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Copyright (c) 2020 Paola Vernaza, Jayson Chavarria , Rosa Amalia Dueñas Cuellar , Victoria Eugenia Niño , Gloria Inés Ávila González Ávila González , Julio César Klínger Hernández , Jerónimo Londoño Prieto
This work is licensed under a Creative Commons Attribution 4.0 International License.
Relationship between perceived academic stress and Interleukin 6 levels in health students
Corresponding Author(s) : Paola Vernaza
Ciencia e Innovación en Salud,
2020
Abstract
quality of life of students, future professionals and therefore, adult contributors in a society.
It has been shown that students in the health field face additional stressors specific from
their careers, and suffer greater stress than the general population of the same age.
Methods: 52 students, 23 from Physiotherapy and 29 from Medicine programs were
surveyed with Academic Stressors Academic Scale (SAS) to know academic stress level
and IL-6 was quantified in serum.
Results: It was found that students who perceive the academic semester as stressful
“fairly often” and “many times”, increases in 50%, 75% and 76.9% during the semester;
while “anxiety/distress” feeling was predominant. The most frequent SAS scale factors
were “methodological deficiencies”, “student overload”, “beliefs about performance”, “lack
of content value”, “participation” and “exams”
Conclusions: The study revealed an IL-6 increment, and their association with
“Methodological Deficiencies” at 1st moment. This study showed the importance of
academic stressors identification at same time that it is a call to construct strategies to
reduce stressors in University context
Keywords
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- Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA.Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. Journal of health, population, and nutrition. 2011;29(5):516. DOI: 10.3329/jhpn.v29i5.8906
- Assaf AM, Al-Abbassi R, Al-Binni M. Academic stress-induced changes in Th1-and Th2-cytokine response. Saudi pharmaceutical journal. 2017;25(8):1237-1247. DOI: 10.1016/j.jsps.2017.09.009Cabanach
- RG, Souto-Gestal A, Franco V. Escala de Estresores Académicos para la evaluación de los estresores académicos en estudiantes universitarios. Revista iberoamericana de psicología y salud. 2016;7(2):41-50.DOI: 10.1016/j.rips.2016.05.001
- Cardona-Arias JA, Pérez-Restrepo D, Rivera-Ocampo S, Gómez-Martínez J, Reyes Á. Prevalence of anxiety in universitary students. Diversitas: Perspectivas en Psicología.2015;11(1):79-89. http://www.scielo.org.co/pdf/dpp/v11n1/v11n1a06.pd
- Castillo Pimienta C, Chacón de la Cruz T, Díaz-Véliz G. Ansiedad y fuentes de estrés académico en estudiantes de carreras de la salud. Investigación en Educación Médica. 2016;5(20):230-237. DOI: 10.1016/j.riem.2016.03.001Compton
- MT, Carrera J, Frank E. Stress and depressive symptoms/dysphoria among US medical students: results from a large, nationally representative survey. The Journal of nervous and mental disease. 2008;196(12):891-897. DOI: 10.1097/NMD.0b013e3181924d03
- Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross?sectional study. Medical education. 2005;39(6):594-604. DOI: 10.1111/j.1365-2929.2005.02176.x
- Deinzer R, Hilpert D, Bach K, Schawacht M, Herforth A. Effects of academic stress on oral hygiene–a potential link between stress and plaque?associated disease?. Journal of clinical periodontology. 2001;28(5):459-464. DOI: 10.1034/j.1600-051x.2001.028005459.x
- Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic medicine.2009;71(2):243. DOI: 10.1097/PSY.0b013e3181907888
- Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among US medical students. Annals of internal medicine. 2008;149(5):334-341. DOI: 10.7326/0003-4819-149-5-200809020-00008.
- Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Academic medicine. 2006;81(4):354-373. DOI: 10.1097/00001888-200604000-00009
- Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among US medical students, residents, and early career physicians relative to the general US population. Academic medicine. 2014;89(3):443-451. DOI: 10.1097/ACM.0000000000000134Ekpenyong
- CE, Daniel NE, Aribo E. Associations between academic stressors, reaction to stress, coping strategies and musculoskeletal disorders among college students. Ethiopian journal of health sciences. 2013;23(2):98-112. PubMed
- Elenkov IJ, Chrousos GP. Stress hormones, Th1/Th2 patterns, pro/anti-inflammatory cytokines and susceptibility to disease. Trends in Endocrinology & Metabolism. 1999;10(9):359-368. DOI: 10.1016/s1043-2760(99)00188-5
- García BR, Arrieta MdPG, Montagut ALEB. Estresores académicos percibidos por estudiantes pertenecientes a la escuela de enfermería de Ávila, centro adscrito a la Universidad de Salamanca. RevistaEnfermeríaCyL. 2014;6(2):98-105. http://www.revistaenfermeriacyl.com/index.php/revi
- Glaser R, Pearl DK, Kiecolt-Glaser J, Malarkey WB. Plasma cortisol levels and reactivation of latent Epstein-Barr virus in response to examination stress. Psychoneuroendocrinology. 1994;19(8):765-772. DOI: 10.1016/0306-4530(94)90023-x.
- Godbout JP, Glaser R. Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. Journal of Neuroimmune Pharmacology. 2006;1(4):421-427. DOI: 10.1007/s11481-006-9036-0
- Gomathi KG, Ahmed S, Sreedharan J. Causes of stress and coping strategies adopted by undergraduate health professions students in a university in the United Arab Emirates. Sultan Qaboos University Medical Journal. 2013;13(3):437. PubMed
- Hernández JÁ, Parra JMA, Campoy JMF, García DS, Pérez-Gallardo ER.El estrés ante los exámenes en los estudiantes universitarios. propuesta de intervención. International Journal of Developmental and Educational Psychology. 2013;2(1):179-187. https://www.redalyc.org/articulo.oa?id=34985217300
- Hojat M, Vergare M, Isenberg G, Cohen M, Spandorfer J. Underlying construct of empathy, optimism, and burnout in medical students. International journal of medical education. 2015;6:12. DOI: 10.5116/ijme.54c3.60cd
- Jalilian F, Karami Matin B, Ahmadpanah M, Ataee M, Ahmadi Jouybari T, Eslami AA, et al. Socio-demographic characteristics associated with cigarettes smoking, drug abuse and alcohol drinking among male medical university students in Iran. Journal of research in health sciences. 2015; 15(1):42-46 PubMed
- Kang DH, Fox C. Th1 and Th2 cytokine responses to academic stress. Research in nursing & health. 2001;24(4):245-257. DOI: 10.1002/nur.1027
- Koelsch S, Boehlig A, Hohenadel M, Nitsche I, Bauer K, Sack U. The impact of acute stress on hormones and cytokines, and how their recovery is affected by music-evoked positive mood. Scientific reports. 2016;6:23008. DOI 10.1038/srep23008Koh
- KB, Lee YJ, Beyn KM, Chu SH, Kim DM, Seo WY. Effects of high and low stress on proinflammatory and antiinflammatory cytokines. Psychophysiology. 2012;49(9):1290-1297. DOI: 10.1111/j.1469-8986.2012.01409.x
- La Fratta I, Tatangelo R, Campagna G, Rizzuto A, Franceschelli S, Ferrone A, et al.The plasmatic and salivary levels of IL-1?, IL-18 and IL-6 are associated to emotional difference during stress in young male. Scientific reports. 2018;8(1):3031. DOI: 10.1038/s41598-018-21474-y
- Lester SR, Brown JR, Aycock JE, Grubbs SL, Johnson RB. Use of saliva for assessment of stress and its effect on the immune system prior to gross anatomy practical examinations. Anatomical sciences education. 2010;3(4):160-167. DOI: 10.1002/ase.161
- Loftis JM, Huckans M, Morasco BJ. Neuroimmune mechanisms of cytokine-induced depression: current theories and novel treatment strategies. Neurobiology of disease. 2010;37(3):519-533. DOI: 10.1016/j.nbd.2009.11.015
- Marshall Jr GD, Agarwal SK, Lloyd C, Cohen L, Henninger EM, Morris GJ.Cytokine dysregulation associated with exam stress in healthy medical students. Brain, behavior, and immunity. 1998;12(4):297-307. DOI: 10.1006/brbi.1998.0537
- Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature reviews immunology. 2016;16(1):22. DOI: 10.1038/nri.2015.5
- Murali R, Hanson MD, Chen E. Murali R, Hanson MD, Chen E. Psychological stress and its relationship to cytokines and inflammatory diseases. Cytokines: Stress and Immunity.2nd Edition ed. Boca Raton, FL: Taylor & Francis Group. 2007. https://www.scholars.northwestern.edu/en/publicati
- Sarid O, Anson O, Yaari A, Margalith M. Academic stress, immunological reaction, and academic performance among students of nursing and physiotherapy. Research in nursing & health. 2004;27(5):370-387. DOI: 10.1002/nur.20028Segerstrom
- SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological bulletin. 2004;130(4):601.DOI: 10.1037/0033-2909.130.4.601
- Taboada MVF, Cabanach RG. La medición del estrés en contextos académicos en estudiantes universitarios: Universidade da Coruña; 2015. https://ruc.udc.es/dspace/handle/2183/15705
- Tangarife JL, Arias JAC. Construcción y validación de escalas de medición en salud: revisión de propiedades psicométricas. Archivos de medicina. 2015;11(3):1. http://www.archivosdemedicina.com/medicina-de-fami
- Tian R, Hou G, Li D, Yuan T-F. A possible change process of inflammatory cytokines in the prolonged chronic stress and its ultimate implications for health. The Scientific World Journal.2014. DOI: 10.1155/2014/780616
- Toribio-Ferrer C, Franco-Bárcenas S. Estrés académico: el enemigo silencioso del estudiante. Revista Salud y Administración. 2016;3(7):11-18. http://www.unsis.edu.mx/revista/doc/vol3num7/A2_Es18 de 19
- Trueba A, Ryan MW, Vogel PD, Ritz T. Effects of academic exam stress on nasal leukotriene B4 and vascular endothelial growth factor in asthma and health. Biological psychology. 2016;118:44-51. DOI: 10.1016/j.biopsycho.2016.04.009
- Tseng T, Iosif AM, Seritan AL. Stress effects:A study of salivary cortisol levels in third?year medical students. Stress and health. 2011;27(5):436-440. DOI: 10.1002/smi.1377
- Walsh J, Feeney C, Hussey J, Donnellan C. Sources of stress and psychological morbidity among undergraduate physiotherapy students. Physiotherapy. 2010;96(3):206-212.DOI: 10.1016/j.physio.2010.01.005
- Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. The Journal of clinical investigation. 2005;115(5):1111-1119. DOI: 10.1172/JCI2510219 de 19
References
Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA.Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. Journal of health, population, and nutrition. 2011;29(5):516. DOI: 10.3329/jhpn.v29i5.8906
Assaf AM, Al-Abbassi R, Al-Binni M. Academic stress-induced changes in Th1-and Th2-cytokine response. Saudi pharmaceutical journal. 2017;25(8):1237-1247. DOI: 10.1016/j.jsps.2017.09.009Cabanach
RG, Souto-Gestal A, Franco V. Escala de Estresores Académicos para la evaluación de los estresores académicos en estudiantes universitarios. Revista iberoamericana de psicología y salud. 2016;7(2):41-50.DOI: 10.1016/j.rips.2016.05.001
Cardona-Arias JA, Pérez-Restrepo D, Rivera-Ocampo S, Gómez-Martínez J, Reyes Á. Prevalence of anxiety in universitary students. Diversitas: Perspectivas en Psicología.2015;11(1):79-89. http://www.scielo.org.co/pdf/dpp/v11n1/v11n1a06.pd
Castillo Pimienta C, Chacón de la Cruz T, Díaz-Véliz G. Ansiedad y fuentes de estrés académico en estudiantes de carreras de la salud. Investigación en Educación Médica. 2016;5(20):230-237. DOI: 10.1016/j.riem.2016.03.001Compton
MT, Carrera J, Frank E. Stress and depressive symptoms/dysphoria among US medical students: results from a large, nationally representative survey. The Journal of nervous and mental disease. 2008;196(12):891-897. DOI: 10.1097/NMD.0b013e3181924d03
Dahlin M, Joneborg N, Runeson B. Stress and depression among medical students: A cross?sectional study. Medical education. 2005;39(6):594-604. DOI: 10.1111/j.1365-2929.2005.02176.x
Deinzer R, Hilpert D, Bach K, Schawacht M, Herforth A. Effects of academic stress on oral hygiene–a potential link between stress and plaque?associated disease?. Journal of clinical periodontology. 2001;28(5):459-464. DOI: 10.1034/j.1600-051x.2001.028005459.x
Dube SR, Fairweather D, Pearson WS, Felitti VJ, Anda RF, Croft JB. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic medicine.2009;71(2):243. DOI: 10.1097/PSY.0b013e3181907888
Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among US medical students. Annals of internal medicine. 2008;149(5):334-341. DOI: 10.7326/0003-4819-149-5-200809020-00008.
Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Academic medicine. 2006;81(4):354-373. DOI: 10.1097/00001888-200604000-00009
Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among US medical students, residents, and early career physicians relative to the general US population. Academic medicine. 2014;89(3):443-451. DOI: 10.1097/ACM.0000000000000134Ekpenyong
CE, Daniel NE, Aribo E. Associations between academic stressors, reaction to stress, coping strategies and musculoskeletal disorders among college students. Ethiopian journal of health sciences. 2013;23(2):98-112. PubMed
Elenkov IJ, Chrousos GP. Stress hormones, Th1/Th2 patterns, pro/anti-inflammatory cytokines and susceptibility to disease. Trends in Endocrinology & Metabolism. 1999;10(9):359-368. DOI: 10.1016/s1043-2760(99)00188-5
García BR, Arrieta MdPG, Montagut ALEB. Estresores académicos percibidos por estudiantes pertenecientes a la escuela de enfermería de Ávila, centro adscrito a la Universidad de Salamanca. RevistaEnfermeríaCyL. 2014;6(2):98-105. http://www.revistaenfermeriacyl.com/index.php/revi
Glaser R, Pearl DK, Kiecolt-Glaser J, Malarkey WB. Plasma cortisol levels and reactivation of latent Epstein-Barr virus in response to examination stress. Psychoneuroendocrinology. 1994;19(8):765-772. DOI: 10.1016/0306-4530(94)90023-x.
Godbout JP, Glaser R. Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. Journal of Neuroimmune Pharmacology. 2006;1(4):421-427. DOI: 10.1007/s11481-006-9036-0
Gomathi KG, Ahmed S, Sreedharan J. Causes of stress and coping strategies adopted by undergraduate health professions students in a university in the United Arab Emirates. Sultan Qaboos University Medical Journal. 2013;13(3):437. PubMed
Hernández JÁ, Parra JMA, Campoy JMF, García DS, Pérez-Gallardo ER.El estrés ante los exámenes en los estudiantes universitarios. propuesta de intervención. International Journal of Developmental and Educational Psychology. 2013;2(1):179-187. https://www.redalyc.org/articulo.oa?id=34985217300
Hojat M, Vergare M, Isenberg G, Cohen M, Spandorfer J. Underlying construct of empathy, optimism, and burnout in medical students. International journal of medical education. 2015;6:12. DOI: 10.5116/ijme.54c3.60cd
Jalilian F, Karami Matin B, Ahmadpanah M, Ataee M, Ahmadi Jouybari T, Eslami AA, et al. Socio-demographic characteristics associated with cigarettes smoking, drug abuse and alcohol drinking among male medical university students in Iran. Journal of research in health sciences. 2015; 15(1):42-46 PubMed
Kang DH, Fox C. Th1 and Th2 cytokine responses to academic stress. Research in nursing & health. 2001;24(4):245-257. DOI: 10.1002/nur.1027
Koelsch S, Boehlig A, Hohenadel M, Nitsche I, Bauer K, Sack U. The impact of acute stress on hormones and cytokines, and how their recovery is affected by music-evoked positive mood. Scientific reports. 2016;6:23008. DOI 10.1038/srep23008Koh
KB, Lee YJ, Beyn KM, Chu SH, Kim DM, Seo WY. Effects of high and low stress on proinflammatory and antiinflammatory cytokines. Psychophysiology. 2012;49(9):1290-1297. DOI: 10.1111/j.1469-8986.2012.01409.x
La Fratta I, Tatangelo R, Campagna G, Rizzuto A, Franceschelli S, Ferrone A, et al.The plasmatic and salivary levels of IL-1?, IL-18 and IL-6 are associated to emotional difference during stress in young male. Scientific reports. 2018;8(1):3031. DOI: 10.1038/s41598-018-21474-y
Lester SR, Brown JR, Aycock JE, Grubbs SL, Johnson RB. Use of saliva for assessment of stress and its effect on the immune system prior to gross anatomy practical examinations. Anatomical sciences education. 2010;3(4):160-167. DOI: 10.1002/ase.161
Loftis JM, Huckans M, Morasco BJ. Neuroimmune mechanisms of cytokine-induced depression: current theories and novel treatment strategies. Neurobiology of disease. 2010;37(3):519-533. DOI: 10.1016/j.nbd.2009.11.015
Marshall Jr GD, Agarwal SK, Lloyd C, Cohen L, Henninger EM, Morris GJ.Cytokine dysregulation associated with exam stress in healthy medical students. Brain, behavior, and immunity. 1998;12(4):297-307. DOI: 10.1006/brbi.1998.0537
Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nature reviews immunology. 2016;16(1):22. DOI: 10.1038/nri.2015.5
Murali R, Hanson MD, Chen E. Murali R, Hanson MD, Chen E. Psychological stress and its relationship to cytokines and inflammatory diseases. Cytokines: Stress and Immunity.2nd Edition ed. Boca Raton, FL: Taylor & Francis Group. 2007. https://www.scholars.northwestern.edu/en/publicati
Sarid O, Anson O, Yaari A, Margalith M. Academic stress, immunological reaction, and academic performance among students of nursing and physiotherapy. Research in nursing & health. 2004;27(5):370-387. DOI: 10.1002/nur.20028Segerstrom
SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological bulletin. 2004;130(4):601.DOI: 10.1037/0033-2909.130.4.601
Taboada MVF, Cabanach RG. La medición del estrés en contextos académicos en estudiantes universitarios: Universidade da Coruña; 2015. https://ruc.udc.es/dspace/handle/2183/15705
Tangarife JL, Arias JAC. Construcción y validación de escalas de medición en salud: revisión de propiedades psicométricas. Archivos de medicina. 2015;11(3):1. http://www.archivosdemedicina.com/medicina-de-fami
Tian R, Hou G, Li D, Yuan T-F. A possible change process of inflammatory cytokines in the prolonged chronic stress and its ultimate implications for health. The Scientific World Journal.2014. DOI: 10.1155/2014/780616
Toribio-Ferrer C, Franco-Bárcenas S. Estrés académico: el enemigo silencioso del estudiante. Revista Salud y Administración. 2016;3(7):11-18. http://www.unsis.edu.mx/revista/doc/vol3num7/A2_Es18 de 19
Trueba A, Ryan MW, Vogel PD, Ritz T. Effects of academic exam stress on nasal leukotriene B4 and vascular endothelial growth factor in asthma and health. Biological psychology. 2016;118:44-51. DOI: 10.1016/j.biopsycho.2016.04.009
Tseng T, Iosif AM, Seritan AL. Stress effects:A study of salivary cortisol levels in third?year medical students. Stress and health. 2011;27(5):436-440. DOI: 10.1002/smi.1377
Walsh J, Feeney C, Hussey J, Donnellan C. Sources of stress and psychological morbidity among undergraduate physiotherapy students. Physiotherapy. 2010;96(3):206-212.DOI: 10.1016/j.physio.2010.01.005
Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. The Journal of clinical investigation. 2005;115(5):1111-1119. DOI: 10.1172/JCI2510219 de 19