Stress arousal reappraisal and worked example effects on the neuroendocrine stress response during breaking bad news in medical education.
Details
Serval ID
serval:BIB_062E4C46077A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Stress arousal reappraisal and worked example effects on the neuroendocrine stress response during breaking bad news in medical education.
Journal
Psychoneuroendocrinology
ISSN
1873-3360 (Electronic)
ISSN-L
0306-4530
Publication state
Published
Issued date
06/2025
Peer-reviewed
Oui
Volume
176
Pages
107439
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Breaking bad news (BBN; i.e., the disclosure of a serious diagnosis) is a necessary but challenging task in the medical field, often raising stress levels among physicians. According to the biopsychosocial model of challenge and threat, stress responses can manifest as adaptive challenge states or maladaptive threat states. Prior research has proposed that specific patterns in neuroendocrine responses may signal challenge and threat. In this study, we employed a 2 × 2 design to examine the effects of stress arousal reappraisal (SAR; i.e., reframing bodily arousal as a functional response) and worked example (WE; i.e., stepwise demonstration of BBN) interventions on salivary cortisol, dehydroepiandrosterone, and alpha-amylase responses. A total of 229 third-year medical students participated in a BBN simulation. While significant activation (rise) and regulation (decline) of neuroendocrine markers were observed in response to the BBN encounter, neither the SAR nor the WE intervention affected their peak levels or the magnitude (area under the curve) of the response. Only the WE intervention decelerated the rise and decline in dehydroepiandrosterone levels around individual peaks, potentially indicating an attenuated stress response. These findings suggest that neither of the interventions induced the expected challenge pattern in neuroendocrine activity. However, due to the low temporal resolution of salivary measurements and the dynamic process of challenge and threat orientations, we propose that the neuroendocrine responses may have limitations in distinguishing between challenge and threat.
Keywords
Humans, Stress, Psychological/metabolism, Stress, Psychological/physiopathology, Stress, Psychological/psychology, Hydrocortisone/analysis, Hydrocortisone/metabolism, Saliva/chemistry, Male, Dehydroepiandrosterone/analysis, Dehydroepiandrosterone/metabolism, Female, Arousal/physiology, Students, Medical/psychology, Neurosecretory Systems/metabolism, Neurosecretory Systems/physiology, Adult, alpha-Amylases/analysis, alpha-Amylases/metabolism, Truth Disclosure, Young Adult, Education, Medical/methods, Breaking Bad News, Challenge and Threat, Neuroendocrine Stress Response, Simulation Training, Stress Arousal Reappraisal, Worked Example
Pubmed
Open Access
Yes
Funding(s)
Swiss National Science Foundation / Projects / 100019_200831
Create date
27/03/2025 23:46
Last modification date
16/04/2025 7:10