Sandra Waeldin - Academia.edu (original) (raw)
Papers by Sandra Waeldin
Psychotherapy and Psychosomatics, Nov 27, 2015
clusion: Poststress symptoms are rather common in clinical populations, and they are primarily as... more clusion: Poststress symptoms are rather common in clinical populations, and they are primarily associated with the degree of perceived exhaustion. Preliminary evidence suggests that poststress symptoms are possibly related to depletion of norepinephrine stores, which may facilitate a stratified preventive and therapeutic treatment of these subjects.
Zeitschrift für Gesundheitspsychologie, Jun 15, 2015
Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Er... more Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Erschöpfungsqualität ein verlässlicher Indikator für stressbezogene Gesundheitsstörungen und den daraus resultierenden direkten, indirekten und intangiblen Gesundheitskosten ist. Zur Anwendung kam eine Erschöpfungsskala (Neuropattern-Questionnaire, NPQ-S), deren Cut-off-Werte und Reliabilität anhand einer bevölkerungsrepräsentativen Stichprobe (N = 998) ermittelt wurden. Die Validität wurde bei ambulanten Patienten (N = 455) über Angaben zu psychischen Erkrankungen, gesundheitsbezogenen Kosten und strukturierten Anamnesen sowie einer berufshomogene Stichprobe mit stressbezogenen Beschwerden (N = 69) über Angaben zu Burnout und Gratifikationskrisen untersucht. Die Reliabilität und Validität der Erschöpfungsqualität konnten als gut bis sehr gut eingestuft werden. Die Ergebnisse zeigten, dass ein erhöhtes Ausmaß an Erschöpfung mit erhöhter Stressbelastung, einer erhöhten Chance für verschiedene psychische Erkrankungen sowie erhöhten Kosten (reduziertes Wohlbefinden, häufigere Therapeuten- und Arztbesuche, erhöhter Medikamentenkonsum, mehr Arbeitsunfähigkeitstage) einhergeht. Die Erschöpfungsqualität zeigt sich als störungsübergreifender Indikator und kann als ökonomisches Indikations- und Evaluationsmaß für gesundheitsförderliche Maßnahmen dienen.
Journal of Psychiatric Research, 2016
Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative he... more Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative health outcomes during adult life. However, it is unclear, if these factors independently predict mental health in adulthood. We estimated potential associations between reports of pre-, peri-, and postnatal stress and depression severity in outpatients (N=473) diagnosed with depression, anxiety or somatoform disorders by their family physician. We retrospectively assessed pre-, peri-, and postnatal stress and measured depression severity as well as recent life stress using questionnaires. First, we estimated if depression severity was predicted by pre-, peri-and/or postnatal stress using multiple regression models. Second, we compared preand postnatal stress levels between patient subgroups of different degrees of depression severity performing multilevel linear modeling. Third, we analyzed if an association between postnatal stress and current depression severity was mediated by recent life stress. We found no associations of pre-, or perinatal stress with depression severity (all p > 0.05). Higher postnatal stress was associated with higher depression severity (p < 0.001). Patients with moderately severe and severe depression reported higher levels of postnatal stress as compared to patients with none to minimal, or mild depression (all p < 0.05). Mediation analysis revealed a significant indirect effect via recent life stress of the association between postnatal stress and depression severity (p < 0.001). In patients diagnosed for depression, anxiety, and/or somatoform disorders, postnatal but neither pre-nor perinatal stress predicted depression severity in adult life. This association was mediated by recent life stress.
Psychotherapy and psychosomatics, Jan 27, 2015
Poststress symptoms occur as a consequence of stress, most commonly during leisure periods such a... more Poststress symptoms occur as a consequence of stress, most commonly during leisure periods such as weekends and vacations. However, the prevalence and the pathological mechanisms of poststress symptoms are poorly understood. Here, we compared the frequency of poststress symptoms in healthy controls (n = 984), outpatients (n = 420), and inpatients (n = 101). In outpatients, demographic factors, psychosocial stress, and perceived exhaustion were tested as predictors of poststress symptoms with multivariate regression analysis. Poststress symptoms and perceived exhaustion were assessed using 2 Neuropattern Questionnaires (the NPQ - Patient Questionnaire and the NPQ - Symptom List), and psychosocial stress was evaluated using the Patient Health Questionnaire (PHQ). Poststress symptoms appeared in 2.9% of healthy controls, 20.0% of outpatients, and 34.7% of inpatients. Predictors were educational level, psychosocial stress, and perceived exhaustion. Poststress symptoms differed primarily...
European Journal of Psychotraumatology, 2012
ABSTRACT Rationale/ statement of the problem: The low-dose dexamethasone-suppression test (DST) h... more ABSTRACT Rationale/ statement of the problem: The low-dose dexamethasone-suppression test (DST) has originally been introduced by Yehuda et al. Method: We here report data on the salivary cortisol responses to awakening (CAR) to the DST in healthy subjects (N102), as well as in outpatients (N92) and inpatients (N99) with stress related disorders. Patient groupswere matched for age and sex by propensity score matching. Stress pathology was assessed by the Patient Health Questionnaire (PHQ). Results: We observed stepwise highly significant differences among these three populations with respect to both supersuppression (B2 nmol/l) and escape (6 nmol/l) of cortisol levels. Amazingly, a supersuppression was most frequently observed in healthy subjects, while an escape was most prevalent in inpatients, less common in outpatients, and rare in healthy subjects. While none of the healthy subjects got a PHQ diagnosis, inpatients and outpatients showed an average of 1.8 and 1.9 diagnoses, respectively, but did not differ with respect to the type and degree of stress pathology. Thus, the DST may rather be considered an unspecific test of dysregulations of the pituitary-adrenal axis. Conclusion: Many research studies observed a supersuppression of cortisol levels in hypocortisolemic subjects with stress related disorders, such as post traumatic stress disorder (PTSD), fibromyalgia, chronic pelvic pain. These subjects commonly express symptoms of fatigue, pain, and an enhanced stress sensitivity, but seem to be protected against deleterious effects of cortisol on organ functions. Such a protective effect may possibly explain our observation that hypocortisolemia and supersuppression are less common in inpatients and outpatients. However, the increasing number of escapes from healthy subjects to outpatients and inpatients was not unexpected. We discuss these findings by applying an additional analysis of endophenotypes.
Zeitschrift für Gesundheitspsychologie, 2015
Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Er... more Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Erschöpfungsqualität ein verlässlicher Indikator für stressbezogene Gesundheitsstörungen und den daraus resultierenden direkten, indirekten und intangiblen Gesundheitskosten ist. Zur Anwendung kam eine Erschöpfungsskala (Neuropattern-Questionnaire, NPQ-S), deren Cut-off-Werte und Reliabilität anhand einer bevölkerungsrepräsentativen Stichprobe (N = 998) ermittelt wurden. Die Validität wurde bei ambulanten Patienten (N = 455) über Angaben zu psychischen Erkrankungen, gesundheitsbezogenen Kosten und strukturierten Anamnesen sowie einer berufshomogene Stichprobe mit stressbezogenen Beschwerden (N = 69) über Angaben zu Burnout und Gratifikationskrisen untersucht. Die Reliabilität und Validität der Erschöpfungsqualität konnten als gut bis sehr gut eingestuft werden. Die Ergebnisse zeigten, dass ein erhöhtes Ausmaß an Erschöpfung mit erhöhter Stressbelastung, einer erhöhten Chance für verschiede...
Mental Health & Prevention, 2018
Stress is considered to impair health and to be a burden for the individual and the health system... more Stress is considered to impair health and to be a burden for the individual and the health system. Here, we compared the influence of psychosocial stress and perceived exhaustion as predictors for the development of stress related disorders. Methods: Outpatients took part in a clinical trial with Neuropattern, a diagnostic tool to detect stress pathology (Hellhammer, D. H., Hero, T., Gerhards, F., & Hellhammer, J., 2012). The patients answered questions about perceived exhaustion, mental health, psychosocial stress, and demographic variables at their first visit. Further, they answered questions about their health status at five different time points (baseline and 3, 6, 9, and 12 months later). Associations between psychosocial stress, perceived exhaustion, and health status were analyzed at these five time points with mixed models. Furthermore, we explored the potential role of perceived exhaustion as a mediator for the association between psychosocial stress and health status. Results: Both perceived exhaustion and psychosocial stress predicted the development of a poorer health status. Statistical analyses showed the association between psychosocial stress and health status to be mediated by perceived exhaustion. Conclusion: Our findings highlight the importance of perceived exhaustion as a relevant and easy measure to predict the development of impaired health in stress-related disorders.
Psychotherapy and Psychosomatics, Nov 27, 2015
clusion: Poststress symptoms are rather common in clinical populations, and they are primarily as... more clusion: Poststress symptoms are rather common in clinical populations, and they are primarily associated with the degree of perceived exhaustion. Preliminary evidence suggests that poststress symptoms are possibly related to depletion of norepinephrine stores, which may facilitate a stratified preventive and therapeutic treatment of these subjects.
Zeitschrift für Gesundheitspsychologie, Jun 15, 2015
Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Er... more Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Erschöpfungsqualität ein verlässlicher Indikator für stressbezogene Gesundheitsstörungen und den daraus resultierenden direkten, indirekten und intangiblen Gesundheitskosten ist. Zur Anwendung kam eine Erschöpfungsskala (Neuropattern-Questionnaire, NPQ-S), deren Cut-off-Werte und Reliabilität anhand einer bevölkerungsrepräsentativen Stichprobe (N = 998) ermittelt wurden. Die Validität wurde bei ambulanten Patienten (N = 455) über Angaben zu psychischen Erkrankungen, gesundheitsbezogenen Kosten und strukturierten Anamnesen sowie einer berufshomogene Stichprobe mit stressbezogenen Beschwerden (N = 69) über Angaben zu Burnout und Gratifikationskrisen untersucht. Die Reliabilität und Validität der Erschöpfungsqualität konnten als gut bis sehr gut eingestuft werden. Die Ergebnisse zeigten, dass ein erhöhtes Ausmaß an Erschöpfung mit erhöhter Stressbelastung, einer erhöhten Chance für verschiedene psychische Erkrankungen sowie erhöhten Kosten (reduziertes Wohlbefinden, häufigere Therapeuten- und Arztbesuche, erhöhter Medikamentenkonsum, mehr Arbeitsunfähigkeitstage) einhergeht. Die Erschöpfungsqualität zeigt sich als störungsübergreifender Indikator und kann als ökonomisches Indikations- und Evaluationsmaß für gesundheitsförderliche Maßnahmen dienen.
Journal of Psychiatric Research, 2016
Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative he... more Pre-, peri-, and postnatal stress have frequently been reported to be associated with negative health outcomes during adult life. However, it is unclear, if these factors independently predict mental health in adulthood. We estimated potential associations between reports of pre-, peri-, and postnatal stress and depression severity in outpatients (N=473) diagnosed with depression, anxiety or somatoform disorders by their family physician. We retrospectively assessed pre-, peri-, and postnatal stress and measured depression severity as well as recent life stress using questionnaires. First, we estimated if depression severity was predicted by pre-, peri-and/or postnatal stress using multiple regression models. Second, we compared preand postnatal stress levels between patient subgroups of different degrees of depression severity performing multilevel linear modeling. Third, we analyzed if an association between postnatal stress and current depression severity was mediated by recent life stress. We found no associations of pre-, or perinatal stress with depression severity (all p > 0.05). Higher postnatal stress was associated with higher depression severity (p < 0.001). Patients with moderately severe and severe depression reported higher levels of postnatal stress as compared to patients with none to minimal, or mild depression (all p < 0.05). Mediation analysis revealed a significant indirect effect via recent life stress of the association between postnatal stress and depression severity (p < 0.001). In patients diagnosed for depression, anxiety, and/or somatoform disorders, postnatal but neither pre-nor perinatal stress predicted depression severity in adult life. This association was mediated by recent life stress.
Psychotherapy and psychosomatics, Jan 27, 2015
Poststress symptoms occur as a consequence of stress, most commonly during leisure periods such a... more Poststress symptoms occur as a consequence of stress, most commonly during leisure periods such as weekends and vacations. However, the prevalence and the pathological mechanisms of poststress symptoms are poorly understood. Here, we compared the frequency of poststress symptoms in healthy controls (n = 984), outpatients (n = 420), and inpatients (n = 101). In outpatients, demographic factors, psychosocial stress, and perceived exhaustion were tested as predictors of poststress symptoms with multivariate regression analysis. Poststress symptoms and perceived exhaustion were assessed using 2 Neuropattern Questionnaires (the NPQ - Patient Questionnaire and the NPQ - Symptom List), and psychosocial stress was evaluated using the Patient Health Questionnaire (PHQ). Poststress symptoms appeared in 2.9% of healthy controls, 20.0% of outpatients, and 34.7% of inpatients. Predictors were educational level, psychosocial stress, and perceived exhaustion. Poststress symptoms differed primarily...
European Journal of Psychotraumatology, 2012
ABSTRACT Rationale/ statement of the problem: The low-dose dexamethasone-suppression test (DST) h... more ABSTRACT Rationale/ statement of the problem: The low-dose dexamethasone-suppression test (DST) has originally been introduced by Yehuda et al. Method: We here report data on the salivary cortisol responses to awakening (CAR) to the DST in healthy subjects (N102), as well as in outpatients (N92) and inpatients (N99) with stress related disorders. Patient groupswere matched for age and sex by propensity score matching. Stress pathology was assessed by the Patient Health Questionnaire (PHQ). Results: We observed stepwise highly significant differences among these three populations with respect to both supersuppression (B2 nmol/l) and escape (6 nmol/l) of cortisol levels. Amazingly, a supersuppression was most frequently observed in healthy subjects, while an escape was most prevalent in inpatients, less common in outpatients, and rare in healthy subjects. While none of the healthy subjects got a PHQ diagnosis, inpatients and outpatients showed an average of 1.8 and 1.9 diagnoses, respectively, but did not differ with respect to the type and degree of stress pathology. Thus, the DST may rather be considered an unspecific test of dysregulations of the pituitary-adrenal axis. Conclusion: Many research studies observed a supersuppression of cortisol levels in hypocortisolemic subjects with stress related disorders, such as post traumatic stress disorder (PTSD), fibromyalgia, chronic pelvic pain. These subjects commonly express symptoms of fatigue, pain, and an enhanced stress sensitivity, but seem to be protected against deleterious effects of cortisol on organ functions. Such a protective effect may possibly explain our observation that hypocortisolemia and supersuppression are less common in inpatients and outpatients. However, the increasing number of escapes from healthy subjects to outpatients and inpatients was not unexpected. We discuss these findings by applying an additional analysis of endophenotypes.
Zeitschrift für Gesundheitspsychologie, 2015
Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Er... more Erschöpfung kennzeichnet zahlreiche psychische Störungen. Wir haben geprüft, ob die subjektive Erschöpfungsqualität ein verlässlicher Indikator für stressbezogene Gesundheitsstörungen und den daraus resultierenden direkten, indirekten und intangiblen Gesundheitskosten ist. Zur Anwendung kam eine Erschöpfungsskala (Neuropattern-Questionnaire, NPQ-S), deren Cut-off-Werte und Reliabilität anhand einer bevölkerungsrepräsentativen Stichprobe (N = 998) ermittelt wurden. Die Validität wurde bei ambulanten Patienten (N = 455) über Angaben zu psychischen Erkrankungen, gesundheitsbezogenen Kosten und strukturierten Anamnesen sowie einer berufshomogene Stichprobe mit stressbezogenen Beschwerden (N = 69) über Angaben zu Burnout und Gratifikationskrisen untersucht. Die Reliabilität und Validität der Erschöpfungsqualität konnten als gut bis sehr gut eingestuft werden. Die Ergebnisse zeigten, dass ein erhöhtes Ausmaß an Erschöpfung mit erhöhter Stressbelastung, einer erhöhten Chance für verschiede...
Mental Health & Prevention, 2018
Stress is considered to impair health and to be a burden for the individual and the health system... more Stress is considered to impair health and to be a burden for the individual and the health system. Here, we compared the influence of psychosocial stress and perceived exhaustion as predictors for the development of stress related disorders. Methods: Outpatients took part in a clinical trial with Neuropattern, a diagnostic tool to detect stress pathology (Hellhammer, D. H., Hero, T., Gerhards, F., & Hellhammer, J., 2012). The patients answered questions about perceived exhaustion, mental health, psychosocial stress, and demographic variables at their first visit. Further, they answered questions about their health status at five different time points (baseline and 3, 6, 9, and 12 months later). Associations between psychosocial stress, perceived exhaustion, and health status were analyzed at these five time points with mixed models. Furthermore, we explored the potential role of perceived exhaustion as a mediator for the association between psychosocial stress and health status. Results: Both perceived exhaustion and psychosocial stress predicted the development of a poorer health status. Statistical analyses showed the association between psychosocial stress and health status to be mediated by perceived exhaustion. Conclusion: Our findings highlight the importance of perceived exhaustion as a relevant and easy measure to predict the development of impaired health in stress-related disorders.