in Rheumatoid Arthritis Patients The study also covered the epidemiological and pathophysiology of RA and looked at data linking psychological trauma to the emergence and aggravation of the clinical disease.
• Stress Management Benefits for Health Therefore, stress management strategies are crucial to eliminating the adverse impact of tension and anxiety. Physical activity and socializing are the techniques I have successfully applied to manage stress.
• Stress Management Techniques for Students: Yoga Yoga’s most major benefits are its capacity to relieve stress and exhaustion, to stimulate and revive, and to be used for anti-aging and calming treatment.
• Thoughts on Stress Management and Happiness Although she has all her financial needs met overwhelmingly, her failure to proceed with her studies and get employment makes her feel unsatisfied.
• Analysis of Stress Management Aspects In the science of stress management, there are a number of practices aimed at strengthening the mental health of the student, thus improving their response to potentially stressful events.
• Stress Management Techniques The proposed strategies and examples should help students to understand different situations and overcome stress disregarding settings and external factors.
• The Effectiveness of Occupational Stress Management However, as it relates to analyzing the shipbuilding and ship-repair industries, the level of occupational stress is higher in comparison to other sectors of the economy, and the effectiveness of managing the problem is lower.
• Stress Management Through Transcendental Meditation Thus, to improve productivity and the general wellbeing of its employees, a company ought to offer stress management program. However, transcendental meditation seems to be the most beneficial as it enables people to deal with […]
• Personal Stress Management and Relaxation Techniques In fact, I was rather frustrated and I thought it was all my fault I could not do it. I love the ocean and when I am meditating, I imagine a palm by the ocean.
• Stress Management in University Students The purpose of this systematic review is to investigate how stress management research techniques have changed in the PICOS framework and tendencies in stress levels and stress factors in the period of the last ten […]
• Work Related Stress: Symptoms and Management The proper prevention of work-related stress is essential for successful outcomes, and it should include interventions that aim at reducing the stressful environment.
• Stress Symptoms and Management This ensures that I have adequate time to finish the assignments and this gives me an apple time to research and organize my work.
• Stress Management and Wellness Programs by Corporate Sector The realities of post-modern living prompt more and more governmental institutions and commercial organizations to pay closer attention to the physical well-being of their employees, as a way of increasing their professional adequacy and as […]
• Stress Management Under Organizational Psychology Stress management refers to various efforts to control and reduce the tension that occurs in stressfull situations. Lack of such people to consult worsens the situation.
• Preventing Burnout in Preschool Teachers This follows with a decline in the immunity of the individual to fight the various common illnesses such as common cold, flu etc and in some cases gives rise to the blood pressure problem in […]
• Sports Demands and Stress Management in Athletics Stress is a harmful physical and emotional response that occur to and individual when the requirements of an activity exceed the capabilities and needs of the individual.
• Reducing Nurses’ Stress: A Web-Based Management Program The title of this primary source accurately depicts the key variable, which is the level of nurses’ stress and mentions the possible solution to this issue the introduction of a special computer program.
• UAE: Stress Management and Organizational Performance The goal of the paper is to examine the phenomenon of workplace stress and its relation to the organizational performance of employees in the UAE context.
• Posttraumatic Stress Disorder Management in Children The purpose of this paper is to determine whether the application of the perspective of clinical psychology as the platform for treating PTSD in children will have better effects than the adoption of the methods […]
• Employment and Stress Management Key to stress management is the capability to identify a victim. I reckon my stress management expertise needs enhancement in areas that relate to diagnosis of stress.
• Stress Management: Personal Success Plan I have also learnt that the world we live in is not perfect and at times people will do unpleasant things to me.
• Crisis Intervention Model and Critical Stress Management The difference between PFA and R-SSCIM is that the latter is aimed at a brief period while the former presupposes stable cooperation with the client.
• Stress Management for Life According to the Yerkes-Dodson principle, a small amount of stress is beneficial for performance and well-being; however, the prolonged influence of the level of stress that surpasses one’s coping ability might translate into the reduction […]
• Workplace Stress Management Programs For instance, the Lazarus and transactional models of stress will be used to provide the definition of stress and the environmental factors that cause it. Interviews will be used to collect data on the causes […]
• Jobforartist.com Company: Stress Management As a result, the cohesiveness between workers and junior managers is at a very good level, with little to no confrontations, and thus, no stress.
• Exam Stress: Effective Management It is important for a child to get enough rest for the relaxation of the mind and body. In line with Hemmings, it is important for parents to analyze the mood of a child who […]
• Office 2010 Transformation: Stress Management Plan The current stress management plan depends on the following factors: The team should be properly motivated to accept the Office 2010 transformation, and the manager has to understand what kind of strategy is more appropriate.
• Genentech Inc.’s Workplace Stress Management The relationship between the management and the employees also encourages the latter to contribute tirelessly towards the organisation’s mission and goals.
• Stress Levels and Stress Management Methods In my opinion, some useful strategies should be used to reduce the level and perception of stress. Stress is considered to be a negative psychological experience, which influences people’s quality of life.
• Stress: Effects and Management Proposal In management of stress, one needs to analyze the causes of the stress, the level of the stress and the effects caused to the body and mind.
• Suggestions on Stress Management It can thus be summarized that if a stress victim adheres strictly to the suggestions made in the article, the victim is bound to reduce his/her level of stress.
• Stress Management and Work Performance in the UK The goal of the study is to establish the relationship between stress management and work performance and the best approach to manage stress to meet organizational goals.
• Critical Evaluation of Stress Management Approaches Thus, the objective of this paper is to analyze the approaches used by individuals and organizations to manage stress. A clear chain of command helps employees to avoid the stress that can result from uncertainty […]
• Stress Management in Work Environment Leka, Griffiths and Cox are of the opinion that work related stress arises from the disparity between the demands of the job and the pressure on the employee on one hand and the mismatch between […]
• Stress Management and Work Performance in the United Kingdom In this society, it is very important for the management of various firms and governmental organizations to take care of the interests of the employees.
• Stress Management among Customer Service Employees: Antecedents & Interventions A focus on the identification of current and potential stressors affecting this group of employees, and the subsequent development of interventions which could be used by the employees to manage and curtail stress effectively, is […]
• Herbal Stress Management Rule, Regular Exercise, and Healthy Diet
• Stress Management With Relaxation Exercises and Visualization
• Stress Management for Parents With a Preschooler
• Yoga and Music Therapy as Effective Methods of Stress Management
• Managerial Stress Management Program
• Relationship Between Time Management and Stress Management
• Stress Management Through the Use of Flowers
• Stress Management for Everyday Living: Solution for Stress Management as It Relates to the Online Student
• Stress Management and Conflict Management
• Stress Management Strategies and the Methods Among Police Officers
• Stress Management Program for Salespeople
• Employee Stress Management During Organizational Change
• The Unease Modulation Model: An Experiential Model of Stress With Implications for Health, Stress Management, and Public Policy
• Biofeedback for Everyday Stress Management: A Systematic Review
• Stress Management and Reduction for Nurses
• Stress Management, Life Balance, and Prioritization Strategies
• Conflict Management and Stress Management: How to Handle
• Personal Stress Management Plan
• Stress and Stress Management: How Food Can Help Your Stress Levels
• Perceived Stress Levels and Stress Management
• Stress Management and the Effects of Stress on the Mind and Body
• Stress Management During Exam Time
• Assessing the Therapeutic Uses and Effectiveness of Virtual Reality, Augmented Reality, and Video Games for Emotion Regulation and Stress Management
• Stress: Personality Psychology and Stress Management Activities
• Stress Effects and Healthy Stress Management Strategies
• Leadership and Stress Management: Keep Moods and Outlooks Positive
• Stress Management Spa Treatments in the Age of Stress
• The Relationship Between Time and Stress Management
• Time and Stress Management in the Workplace
• Stress Management Among Bank Employees
• Stress Management Using Hypnotherapy
• Activities for Stress Management and Prevention
• Stress Management for Emergency Workers
• Stress Management During Pregnancy
• Stress Management and the Effects on Wellness
• Work-Related Stress and Stress Management
• Preventive Stress Management Methods
• Cognitive Behavioural Therapy Based Stress Management Interventions: An Evaluation of Methodology
• Effective Workplace Stress Management
• Decision-Making Skills and Stress Management Psychology
• Why Is Stress Management Necessary for Students?
• What Are the Approaches to Stress Management?
• What Are the Important Factors for Managing Stress?
• What Is Avoid in Stress Management?
• How Does Stress Affect Motivation?
• Why Is Stress Management Critical at the Workplace?
• What Are the Types of Stress Management?
• What Are the Main Stress Management Techniques?
• How Well Do Managers Manage Stress Management?
• What Are the Advantages of Stress Management?
• What Is the Meaning of Stress Management?
• What Is the First Step in Stress Management?
• What Are the Critical Factors for Stress Management?
• Why Is It Important to Study Stress Management?
• What Are the Objectives of Stress Management?
• What Is the Most Effective Stress Management Strategy?
• How Can Effective Stress Management Help to Develop Healthy Responses to Given Tasks?
• What Are the Stress Management Techniques and Relaxation Methods?
• What Is a Stress Management Study?
• What Are the Strategies of Stress Management?
• Why Is Stress Management Important to Health?
• What Are the Positive Methods of Stress Management?
• What Are the Sources of Stress Management?
• Why Is Stress Harmful?
• What Are the Steps for Stress Management?
• Why Is Stress Management Critical?
• What Are the 3 Stress Hormones?
• How Does Stress Affect the Brain?
• What Is the Best Definition of Stress Management?
• Chicago (A-D)
• Chicago (N-B)

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IvyPanda . "117 Stress Management Essay Topic Ideas & Examples." February 29, 2024. https://ivypanda.com/essays/topic/stress-management-essay-topics/.

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