Chronic Stress最新文献

{"title":"Behavioral Academic Avoidance as an Indirect Partial Mediator of the Association Between Chronic Family Stress and University Grades.","authors":"Anne Fletcher, Xiaochen Xie, Michaeline Jensen, Suzanne Vrshek-Schallhorn","doi":"10.1177/24705470261426467","DOIUrl":"https://doi.org/10.1177/24705470261426467","url":null,"abstract":"<p><strong>Background: </strong>American university students who self-report higher levels of family stress have lower grade point averages and are less likely to remain enrolled through graduation. Existing research seeking to identify mechanisms that might explain this association has focused primarily on students' psychological adjustment (eg, levels of depression, anxiety, self-efficacy). In this study, we sought to explicate the family stress - academic grade association by focusing on a behavioral explanation, considering the extent to which students respond to academic difficulties by demonstrating avoidance behaviors specific to their academic experiences.</p><p><strong>Methods: </strong>Undergraduate students (<i>N</i> = 597) completed self-report surveys during Fall 2021: a measure of chronic family stress at the start of the semester, a measure of behavioral academic avoidance mid-semester. Students provided consent for researchers to access their official grade point averages (GPAs) from the university. Model fit and mediation were tested using structural equation modeling with bias-corrected bootstrapping.</p><p><strong>Results: </strong>An indirect-only mediation effect was present whereby higher levels of chronic family stress at the start of the academic semester predicted higher levels of behavioral academic avoidance midterm which then predicted lower cumulative GPA.</p><p><strong>Conclusion: </strong>Students who experience higher levels of family stress may struggle to engage in the behaviors that support their academic success: attending class, completing assignments, and maintaining communication with instructors. Effective support of student success in the postsecondary environment requires not only encouraging these behaviors but also helping students to successfully manage the stress they experience within their family environments.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"10 ","pages":"24705470261426467"},"PeriodicalIF":0.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12929879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Trajectories of Post-Traumatic Stress Among Ukrainian Refugees: A Cohort Study.","authors":"Liudmyla Krupelnytska, Nazar Yatsenko, Olha Morozova-Larina","doi":"10.1177/24705470261422385","DOIUrl":"10.1177/24705470261422385","url":null,"abstract":"<p><strong>Background: </strong>Displacement caused by the Russian invasion of Ukraine has subjected millions of Ukrainians to forced displacement, migration, exposing them not only to direct war-related trauma but also to substantial post-displacement stress. Refugees face disrupted employment, residential instability, and ongoing uncertainty in host countries. While prevalence of stress-related disorders is well established, less is known about how war-related stress and life satisfaction evolve over time in this population.</p><p><strong>Methods: </strong>A longitudinal cohort study was conducted among Ukrainian refugees in Germany. The analytic sample comprised 164 participants who completed at least two of five survey waves over a six-month period (September 2022-March 2023). Post-traumatic stress symptoms were assessed with the <i>Posttraumatic Symptom Scale</i> at each wave and validated against the <i>Impact of Event Scale - Revised</i> at baseline and follow-up. Life satisfaction was assessed with the <i>Satisfaction With Life Scale</i>. Distinct adjustment patterns were identified through group-based multi-trajectory modelling. Descriptive statistics, group comparisons, and linear mixed-effects modelling were additionally used to contextualize data.</p><p><strong>Results: </strong>Multi-trajectory analysis yielded four main groups: persistently high stress with poor satisfaction with life; broadly diverse, but stable profiles; stress reduction without parallel gains in life satisfaction; and combined stress reduction with later improvements in life satisfaction. More favourable courses were associated with younger age, higher education, urban residence, and prior public-sector employment. Across the full sample, post-traumatic stress symptoms declined sharply over time, with the proportion meeting the cutoff for probable PTSD decreasing, whereas mean life satisfaction remained low and showed no systematic change.</p><p><strong>Conclusion: </strong>Adjustment following war-related displacement is highly heterogeneous. Although acute symptoms of traumatic stress tended to subside, life satisfaction showed little recovery, underscoring a divergence between symptom relief and overall well-being. Patterns of adaptation were shaped not only by individual resources but also by structural constraints such as job loss and residential downgrading. Interventions for displaced populations should therefore address both clinical needs and socioeconomic integration to enable sustainable recovery of refugees.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"10 ","pages":"24705470261422385"},"PeriodicalIF":0.0,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Passive Heat Stress Affects Decision-Making, but not Situational Awareness and Executive Functioning in Virtual Simulations in Military Personnel.","authors":"Frank P M Schilder, Antoin D de Weijer, Bastiaan Bruinsma, Elbert Geuze","doi":"10.1177/24705470261416768","DOIUrl":"10.1177/24705470261416768","url":null,"abstract":"<p><p>Decision-making in military occupations is vital for operational success and personnel safety and relies on situational awareness, executive control, and strategic alignment of operational goals. This study examined the effects of acute operational and passive heat stress on cognitive performance in a randomized controlled trial with 68 service members. Participants were assigned to either a low- or high-stress group and completed two military scenarios using a desktop simulator. Passive heat stress was applied only to the high-stress group in a portable environmental facility. Decision-making and situational awareness were scored from scenario recordings, while executive functioning was assessed through a cognitive test battery. In addition to the group comparison, a heat index capturing individual variability in thermal strain was calculated. Contrary to expectations, heat stress did not impair cognitive performance across most domains. Decision-making performance actually improved over time in the high-stress group, with significantly better performance during the second assessment compared to the low-stress group. Cognitive flexibility also improved significantly within both groups. These changes are attributed primarily to learning effects rather than stress-induced performance. Situational awareness showed no significant differences between groups. Exploratory heat index analyses revealed that participants in the high heat index group exhibited increased situational awareness over time, suggesting a possible inverted U-shaped relationship between thermal strain and performance. In contrast, inhibition improved only in the low heat index group. Together, these findings emphasize that the heat stress protocol may not have been potent enough to generate the cortisol response needed to detrimentally affect higher-order cognition. Nevertheless, the findings highlight that thermal strain can interact with cognitive performance in complex, nonlinear ways. While passive heat stress remains a promising stressor for research, its effect may only become fully apparent under more intense or physiologically demanding conditions, warranting further investigation into its potential impact on higher-order cognitive functions in military contexts.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"10 ","pages":"24705470261416768"},"PeriodicalIF":0.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12864672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Efficacy as the Key Mechanism in Student Help-Seeking: A Commentary on Patricio et al (2025).","authors":"Triyono Triyono, Rahma Wira Nita, Septya Suarja, Puji Gusri Handayani, Rahmi Dwi Feberiani, Hafiz Hidayat","doi":"10.1177/24705470261416642","DOIUrl":"10.1177/24705470261416642","url":null,"abstract":"<p><p>This commentary highlights the significance of Patricio et al.'s (2025) findings on the mediating role of self-efficacy in the relationship between shyness and help-seeking among Filipino college students. The study challenges assumptions that shyness directly hinders help-seeking and emphasizes the cultural influence of hiya. Notably, self-efficacy mediates help-seeking for suicidal ideation, underscoring its importance in high-risk situations and its relevance for suicide-prevention initiatives in higher education. We further discuss the roles of stigma, social support, and cultural expectations, as well as the need for gender-sensitive research. The commentary advocates culturally grounded interventions to strengthen student mental-health help-seeking.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"10 ","pages":"24705470261416642"},"PeriodicalIF":0.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12819965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prior History of Traumatic Stress on Autonomic and Multi-System Symptoms Following COVID-19 Infection.","authors":"Rebecca C Hendrickson, Christine S Cheah, Marlene L Tai, Kathleen F Pagulayan, Katharine J Liang, Catherine A McCall, Abigail G Schindler, Kimberly L Hart, Aaron F Rosser, John C Oakley","doi":"10.1177/24705470251407210","DOIUrl":"10.1177/24705470251407210","url":null,"abstract":"<p><strong>Background: </strong>Persistent symptoms of autonomic dysregulation are common after COVID-19 infection and may result from alterations in central and/or peripheral autonomic regulatory processes. Traumatic stress can cause persistent alterations in autonomic function, potentially changing the response to future traumatic or physiologic stressors. However, the relationship between prior history of traumatic stress and autonomic symptom burden after COVID-19 infection has not been explored.</p><p><strong>Objectives: </strong>Examine the potential for additive and/or interactive effects of traumatic stress and COVID-19 infection on autonomic symptom burden, and compare this with other common post-acute sequelae of COVID-19 (PASC) symptom domains.</p><p><strong>Design: </strong>Observational, self-report, single time-point online assessment.</p><p><strong>Participants: </strong>404 United States adults with (N = 289) and without (N = 112) a self-reported history of COVID-19 infection.</p><p><strong>Main outcomes and measures: </strong>Autonomic symptom burden (Composite Autonomic Symptom Score [COMPASS 31]), lifetime traumatic stressors (Life Events Checklist), posttraumatic stress disorder (PTSD Checklist-5), self-reported neurocognitive functioning (Neuro-QoL), insomnia (Insomnia Severity Index), and fatigue and pain (PROMIS Fatigue and Pain Interference measures).</p><p><strong>Results: </strong>Autonomic symptom burden was significantly and positively related to both history of COVID-19 infection and number of probable lifetime traumatic stressors, with probable lifetime traumatic stressors functioning as a positive moderator of the relationship between history of COVID-19 infection and autonomic symptom burden (Cohen's partial f²= .11, .07 and .02 for COVID history, trauma history and interaction term respectively, all <i>p</i> < .05, in a model also including age and gender). The moderation effect remained significant when adjusting for both current PTSD symptoms and pre-existing multi-system PASC-like symptoms prior to COVID-19. History of traumatic stress and of COVID-19 infection each had significant and positive associations with other PASC symptom domains, but with domain-specific patterns.</p><p><strong>Conclusions and relevance: </strong>Prior history of traumatic stress has a positive and interactive effect on symptoms of autonomic dysregulation following COVID-19 infection, independent of PTSD symptoms. This suggests that exposure to traumatic stress may affect the response to future stressors, including physiologic stressors such as COVID-19 infection, through persistent changes in stress-threat response systems. This relationship may provide a physiologic explanation for prior observations that baseline anxiety prior to COVID-19 infection is associated with increased likelihood of PASC.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251407210"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Mediating Role of Self-Efficacy in the Relationship Between Shyness and Help-Seeking Behavior among College Students.","authors":"Lennon Andre Patricio, Christian Jasper Nicomedes, Jhaven Mañas, Jeremy Dela Torre, Ryan Francis O Cayubit","doi":"10.1177/24705470251383469","DOIUrl":"10.1177/24705470251383469","url":null,"abstract":"<p><p>This study explored the mediating role of self-efficacy in the relationship between shyness and help-seeking behavior among Filipino college students. With mental health concerns rising in the Philippines, help-seeking behaviors are crucial in addressing issues like emotional distress, and suicidal ideation. A sample of 440 college students aged 18-30 from Metro Manila were surveyed to determine whether self-efficacy affects the likelihood of seeking help for personal/emotional problems and suicidal ideation. Three validated instruments- the McCroskey Shyness Scale, the General Help-Seeking Questionnaire, and the General Self-Efficacy Scale- were used through an online survey. The results indicated that self-efficacy was found to be an indirect pathway linking shyness and help-seeking behavior for suicidal ideation but did not have the same effect for personal/emotional problems. Also, shyness alone did not significantly predict help-seeking behavior for either problem. Furthermore, moderated mediation analyses showed that these pathways did not significantly differ by sex, although conditional effects suggested that mediating role of self-efficacy may be more pronounced among females. Our findings suggest that enhancing college students' self-efficacy may improve help-seeking behaviors, particularly in serious mental health situations like suicidal ideation, and highlight the need for interventions addressing cultural and psychological barriers to help-seeking. Given the cross-sectional design of this study, the observed associations should not be interpreted as causal relationships.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251383469"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repurposing Existing Drugs for the Treatment of Post-Traumatic Stress Disorder.","authors":"Olha Strilbytska, Oleh Lushchak","doi":"10.1177/24705470251392481","DOIUrl":"10.1177/24705470251392481","url":null,"abstract":"<p><p>Chronic stress and traumatic events affect the psychological and physiological state of a person. Post-traumatic stress disorder (PTSD) is a type of psychological stress that occurs in critical situations that pose a direct threat to the life of the person and/or his or her loved ones. The prevalence of PTSD is increasing every year due to growing exposure to traumatic factors such as wars, natural disasters, and other crises. These events lead to severe psychological consequences, affecting a rising number of people worldwide. Currently, PTSD can be challenging to treat due to the complex nature of the disorder, variability in individual responses to treatment, and limitations in available therapeutic options. Considering the emergency need for effective PTSD treatment, a drug repurposing strategy presents a promising avenue to accelerate the availability of therapies. Here, we summarized and described drugs that were repurposed for alleviating PTSD symptoms. Moreover, we discussed the potential of some drugs, including alpha-adrenergic modulators, cannabinoids, glutamatergic modulators, and antipsychotics, for being repurposed for PTSD treatment. Drug repurposing implies the rapid identification of compounds with an established safety profile and known therapeutic effects that may be effective in PTSD. Repurposing existing drugs with already established pharmacokinetics and pharmacodynamics may shorten development timelines, facilitate a direct transition to the second phase of clinical trials, and lower costs. However, potential drawbacks and negative aspects should be discussed comprehensively.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251392481"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12559684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glutamine Metabolite Ratios are Related to Thwarted Belongingness and Perceived Burdensomeness: Preliminary Evidence from a Veteran Sample with and Without History of Suicidal Ideation.","authors":"James R Yancey, Punitha Subramaniam, Jiyoung Ma, Chelsea N Carson, Keenan E Roberts, Erin C McGlade, Perry F Renshaw, Deborah A Yurgelun-Todd","doi":"10.1177/24705470251385745","DOIUrl":"10.1177/24705470251385745","url":null,"abstract":"<p><strong>Background: </strong>Suicidal thoughts and behaviors are an acute public health issue, particularly among US Veterans. The interpersonal-psychological theory of suicide posits that unmet interpersonal needs, specifically thwarted belongingness (TB) and perceived burdensomeness (PB) contribute to desire for death by suicide and increased suicidal ideation (SI). However, little is known about the neurochemical correlates of TB and PB. Prior research using proton magnetic resonance spectroscopy (1H-MRS) has implicated glutamate (Glu) and glutamine (Gln), as well as gamma-aminobutyric acid (GABA), in SI and related psychiatric disorders. The current study sought to examine the relationship between thwarted belongingness and perceived burdensomeness and concentrations of Gln, Glu, and GABA in US Veterans with and without a history of SI.</p><p><strong>Methods: </strong>In this preliminary exploratory study, 25 US Veterans underwent a two-dimensional J-resolved 1H-MRS exam to measure in vivo concentrations of Gln, Glu, and GABA in the anterior cingulate cortex. Veterans also completed the Columbia Suicide Severity Rating Scale to characterize lifetime history of suicidal thoughts and behaviors and the Interpersonal Needs Questionnaire to measure TB and PB.</p><p><strong>Results: </strong>Reduced Gln/water was associated with increased TB and PB scores. Reduced Gln/Glu was associated with increased TB scores. Veterans with a lifetime history of SI also exhibited reduced Gln/water and Gln/Glu. Follow-up regression models showed that neither TB, PB, nor SI history were uniquely associated with Gln, but TB was uniquely associated with Gln/Glu.</p><p><strong>Conclusion: </strong>Results provide preliminary evidence that TB and PB may be linked to abnormalities in Gln. This work further integrates biological and psychosocial perspectives on SI.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251385745"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Intravenous Injection of Reelin Rescues Endogenous Reelin Expression and Epithelial Cell Apoptosis in the Small Intestine Following Chronic Stress.","authors":"Ciara S Halvorson, Carla Liria Sánchez-Lafuente, Brady S Reive, Lara S Solomons, Josh Allen, Lisa E Kalynchuk, Hector J Caruncho","doi":"10.1177/24705470251381456","DOIUrl":"10.1177/24705470251381456","url":null,"abstract":"<p><p>Chronic stress disrupts the integrity of the gut environment, including leaking of the intestinal epithelium. Reelin, an extracellular matrix protein, is released from cells of the <i>lamina propria</i> and promotes epithelial cell proliferation and migration up the crypt-villus axis to facilitate renewal of the gut lining. In the present study, we evaluated Reelin expression and apoptosis in the small intestine of Long Evan's rats treated with recombinant Reelin (3 µg) or vehicle following 3 weeks of daily corticosterone (40 mg/kg/day) or vehicle injections. We show that Reelin- and cleaved caspase-3- immunoreactive cells are diminished in the <i>lamina propria</i> or epithelial cells of the gut lining following chronic stress (∼ 50% and 55%, respectively), and that a single injection of 3 µg of Reelin delivered intravenously can reverse these parameters. We also found Reelin cell counts in the small intestine did not correlate to counts in the hippocampus regardless of exposure to chronic stress or Reelin treatment. Our results suggest that Reelin may serve a protective function over gut barrier integrity through the restoration of epithelial cell turnover, and that Reelin may have a role in reversing chronic stress-induced changes to the gut environment.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251381456"},"PeriodicalIF":0.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12480799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do People Seeking Care for Musculoskeletal Symptoms Experience Greater Agency and Better Experience Based on Written Information About Their Illness?","authors":"Emily H Jaarsma, Ali Azarpey, Drew Aronoff, David Ring, Amin Razi","doi":"10.1177/24705470251382668","DOIUrl":"10.1177/24705470251382668","url":null,"abstract":"<p><strong>Objectives: </strong>Current patient-facing health information may unintentionally reinforce unhelpful and less adaptive mindsets regarding musculoskeletal symptoms. This prospective randomized trial evaluated the impact of psychologically-informed educational material, explicitly designed to promote healthier interpretations of bodily sensations according to cognitive science principles, on patient experience when compared to standard professional society materials.</p><p><strong>Methods: </strong>In this trial, 133 adults presenting to an upper extremity specialist with one of eight common non-traumatic musculoskeletal conditions were randomly assigned to review health information produced by either: 1) a professional musculoskeletal society or 2) revised material created by the authors and psychologist collaborators. Participants completed surveys containing validated measures assessing personal health agency (PAM-13), perceived clinician empathy (JSPPPE) and emotional response to the material.</p><p><strong>Results: </strong>There were no significant differences based on the type of material reviewed. However, on multivariable analysis, participants diagnosed with rotator cuff tendinopathy, ganglion cyst, or carpal and cubital tunnel syndrome reported more negative emotional responses compared to those with lateral epicondylitis, regardless of the type of written material reviewed.</p><p><strong>Conclusions: </strong>Cognitively-informed musculoskeletal health information was acceptable to patients but did not yield measurable improvements in emotional response, agency, or perceived empathy when compared to standard material. During the visit, diagnosis-specific factors may influence patient reactions more than information framing.</p><p><strong>Practice implications: </strong>Patients find clear, accessible material designed to cultivate the healthiest possible interpretation of bodily sensations acceptable and non-distressing. Future interventions should explore diagnosis-specific tailoring of information or repeated exposure to impact outcomes.</p><p><strong>Level of evidence: </strong>II.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":"9 ","pages":"24705470251382668"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}