Auer, Alisa

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Beneficial effects of a cognitive-behaviorally-based occupational stress management training : the mediating role of changing cognitions

2023, Wirtz, Petra H., Auer, Alisa, Semmer, Norbert K., Ehlert, Ulrike, Nussbeck, Fridtjof W.

Introduction: While the effectiveness of cognitive-behavioral stress management trainings (SMT) is well documented, the underlying mechanisms, especially in an occupational context, are not fully understood. We tested whether SMT-induced improvements in stress management skills, in particular in mastery of changing cognitions, may explain beneficial SMT effects. Methods: Our non-randomized controlled trial comprised 108 employees of a German health insurance company with 65 participating in a cognitive-behavioral SMT and 43 participating in an alternative control training (AT). As outcome variables we repeatedly assessed stress-related (functional stress management skills, relaxation, stress reactivity, exhaustion), work-related (job dissatisfaction), and specific-context-related (social support, trait anger) measures at baseline, two weeks, and three months after the trainings. Functional stress management skills and in particular a subscale assessing perceived mastery of changing cognitions (“cognitive-strategies-and-problem-solving”) were tested as mediators of change. Results: Repeated measures (M)AN(C)OVAs and complementary multigroup latent difference models confirmed improvements in all outcomes in the SMT-group compared to the AT-group (p`s≤.015). Multivariate mediation path analyses revealed that regarding mechanisms of change, the subscale cognitive-strategies-and-problem-solving was identified as the most important mediator for all outcomes (95%CIs for expected increases in SMT- vs. AT-group=[lower limits(LLs)≥.004]; 95%CIs for expected decreases in SMT- vs. AT-group=[upper limits(ULs)≤-.078]) except for job dissatisfaction. Discussion: Our findings confirm that employees can effectively learn to master stress reduction techniques and consequently lower resulting burden. Moreover, beneficial SMT effects seem to result from improvements in functional stress management skills, particularly in the ability of changing cognitions. This points to the importance of training cognitive techniques.

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Do Hypertensive Men Spy With an Angry Little Eye? : Anger Recognition in Men With Essential Hypertension - Cross-sectional and Prospective Findings

2022-08-30, Auer, Alisa, von Känel, Roland, Lang, Ilona, Thomas, Livia, Zuccarella-Hackl, Claudia, Degroote, Cathy, Gideon, Angelina, Wiest, Roland, Wirtz, Petra H.

Higher trait anger has inconsistently been associated with hypertension and hypertension development, but social context in terms of recognition of other persons' anger has been neglected in this context.Background Higher trait anger has inconsistently been associated with hypertension and hypertension development, but social context in terms of recognition of other persons’ anger has been neglected in this context.

Here, we investigated anger recognition of facial affect and trait anger in essential hypertensive and normotensive men in addition to prospective associations with blood pressure (BP) increases.

Baseline assessment comprised a total of 145 participants including 57 essential hypertensive and 65 normotensive men who were otherwise healthy and medication-free. Seventy-two eligible participants additionally completed follow-up assessment 3.1 (±0.08 SEM) years later to analyze BP changes over time. We assessed emotion recognition of facial affect with a paradigm displaying mixed facial affect of two morphed basic emotions including anger, fear, sadness, and happiness. Trait anger was assessed with the Spielberger trait anger scale.

Cross-sectionally, we found that with increasing BP, hypertensive men overrated anger displayed in facial expressions of mixed emotions as compared to normotensive men (ps ≤ .019) while there were no differences in trait anger (p = .16). Prospectively, the interaction between mean anger recognition and trait anger independently predicted BP increases from baseline to follow-up (ps ≤ .043), in that overrating displayed anger predicted future BP increases only if trait anger was high.

Our findings indicate an anger recognition bias in men with essential hypertension and that overrating displayed anger in combination with higher trait anger seems to predict future BP increases. This might be of clinical relevance for the development and progression of hypertension and cardiovascular disease.