Stress Management Training (SMT) Improves Coping of Tremor-Boosting Psychosocial Stressors and Depression in Patients with Parkinson’s Disease: A Controlled Prospective Study

Table 1

Psychosocial stress factors according to Kaluza.

(A) Warning signs for stress
The following aspects can be signs of excessive demand. Which of them did you self-percept within the last week?
Physical warning signs	Palpitation; tight feelings in the breast; difficulty breathing; difficulty falling asleep; chronic fatigue; indigestion; stomach pain; anorexia; sexual dysfunction; muscle tension; headache; back pain; cold feet/hands; severe sweating
Emotional warning signs	Nervousness/inner restlessness; irritability/anger feelings; fear emotions/fear of failure; dissatisfaction/unbalance; listlessness (including sexual); inner emptiness/“burned out”
Cognitive warning signs	Constantly circling thoughts/musing; concentration disorders; emptiness in the head/“black out”; daydreams; nightmares; loss of power/high frequency of mistakes
Behavioural warning signs	Aggressive behaviour against others/“to fly off the handle”; finger thrumming/to shuffle one’s feet/trembling/to gnash one’s teeth; speak too fast/stuttering; interrupt someone/inability to listen to someone; irregular eating; consuming of alcohol or drugs for calming; not cultivating private contacts/“to let contacts slide”; smoking more than intended; doing less sport and exercise than desired
(B) Stress-amplifying thoughts
Personal stress enhancer profile
I cannot	I cannot stand it; I will fail; I can never make it; I cannot stand the pressure (fear, pain, etc.); problems and difficulties simply are terrible
Be on your guard	It is horrible if something is not running as I want; it is important that I have everything under control; in decisions I must be 100% sure; I always have to think about what could happen; it is terrible if I do not know what is coming towards me
Be strong	I like to do everything myself; strong people need no help; when I rely on others I’m abandoned; without me nothing works; it is terrible to depend on others
Be popular	I do not want to disappoint others; it is terrible when others are evil to me; I want to get along well with all others; It’s bad when others criticize me; it is important that everyone likes me
Be perfect	It is not acceptable if I am not able to cope with a job or meet a deadline; I always have to be available for my company; there is nothing worse than making mistakes; there must be 100% reliability on me; I always have to make everything right

Part A shows the 35 questions of warning signs for stress in the 4 categories according to Kaluza [17]. The total score ranges from 0 to 70 points, and each symptom was self-rated by the patient to be present “barely or not at all” (score 0), “slight” (score 1), or “severe” (score 2). The higher the value is, the more the warning signs for stress in the subdomain or in total the subject has. Part B shows the 25 questions of stress-amplifying thoughts in the 5 categories according to Kaluza [17]. The total score ranges from 0 to 50 points, and presence of each attribute was rated by the patient to be either “never” (score 0), “sometimes” (score 1), or “frequently” (score 2). The higher the value is, the more the stress-amplifying thoughts in the subdomain or in total the subject has.