Stress arousal reappraisal and worked example effects on the neuroendocrine stress response during breaking bad news in medical education
- Autor(en)
- Michel Bosshard, Urs Markus Nater, Sissel Guttormsen, Felix Schmitz, Patrick Gomez, Christoph Berendonk
- Abstrakt
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.
- Organisation(en)
- Institut für Klinische und Gesundheitspsychologie
- Externe Organisation(en)
- Universität Bern, Université de Lausanne, Research Platform “The Stress of Life (SOLE) - Processes and Mechanisms underlying Everyday Life Stress”
- Journal
- Psychoneuroendocrinology
- Band
- 176
- ISSN
- 0306-4530
- DOI
- https://doi.org/10.1016/j.psyneuen.2025.107439
- Publikationsdatum
- 06-2025
- Peer-reviewed
- Ja
- ÖFOS 2012
- 305909 Stressforschung, 501010 Klinische Psychologie
- Schlagwörter
- ASJC Scopus Sachgebiete
- Endocrinology, Diabetes and Metabolism, Endocrinology, Endocrine and Autonomic Systems, Psychiatry and Mental health, Biological Psychiatry
- Sustainable Development Goals
- SDG 3 – Gesundheit und Wohlergehen
- Link zum Portal
- https://ucrisportal.univie.ac.at/de/publications/f68a13ef-2b25-46e9-afc2-d52ae166328a