Stress-related research has employed several procedures to activate the human stress system. Two of the most commonly used laboratory paradigms are the Trier Social Stress Test (TSST) and the Cold Pressor Test (CPT). We combined their most stressful features to create a simple laboratory stress test capable of eliciting strong autonomic and glucocorticoid stress responses. In comparison with the CPT and its variations, our stress tool (labeled the Maastricht Acute Stress Test; MAST) was found to yield superior salivary cortisol responses, while being equally effective in eliciting subjective stress reactions and (systolic and diastolic) blood pressure increases (study 1; N=80). In study 2 (N=20), we directly compared the effectiveness of the MAST and TSST and found that both methods elicited similar subjective, salivary alpha-amylase, and salivary cortisol stress responses. Finally, we developed and evaluated an appropriate no-stress control version of the MAST that was similar to the stress version, although it did not comprise stressful components (study 3; N=40). Collectively, our results confirm the effectiveness of the MAST in terms of subjective, autonomic, and--most importantly--glucocorticoid stress responses. Thus, as a brief and simple stress protocol, the MAST holds considerable promise for future research.

We have compared three measurements of anxiety to determine their equivalence in assessing anxiety before surgery. Forty-four patients awaiting breast cancer surgery completed the state scale of the state-trait anxiety inventory (STAI), the hospital anxiety and depression scale (HAD) and a 100-mm visual analogue scale (VAS). Analysis restricted to correlations between the scales gave the misleading impression that VAS scores were inconsistent with those of the HAD and STAI. However, when scores were considered in relation to normative cut-off values to categorize anxiety levels, the three scales showed good agreement. We conclude that the scales were equivalent in their assessment of anxiety before surgery, but that reference to normative data was important in establishing such equivalence and in determining the patient's state.

Subjective sleep complaints predict cognitive decline in middle aged and older adults. Mechanisms behind the effect of subjective sleep complaints on cognitive performance are discussed.

This article examines the main and moderating effects of 3 personality characteristics on the association between chronic medical morbidity and health-related quality of life (HRQL) in a large (N = 5,279) community-based older sample. Reasonably high unique contributions of neuroticism, mastery, and self-efficacy to HRQL were found. The additional amounts of variance explained beyond and above medical morbidity and age vary from about 4% (bodily pain) to above 30% (mental health). Little empirical evidence was found for the moderating effects of personality. In conclusion, personality characteristics such as neuroticism, mastery, and self-efficacy influence the reported levels of HRQL. The extent to which this is due to an influence of personality on true versus perceived levels of HRQL is unclear.

We meta-analytically reviewed studies that used the Structured Inventory of Malingered Symptomatology (SIMS) to detect feigned psychopathology. We present weighted mean diagnostic accuracy and predictive power indices in various populations, based on 31 studies, including 61 subsamples and 4009 SIMS protocols. In addition, we provide normative data of patients, claimants, defendants, nonclinical adults, and various experimental feigners, based on 41 studies, including 125 subsamples and 4810 SIMS protocols. We conclude that the SIMS (1) is able to differentiate well between instructed feigners and honest responders; (2) generates heightened scores in groups that are known to have a raised prevalence of feigning (e.g., offenders who claim crime-related amnesia); (3) may overestimate feigning in patients who suffer from schizophrenia, intellectual disability, or psychogenic non-epileptic seizures; and (4) is fairly robust against coaching. The diagnostic power of the traditional cut scores of the SIMS (i.e., > 14 and > 16) is not so much limited by their sensitivity—which is satisfactory—but rather by their substandard specificity. This, however, can be worked around by combining the SIMS with other symptom validity measures and by raising the cut score, although the latter solution sacrifices sensitivity for specificity.