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Lipowicz A, Bugdol MN, Umławska W, Mitas AW. The long-lasting effect of early life family structure on social position, well-being, and biological condition in adulthood. Aging Male 2023; 26:2239896. [PMID: 37519090 DOI: 10.1080/13685538.2023.2239896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The absence of even one parent has short- and long-term effects on the child's current and future health. The purpose of the study was to determine whether there is a long-term relationship between the type of family in which men were raised and an individual's adult social position, well-being in adulthood and their biological condition regardless of social status in adulthood. MATERIALS AND METHODS Data for 4528 males, aged 25-80 years, were selected from the archives of the Lower Silesian Medical Centre in Wrocław, Poland. A total of 329 men declared that they grew up in incomplete families. Height, weight, % fat, cardiovascular and respiratory systems, blood parameters, and health of men who grew up in complete or incomplete families were compared. RESULTS Growing up in an incomplete family reduced chances for better education, decreased life satisfaction in adulthood, and negatively affected the final height. After taking into account the education achieved, the effect persisted only for diastolic blood pressure, creatinine, and serum phosphorus levels. CONCLUSIONS Growing up in an incomplete family has a significant impact on male's socioeconomic position (SES), life satisfaction, and final height. A poorer quality of diet is proposed as an early life risk factor for adult health.
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Affiliation(s)
- Anna Lipowicz
- Department of Anthropology, Institute of Environmental Biology, Wrocław University of Environmental and Life Sciences, Wrocław, Poland
| | - Monika Natalia Bugdol
- Department of Informatics and Medical Equipment, Faculty of Biomedical Engineering, Silesian University of Technology, Gliwice, Poland
| | - Wioleta Umławska
- Department of Human Biology, University of Wrocław, Wrocław, Poland
| | - Andrzej Waldemar Mitas
- Department of Informatics and Medical Equipment, Faculty of Biomedical Engineering, Silesian University of Technology, Gliwice, Poland
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Schwartz JA, Granger DA, Calvi JL, Jodis CA, Steiner B. The Implications of Stress Among Correctional Officers: A Summary of the Risks and Promising Intervention Strategies. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231213316. [PMID: 38124325 DOI: 10.1177/0306624x231213316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
This paper provides a detailed summary and discussion of the concept of stress and how it relates to the health, wellbeing, and performance of corrections officers. In line with these objectives, we focus on three areas: (1) providing a more detailed definition of the concept of stress; (2) a discussion of the ways that increased exposure to stress may impact corrections officers' physical and mental health; and (3) a summary of prevention and intervention strategies that are relevant for corrections officers and have shown promise in dampening the consequences of increased stress exposure. More in-depth knowledge of the concept of stress and the underlying processes that link stress to negative outcomes will provide policy makers and corrections departments with an understanding of the characteristics of prevention and intervention strategies that are expected to be most effective in limiting the consequences of stress.
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Affiliation(s)
| | - Douglas A Granger
- The Johns Hopkins University, Baltimore, MD, USA
- University of California, Irvine, USA
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Buthmann JL, LeMoult J, Miller JG, Berens A, Gotlib IH. Biological sensitivity to adolescent-parent discrepancies in perceived parental warmth. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100211. [PMID: 37808874 PMCID: PMC10550797 DOI: 10.1016/j.cpnec.2023.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Parenting behaviors are formative to the psychological development of young people; however, parent and adolescent perceptions of parenting are only moderately correlated with each other. Whereas discrepant perceptions may represent a normative process of deindividuation from caregivers in some adolescents, in others a discrepancy might predict psychological maladjustment. The biological sensitivity to context model provides a framework from which individual differences in development can be estimated in adolescents whose perceptions of parenting diverge from those of their parents. Methods At baseline we obtained diurnal cortisol samples from US adolescents (M = 13.37 years of age, SD = 1.06) as well as parents' and adolescents' ratings of parental warmth; we obtained adolescent-reported symptoms of psychopathology at baseline and again at follow-up two years later (N = 108, 57.5% female). We estimated waking cortisol, cortisol awakening response, and daytime cortisol slopes using piecewise regression models. Results Lower adolescent than parent ratings of parental warmth predicted increased externalizing symptoms at follow-up. Higher waking cortisol and steeper cortisol awakening response and daytime slopes predicted increased internalizing symptoms at follow-up. Further, discrepant ratings of parental warmth interacted with cortisol awakening response and daytime slopes such that greater discrepancies predicted greater increases in externalizing symptoms in adolescents with steeper cortisol slopes. Conclusions These findings indicate that steeper changes in cortisol production throughout the day index a greater sensitivity to perceived parental warmth. Lower adolescent than parent ratings of parental warmth may represent dysfunction in the parental relationship rather than a normative process of deindividuation in adolescents with steeper diurnal cortisol slopes.
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Affiliation(s)
- Jessica L. Buthmann
- Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, 2136 West Mall, Cancouver, BC, V6T1Z4, Canada
| | - Jonas G. Miller
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Anne Berens
- Department of Pediatrics, Stanford University, 300 N Pasteur Drive, Palo Alto, CA, 94304, USA
| | - Ian H. Gotlib
- Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
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Norton SA, Baranger DAA, Young ES, Voss M, Hansen I, Bondy E, Rodrigues M, Paul SE, Edershile E, Hill PL, Oltmanns TF, Simpson J, Bogdan R. Reliability of diurnal salivary cortisol metrics: A meta-analysis and investigation in two independent samples. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 16:100191. [PMID: 37635863 PMCID: PMC10458689 DOI: 10.1016/j.cpnec.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/06/2023] [Indexed: 08/29/2023] Open
Abstract
Stress-induced dysregulation of diurnal cortisol is a cornerstone of stress-disease theories; however, observed associations between cortisol, stress, and health have been inconsistent. The reliability of diurnal cortisol features may contribute to these equivocal findings. Our meta-analysis (5 diurnal features from 11 studies; total participant n = 3307) and investigation (15 diurnal cortisol features) in 2 independent studies (St. Louis Personality and Aging Network [SPAN] Study, n = 147, ages 61-73; Minnesota Longitudinal Study of Risk and Adaptation [MLSRA] Study, n = 90, age 37) revealed large variability in the day-to-day test-retest reliability of diurnal features derived from salivary cortisol data (i.e., ICC = 0.00-0.75). Collectively, these data indicate that some commonly used diurnal cortisol features have poor reliability that is insufficient for individual differences research (e.g., cortisol awakening response) while others (e.g., area under the curve with respect to ground) have fair-to-good reliability that could support reliable identification of associations in well-powered studies.
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Affiliation(s)
- Sara A. Norton
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - David AA. Baranger
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Ethan S. Young
- Utrecht University, Department of Psychology, the Netherlands
| | - Michaela Voss
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Isabella Hansen
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Erin Bondy
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Merlyn Rodrigues
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Sarah E. Paul
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | | | - Patrick L. Hill
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | - Thomas F. Oltmanns
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
| | | | - Ryan Bogdan
- Washington University in St. Louis, Department of Psychological & Brain Sciences, USA
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Lee M, Kim Y, Yoon IY, Hong JK. Effects of cranial electrotherapy stimulation on improving depressive symptoms in people with stress: A randomized, double-blind controlled study. J Affect Disord 2023; 340:835-842. [PMID: 37598716 DOI: 10.1016/j.jad.2023.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/18/2023] [Accepted: 08/11/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Cranial electrotherapy stimulation (CES) is a form of neurostimulation that delivers alternating microcurrent via electrodes on the head. We investigated the effectiveness of CES in reducing stress. METHODS Participants who experienced subjective stress combined with subclinical depression or insomnia were recruited based on interviews and questionnaires. The subjects were randomly assigned to the active CES or sham groups and asked to use the device for 30 min twice a day for three weeks. Psychological rating scales, quantitative electroencephalography (QEEG), and serial salivary cortisol levels were measured before and after the intervention. RESULTS Sixty-two participants (58 females, mean age = 47.3 ± 8.2 years) completed the trial. After intervention, the depression scores improved significantly to a nearly normal level (Beck depression inventory-II, 31.3 ± 11.6 to 10.8 ± 7.2, p < 0.001) in the CES group, which were greater improvement compared to the sham group (p = 0.020). There were significant group-by-visit interactions in absolute delta power in the temporal area (p = 0.033), and theta (p = 0.038), beta (p = 0.048), and high beta power (p = 0.048) in the parietal area. CES led to a flattening of the cortisol slope (p = 0.011) and an increase in bedtime cortisol (p = 0.036) compared to the sham group. LIMITATIONS Bias may have been introduced during the process because device use and sample collection were self-conducted by participants at home. CONCLUSIONS CES can alleviate depressive symptoms and stress response, showing a potential as an adjunctive therapy for stress.
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Affiliation(s)
- Minji Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Yuna Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - In-Young Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jung Kyung Hong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
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56
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Goel N, Hernandez AE, Ream M, Clarke ES, Blomberg BB, Cole S, Antoni MH. Effects of neighborhood disadvantage on cortisol and interviewer-rated anxiety symptoms in breast cancer patients initiating treatment. Breast Cancer Res Treat 2023; 202:203-211. [PMID: 37561280 DOI: 10.1007/s10549-023-07050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Shorter breast cancer (BC) survival outcomes persist by neighborhood disadvantage independent of patient, tumor, and treatment characteristics. This suggests unaccounted mechanisms by which neighborhood disadvantage "gets under the skin" to impact BC survival outcomes. Here, we evaluate the relationship between neighborhood disadvantage and clinical and neuroendocrine markers of stress in BC patients. METHODS Women with stage 0-III BC were enrolled 2-10 weeks post-surgery and before initiating adjuvant treatment in a study examining stress and stress management processes. Women provided an afternoon-evening (PM) serum cortisol sample and were administered the Hamilton Anxiety Rating Scale (HAM-A). Home addresses were used to determine the Area Deprivation Index (ADI), a validated measure of neighborhood disadvantage. Multiple regression assessed the relationship between ADI and PM serum cortisol and the presence of elevated HAM-A symptoms. RESULTS Our sample (n = 225) was predominately middle-aged (M = 50.4 years; range 23-70 years), non-Hispanic White (64.3%), with stage I (38.1%), or II (38.6%) disease. The majority (n = 175) lived in advantaged neighborhoods (ADI 1-3). After controlling for age, stage, and surgery type, women from high ADI (4-10) (vs low ADI) neighborhoods had higher PM cortisol levels (β = 0.19, 95% CI [0.24, 5.00], p = 0.031) and were nearly two times as likely to report the presence of elevated anxiety symptoms (OR = 1.96, 95% CI [1.00, 3.86], p = 0.050). CONCLUSION Neighborhood disadvantage is significantly associated with higher levels of PM cortisol and elevated anxiety symptoms suggesting stress pathways could potentially contribute to relationships between neighborhood disadvantage and BC survival.
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Affiliation(s)
- Neha Goel
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14Th Street, Suite 410, Miami, FL, 33136, USA.
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Alexandra E Hernandez
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14Th Street, Suite 410, Miami, FL, 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Molly Ream
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Estefany Saez Clarke
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie B Blomberg
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Microbiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steve Cole
- Department of Psychiatry/Biobehavioral Sciences and Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael H Antoni
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
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Meijer OC, Kooijman S, Kroon J, Winter EM. The importance of the circadian trough in glucocorticoid signaling: a variation on B-flat. Stress 2023; 26:2275210. [PMID: 37874158 DOI: 10.1080/10253890.2023.2275210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/28/2023] [Indexed: 10/25/2023] Open
Abstract
Glucocorticoid hormones are essential for health, but overexposure may lead to many detrimental effects, including metabolic, psychiatric, and bone disease. These effects may not only be due to increased overall exposure to glucocorticoids, but also to elevated hormone levels at the time of the physiological circadian trough of glucocorticoid levels. The late Mary Dallman developed a model that allows the differentiation between the effects of overall 24-hour glucocorticoid overexposure and the effects of a lack of circadian rhythmicity. For this, she continuously treated rats with a low dose of corticosterone (or "B"), which leads to a constant hormone level, without 24-hour overexposure using subcutaneously implanted pellets. The data from this "B-flat" model suggest that even modest elevations of glucocorticoid signaling during the time of the normal circadian trough of hormone secretion are a substantial contributor to the negative effects of glucocorticoids on health.
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Affiliation(s)
- Onno C Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Sander Kooijman
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan Kroon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Elizabeth M Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Sommovigo V, Tavolucci S, Filosa L, Rosa V, Carnevali L, Ottaviani C, Alessandri G. Daily cortisol variations are predicted proximally by self-efficacy beliefs at work and indirectly by perceived self-regulatory abilities in managing negative emotions. Int J Psychophysiol 2023; 193:112244. [PMID: 37716442 DOI: 10.1016/j.ijpsycho.2023.112244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/18/2023]
Abstract
In the present ecological study, we analyzed the relations of a set of self-efficacy beliefs at work to parameters of diurnal cortisol variation. Specifically, using data collected during two consecutive working days from 166 workers, we tested a mediation model positing social and work-related self-efficacy beliefs as mediators of the relations between self-regulatory emotional self-efficacy beliefs in managing negative emotions and cortisol indicators. Results from the multilevel mediation analyses supported the proposed model for work-related self-efficacy, which resulted as a significant mediator of the relation between self-regulatory emotional self-efficacy beliefs in managing negative emotions and the overall cortisol daily production indexed by computing the area under the curve with respect to the ground. Findings suggest the importance of self-efficacy beliefs for workers' physiological adjustment. Theoretical and practical contributions of the findings are discussed.
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Affiliation(s)
- Valentina Sommovigo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
| | - Simone Tavolucci
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
| | - Lorenzo Filosa
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
| | - Valentina Rosa
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
| | - Luca Carnevali
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze, 11/a, 43124 Parma, Italy.
| | - Cristina Ottaviani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
| | - Guido Alessandri
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via dei Marsi, 78, 00185 Rome, Italy.
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Adam EK. Natural disasters as natural experiments: Lessons for human stress science. Proc Natl Acad Sci U S A 2023; 120:e2316231120. [PMID: 37851704 PMCID: PMC10622926 DOI: 10.1073/pnas.2316231120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Affiliation(s)
- Emma K. Adam
- Human Development and Social Policy, School of Education and Social Policy, and Institute for Policy Research, Northwestern University, Evanston, IL60626
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60
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Dibble KE, Murray SM, Baral SD, Zlotorzynska M, Wiginton JM, Stephenson R, Edwards OW, Lyons C, Rainey JC, Xue QL, Sanchez TH. Predicting salivary cortisol and sexual behavior stigma among MSM in the American Men's Internet Survey 2019. Sci Rep 2023; 13:18082. [PMID: 37872353 PMCID: PMC10593931 DOI: 10.1038/s41598-023-44876-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
Physiological stress levels in response to sexual behavior stigma among men who have sex with men (MSM) in the United States (US) are understudied. The current study aims to explore the relationship between sexual behavior stigma and salivary cortisol both overall and stratified by race/ethnicity. If such an association exists, it may suggest that sexual behavior stigma can be physiologically measured or indicated by the presence of heightened salivary cortisol. A subsample of 667 MSM participants from the 2019 American Men's Internet Survey (AMIS; N = 10,129) submitted morning (AM) and evening (PM) saliva cortisol samples using at-home mail-in collection kits. Average daily cortisol and daily cortisol change were calculated; simple linear regressions estimated associations between cortisol measures and sexual behavior stigma characterized in four different ways (ever and recent experience of individual stigma items; average ever and recent experience of three stigma scales: stigma from family and friends, anticipated healthcare stigma, general social stigma). Participants reported a mean age of 36.0 years (SD = 14.9), with most being non-Hispanic white (n = 480, 72.0%), Hispanic (n = 164, 12.3%), or Black/African American (n = 146, 10.9%), and identified as homosexual/gay (n = 562, 84.3%). Reporting ever experiencing healthcare providers gossiping was significantly associated with higher PM cortisol (β = 0.12, p = 0.001) and higher average daily cortisol (β = 0.11, p = 0.004), while reporting ever experiencing police refusing to protect was associated with higher AM cortisol (β = 0.08, p = 0.03) and higher average daily cortisol (β = 0.09, p = 0.02). Recent experiences of stigma were not significant predictors of any measure of cortisol. Measures of salivary cortisol may be used to characterize sexual behavior stigma among MSM populations, however more insight is needed to determine its exact relationship and strength.
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Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6133, Baltimore, MD, 21205, USA.
| | - Sarah M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6133, Baltimore, MD, 21205, USA
| | - Maria Zlotorzynska
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - John Mark Wiginton
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Rob Stephenson
- Department of Systems, Populations, and Leadership, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, 48109, USA
| | - O Winslow Edwards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Carrie Lyons
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Jacob C Rainey
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Qian-Li Xue
- Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Travis H Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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Chen S, Kertes D, Benner A, Kim SY. Short-term cortisol adaption to discrimination and Mexican-origin adolescents' mental and sleep health. Dev Psychopathol 2023:1-13. [PMID: 37791538 DOI: 10.1017/s0954579423001219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Discrimination experiences are a salient contributor to the health disparities facing Latina/x/o youth. The biopsychosocial model of minority health posits that discrimination influences health through wear and tear on the biological stress responses, including the hypothalamic-pituitary-adrenal (HPA) axis, which is a primary stress response system in the body. Emerging evidence suggests that discrimination alters the secretion of cortisol, the end product of the HPA axis, yet, whether the daily processes between discrimination and diurnal cortisol response influence mental and sleep health remains unanswered. This study integrated daily diary and post-diary survey data to examine whether daily diurnal cortisol responses to discrimination influence adolescents' mental (depressive symptoms, anxiety) and sleep (sleep quality, duration) health in a sample of Mexican-origin youth (N = 282; M age = 17.10; 55% female). Results showed that adolescents who experienced more discrimination across the four-day diary period exhibited steeper diurnal cortisol slopes and lower evening cortisol; however, such physiological responses tended to be associated with poorer adolescents' mental and sleep health. The current study underscores the potential adaptation cost associated with short-term cortisol adaptation in the face of discrimination.
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Affiliation(s)
- Shanting Chen
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Darlene Kertes
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Aprile Benner
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
| | - Su Yeong Kim
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX, USA
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Tervahartiala K, Perasto L, Kortesluoma S, Korja R, Karlsson H, Nolvi S, Karlsson L. Latent profile analysis of diurnal cortisol patterns at the ages of 2, 3.5, and 5 years: Associations with childcare setting, child individual characteristics, and maternal distress. Psychoneuroendocrinology 2023; 156:106345. [PMID: 37540904 DOI: 10.1016/j.psyneuen.2023.106345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/22/2023] [Accepted: 07/28/2023] [Indexed: 08/06/2023]
Abstract
This study performed latent profile analysis from more than 4000 saliva cortisol samples collected from children at the ages of 2 (T1), 3.5 (T2), and 5 years (T3). Three clearly different cortisol profiles were identified. The largest group at every age point was the Low/Regular latent profile, in which the cortisol slopes followed typical diurnal variation. A smaller proportion of the children belonged to the latent profile with relatively Low/Flat slope, and a minority belonged to the High/Fluctuating latent group, where the overall cortisol values and variations between the slopes were clearly higher than in the other groups. Most of the children who belonged to the High/Fluctuating group were cared for at home, they had higher temperamental surgency and their mothers had more depressive symptoms than in the other latent profile groups. However, only moderate intraindividual stability in diurnal cortisol profiles was observed across the follow-up period. On average, half of the children moved between the groups from T1 to T3. Neither child temperament, social competence, nor sex explained the stability or movement between the groups across age. Variations in cortisol profiles may be caused by the child's age, and diurnal cortisol rhythm becomes more regular along with development. Methodological issues regarding saliva cortisol research in young children are discussed. Also, more longitudinal research is needed to clarify mechanisms between environmental as well as individual factors and possible dysregulation in a child's HPA axis functioning.
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Affiliation(s)
- Katja Tervahartiala
- Department of Psychology and Speech-Language Pathology, University of Turku, Assistentinkatu 7, 20520 Turku, Finland; Department of Psychology, University of Jyväskylä, Mattilanniemi 6, 40100 Jyväskylä, Finland; Centre of Excellence in Learning Dynamics and Intervention Research (InterLearn), University of Jyväskylä and University of Turku, Mattilanniemi 6, 40100 Jyväskylä, Finland; The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
| | - Laura Perasto
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Susanna Kortesluoma
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Riikka Korja
- Department of Psychology and Speech-Language Pathology, University of Turku, Assistentinkatu 7, 20520 Turku, Finland; Centre of Excellence in Learning Dynamics and Intervention Research (InterLearn), University of Jyväskylä and University of Turku, Mattilanniemi 6, 40100 Jyväskylä, Finland; The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Hasse Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Turku University Hospital and University of Turku, Department of Clinical Medicine, Psychiatry, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Saara Nolvi
- Department of Psychology and Speech-Language Pathology, University of Turku, Assistentinkatu 7, 20520 Turku, Finland; Centre of Excellence in Learning Dynamics and Intervention Research (InterLearn), University of Jyväskylä and University of Turku, Mattilanniemi 6, 40100 Jyväskylä, Finland; The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland
| | - Linnea Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; Turku University Hospital and University of Turku, Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Kiinamyllynkatu 4-8, 20520 Turku, Finland
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Singh Solorzano C, Serwinski B, Grano C, Steptoe A. Longitudinal association between saliva and hair cortisol concentration: A systematic comparison. Psychoneuroendocrinology 2023; 156:106340. [PMID: 37524026 DOI: 10.1016/j.psyneuen.2023.106340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/15/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023]
Abstract
Cortisol assays from hair have become increasingly common in psychoneuroendocrinological research as indicators of long-term output relevant to stress and health outcomes. Comparisons of hair cortisol concentration (HCC) with salivary samples have produced mixed findings, and it remains unclear which aspects of the diurnal salivary profile correspond most closely to HCC, and what time intervals between saliva and hair sampling are most relevant, taking the rate of hair growth into account. This longitudinal study aimed to evaluate the correspondence between HCC and parameters of total salivary cortisol output in the morning (CARauc and CARi) and during the rest of the day excluding the early morning period (DAYauc), by systematically studying three time periods - two weeks, four weeks, and six weeks - before hair sampling. At each time period, 54 female university students (mean age: 20.85 ± 1.16 years) provided three saliva cortisol samples on day 1 at 11 am, 3 pm, at bedtime, then two samples the following day on waking and 30 min after awakening. Hair strand collection (1 cm nearest the scalp) took place two weeks after the last saliva sample. Results of multivariable regressions indicate that HCC was consistently associated with DAYauc for all three time periods and with the aggregate DAYauc across days after adjusting for age, body mass index, smoking, oral contraceptive use, hair washing frequency and hair treatments. The strongest associations were found for DAYauc two weeks before hair sampling (β = 0.578, p < 0.001) and the aggregated DAYauc across all three time periods (β = 0.596, p < 0.001), although the confidence intervals overlapped those for four and six week analyses. There was no significant association between HCC and either CARauc or CARi. Our study confirms that hair cortisol could be a reliable retrospective biomarker of basal and long-term cortisol output secretion at least up to six weeks earlier. The results contribute to a better understanding of the different associations between HCC and salivary cortisol in the morning and the rest of the day, while also having implications for the use of HCC as an outcome measure in intervention and treatment research.
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Affiliation(s)
- Claudio Singh Solorzano
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; Department of Psychology, Sapienza University, Via dei Marsi 78, Rome 00185, Italy.
| | - Bianca Serwinski
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; Northeastern University London, Devon House, 58 St Katharine's Way, London E1W 1LP, UK
| | - Caterina Grano
- Department of Psychology, Sapienza University, Via dei Marsi 78, Rome 00185, Italy
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Frost A, Hagaman A, Baranov V, Chung EO, Bhalotra S, Sikander S, Maselko J. Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan. Dev Psychopathol 2023; 35:2086-2095. [PMID: 35959681 PMCID: PMC9922341 DOI: 10.1017/s0954579422000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypothalamic pituitary adrenal (HPA) axis activity may be a mechanism linking early adversity to child mental health difficulties. However, there is a dearth of longitudinal evidence for the association between HPA axis activity and mental health among children in low-resource contexts. The goal of this study is to examine linear and curvilinear associations between HPA axis activity during infancy and mental health difficulties in early childhood among children in rural Pakistan. Participants included 104 children (46% male) from the Bachpan study, a longitudinal cohort embedded within a maternal depression trial in Pakistan. We examined the associations between hair-derived cortisol and dehydroepiandosterone (DHEA) at 12 months old and mental health difficulties, measured with the Strengths and Difficulties Questionnaire (SDQ), at 36 months old. There was a significant quadratic association between hair cortisol and SDQ scores, with results showing a U-shaped relationship (i.e., having relatively high or low cortisol predicted increased mental health difficulties). DHEA showed a quadratic association with SDQ scores with an inverted U-shaped relationship (i.e., high and low DHEA was associated with decreased mental health difficulties). Results provide evidence of longitudinal and curvilinear effects of cortisol and DHEA during infancy on mental health difficulties in early childhood.
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Affiliation(s)
- Allison Frost
- Carolina Population Center, University of North Carolina, Chapel Hill
| | - Ashley Hagaman
- Social Behavioral Sciences, Yale School of Public Health, Yale University
| | - Victoria Baranov
- Department of Economics, Faculty of Business and Economics, University of Melbourne
| | - Esther O. Chung
- Carolina Population Center, University of North Carolina, Chapel Hill
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill
| | | | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Joanna Maselko
- Carolina Population Center, University of North Carolina, Chapel Hill
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill
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Freilich CD. How does loneliness "get under the skin" to become biologically embedded? BIODEMOGRAPHY AND SOCIAL BIOLOGY 2023; 68:115-148. [PMID: 37800557 PMCID: PMC10843517 DOI: 10.1080/19485565.2023.2260742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Loneliness is linked to declining physical health across cardiovascular, inflammatory, metabolic, and cognitive domains. As a result, loneliness is increasingly being recognized as a public health threat, though the mechanisms that have been studied do not yet explain all loneliness-related health risk. Potential mechanisms include loneliness having 1.) direct, causal impacts on health, possibly maintained by epigenetic modification, 2.) indirect effects mediated through health-limiting behaviors, and 3.) artifactual associations perhaps related to genetic overlap and reverse causation. In this scoping review, we examine the evidence surrounding each of these pathways, with a particular emphasis on emerging research on epigenetic effects, in order to evaluate how loneliness becomes biologically embedded. We conclude that there are significant gaps in our knowledge of how psychosocial stress may lead to physiological changes, so more work is needed to understand if, how, and when loneliness has a direct influence on health. Hypothalamic-pituitary adrenocortical axis disruptions that lead to changes in gene expression through methylation and the activity of transcription factor proteins are one promising area of research but are confounded by a number of unmeasured factors. Therefore, wok is needed using causally informative designs, such as twin and family studies and intensively longitudinal diary studies.
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Handley ED, Rogosch FA, Duprey EB, Russotti J, Cicchetti D. Profiles of diurnal cortisol and DHEA regulation among children: Associations with maltreatment experiences, symptomatology, and positive adaptation. Dev Psychopathol 2023; 35:1614-1626. [PMID: 35635209 PMCID: PMC9708938 DOI: 10.1017/s0954579422000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Person-centered methods represent an important advance in the simultaneous examination of multiple indicators of neuroendocrine functioning and may facilitate a more nuanced understanding of the impact of child maltreatment on hypothalamic-pituitary-adrenal axis dysregulation. The aims of the present study were threefold: (a) identify naturally occurring patterns of diurnal cortisol and dehydroepiandrosterone (DHEA) regulation among a sample of N = 1,258 children with and without histories of maltreatment, (b) investigate which neuroendocrine profiles characterize children with exposure to maltreatment, and (c) examine which profiles are related to adaptive outcomes and symptomatology among children. Cortisol and DHEA were sampled three times per day (9 a.m., 12 p.m., and 4 p.m.) across 5 and 2 days, respectively. Four profiles of cortisol and DHEA regulation were identified. Among females, a pattern marked by high cortisol and low DHEA was associated with more pervasive maltreatment experiences. Furthermore, we found evidence of adaptive interpersonal resilience such that children with maltreatment exposure who evidenced this pattern of high cortisol and low DHEA were viewed as more likeable than maltreated children with other neuroendocrine patterns. Finally, results pointed to higher levels of internalizing symptoms among children who displayed a profile marked by average cortisol and high DHEA.
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Affiliation(s)
| | | | - Erinn B. Duprey
- Mt. Hope Family Center, University of Rochester
- University of Rochester Medical Center
| | | | - Dante Cicchetti
- Mt. Hope Family Center, University of Rochester
- University of Minnesota
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Honceriu C, Roca M, Costache AD, Abălașei B, Popescu L, Puni AR, Maștaleru A, Oancea A, Drugescu A, Adam C, Mitu O, Costache II, Leon MM, Roca IC, Mocanu V, Mitu F. Blood and Salivary Cortisol Variations in Athletes in Relation to Cardiopulmonary Exercise Testing. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1726. [PMID: 37893444 PMCID: PMC10608692 DOI: 10.3390/medicina59101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/12/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Cortisol is a valuable marker for assessing the body's response to any form of stress. We conducted this study in order to evaluate the variations of salivary and serum cortisol levels in professional football players in relation to cardiopulmonary exercise testing (CPET) and their significance in potentially evaluating overtraining in athletes. Also, the question of whether salivary cortisol determination could fully substitute serum sampling was addressed. Materials and Methods: A total of 19 male professional football players were evaluated by measuring serum cortisol levels at rest (T0) and immediately after a CPET (T1) and salivary cortisol levels at rest (T0), 10 min after a CPET (T2), and 30 min after a CPET (T3). Results: T0 serum cortisol showed a statistically significant correlation with the oxygen uptake at the anaerobic threshold divided by the body weight (VO2-AT/weight), as did the T2 salivary cortisol with the maximum oxygen uptake at the anaerobic threshold (VO2-AT) and VO2-AT/weight. T0 salivary cortisol was significantly correlated with the subjects' height and the predicted O2 pulse. Conclusions: While some correlations were discovered, they are insufficient to recommend cortisol as a routine biomarker in athletes' evaluation. However, significant correlations were established between salivary and serum determinations, meaning that the non-invasive procedure could substitute venous blood sampling.
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Affiliation(s)
- Cezar Honceriu
- Faculty of Physical Education and Sports, “Alexandru-Ioan Cuza” University, 700115 Iasi, Romania; (C.H.); (B.A.); (L.P.)
| | - Mihai Roca
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Alexandru Dan Costache
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Beatrice Abălașei
- Faculty of Physical Education and Sports, “Alexandru-Ioan Cuza” University, 700115 Iasi, Romania; (C.H.); (B.A.); (L.P.)
| | - Lucian Popescu
- Faculty of Physical Education and Sports, “Alexandru-Ioan Cuza” University, 700115 Iasi, Romania; (C.H.); (B.A.); (L.P.)
| | - Alexandru Rareș Puni
- Centre of Interdisciplinary Research in Human Motricity Science, “Alexandru-Ioan Cuza” University, 700115 Iasi, Romania;
| | - Alexandra Maștaleru
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andra Oancea
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andrei Drugescu
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Cristina Adam
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ovidiu Mitu
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Irina-Iuliana Costache
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Maria Magdalena Leon
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Iulia Cristina Roca
- “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania;
- Surgery II Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Veronica Mocanu
- Morpho-Functional Sciences II Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Florin Mitu
- Medical I Department, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.M.); (A.O.); (A.D.); (O.M.); (I.-I.C.); (M.M.L.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
- Romanian Academy of Scientists, 050044 Bucharest, Romania
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Sun J, Lunkenheimer E, Lin D. Dimensions of child maltreatment and longitudinal diurnal cortisol patterns: The roles of resilience and child sex. Dev Psychopathol 2023:1-15. [PMID: 37746719 DOI: 10.1017/s0954579423001086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Informed by the dimensional approach to adversity, this study disaggregated child maltreatment effects to examine how abuse versus neglect influenced cortisol at the baseline assessment and longitudinal changes in diurnal cortisol among a sample of Chinese children and adolescents (N = 312; aged 9-13 years; M age = 10.80, SD = 0.84; 67% boys). The moderating roles of resilience and sex differences in these associations were also explored. Results revealed distinct effects of abuse versus neglect on diurnal cortisol in girls, but not boys, which varied by the time scale of assessment and type of cortisol measure. Specifically, abuse was associated with girls' longitudinal changes in awakening cortisol, cortisol awakening response, and diurnal cortisol slope over one year, whereas neglect was associated with girls' awakening cortisol and cortisol awakening response at the baseline assessment. Further, resilience moderated the effects of abuse on girls' baseline awakening cortisol and longitudinal changes in diurnal cortisol slope, suggesting both the potential benefits and costs of resilience. Findings support the application of the dimensional approach to research on stress physiology and deepen our understanding of individual differences in the associations between child maltreatment and diurnal cortisol.
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Affiliation(s)
- Jianing Sun
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Erika Lunkenheimer
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
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Perez VM, Gonzales NA, Tein JY, Ibrahim MH, Luecken LJ, Losoya S. Dispositional Active Coping Predicts Patterns of Adolescents' Cortisol Responsivity in the Context of School-related Stressors. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:604-615. [PMID: 34554861 PMCID: PMC8940737 DOI: 10.1080/15374416.2021.1969651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The goal of this study was to examine the direct and conditional effects of active coping and prior exposure to school-related stressors on cortisol reactivity and recovery in response to an academically salient, social stress task. METHOD Participants included N= 758 adolescents (50% male; M age = 12.03 years, SD = .49) enrolled in the 7th grade in Title 1 middle schools. Adolescents were predominantly ethnic minorities (62% Hispanic, 12% non-Hispanic White, 11% non-Hispanic Black, 7% Native American, and 8% "other"). Youth completed self-reported assessments of their dispositional use of active coping strategies, prior exposure to school hassles, pubertal status, medication use, and relevant demographic information. In addition, youth engaged in an academically salient group public speaking task adapted for adolescents and provided salivary cortisol sample pre-task, immediately post-task, 15-, and 30-minutes post-task. RESULTS Results from piecewise latent growth curve modeling revealed that active coping independently predicted lower cortisol reactivity to the stress task. Furthermore, active coping was associated with slower cortisol recovery when adolescents reported not having experienced any school hassles in the past three months and faster recovery when having experienced several school hassles in the past three months. Results from multinomial logistic regressions revealed that greater use of active coping strategies was less likely to predict a hyper-reactive pattern of cortisol responding compared to other patterns. CONCLUSION Findings provide support for active coping as a way to promote adaptive physiological responding to school-related stressors among ethnically diverse youth residing in low-income communities.
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Affiliation(s)
- Vanesa M. Perez
- Department of Psychology, Arizona State University, Tempe, AZ
| | | | - Jenn-Yun Tein
- Department of Psychology, Arizona State University, Tempe, AZ
| | | | | | - Sandra Losoya
- Department of Psychology, Arizona State University, Tempe, AZ
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70
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Ahabrach H, El Mlili N, Mafla-España MA, Cauli O. Hair cortisol concentration associates with insomnia and stress symptoms in breast cancer survivors. Int J Psychophysiol 2023; 191:49-56. [PMID: 37532197 DOI: 10.1016/j.ijpsycho.2023.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/25/2023] [Accepted: 07/30/2023] [Indexed: 08/04/2023]
Abstract
Stress, depressive symptoms and sleep quality are important and modifiable determinant of health and their association with hair cortisol concentrations (HCC) in breast cancer survivors has not been evaluated. We selected a random sample of 65 participants (mean age 57.9 years old, range 44-75 years) recruited from local patients' associations of breast cancer survivors. Each provided a hair sample at enrollment and basic clinical data and psychological evaluation regarding self-perceived stress (PSS-scale), depressive (GDS scale) and insomnia symptoms (Athens scale). We observed a direct and significant (p = 0.001) association between HCC and stress-levels. Depressive symptoms associated significantly (p < 0.01) with stress levels but not with HCC. There were also a significant and direct correlation between hair cortisol concentration and totals core of insomnia symptoms (p = 0.002), and the subdimension of sleep difficulty symptoms (p = 0.002), and with daytime sleepiness symptoms (p = 0.016). Further investigations into the association between stress and insomnia and changes in HCC in breast cancer survivors are warranted in order to validate this biomarker for diagnosis of psychological alterations and to tailor the effects of interventions aimed to reduced stress and improve sleep quality in these women.
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Affiliation(s)
- Hanan Ahabrach
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Nisrin El Mlili
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), 93000 Tetouan, Morocco; Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, 93000 Tetouan, Morocco
| | - Mayra Alejandra Mafla-España
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; Frailty and Cognitive Impairment Group (FROG), University of Valencia, 46010 Valencia, Spain; Chair of Healthy, Active and Participatory Aging, Valencia City Council, University of Valencia, 46010 Valencia, Spain.
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71
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Doerr JM, Juenemann M, Hakel L, Schmidt L, Menzler K, Krause K, Linka L, Skoluda N, Nater UM, Knake S. Effect of transcutaneous vagus nerve stimulation on stress-reactive neuroendocrine measures in a sample of persons with temporal lobe epilepsy. Epilepsia Open 2023; 8:1013-1020. [PMID: 37310988 PMCID: PMC10472404 DOI: 10.1002/epi4.12774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/06/2023] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE Dysregulation of stress-reactive neuroendocrine measures, as well as subjective stress, have been found to worsen epilepsy. Transcutaneous vagus nerve stimulation (tVNS) is a relatively new treatment option for epilepsy. We were interested in its effect on the activity of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) as well as subjective stress and tiredness in patients with temporal lobe epilepsy (TLE). METHODS Twenty patients (age 44 ± 11 years, 13 women) were enrolled in the study. They were free of seizures for more than 1 year. All took part in two sessions with 4 h of stimulation (tVNS vs. sham) in a randomized order. Saliva samples and subjective stress and tiredness levels were measured at five time points each session (before and after stimulation and three time points every hour in between). Data were analyzed using repeated measures analysis of variance as well as paired t-tests. RESULTS There was a dampened salivary cortisol (sCort) decrease during tVNS (time × condition effect: F[2.38, 38.15] = 6.50, P = 0.002, partial η2 = 0.29). Furthermore, we detected a dampened increase in salivary flow rate during tVNS (time × condition effect: F[3.28, 55.67] = 2.82, P = 0.043, partial η2 = 0.14). There was neither a difference in overall sCort or salivary alpha-amylase (sAA) levels nor in subjective stress or tiredness levels between conditions. sAA levels at the last measurement point were slightly higher during tVNS (t(19) = 2.26, P = 0.035, d = 0.51), but this effect failed to reach significance when controlled for multiple comparisons. SIGNIFICANCE Our results partially support that tVNS influences the regulation of stress-reactive neuroendocrine systems (namely the HPA axis and ANS) in epilepsy. More research with larger samples is needed on the difference between short-term and repeated long-term stimulation.
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Affiliation(s)
- Johanna M. Doerr
- Department of NeurologyUniversity Hospital Gießen and MarburgGießenGermany
| | - Martin Juenemann
- Department of NeurologyUniversity Hospital Gießen and MarburgGießenGermany
| | - Lukas Hakel
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Laura Schmidt
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Katja Menzler
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Kristina Krause
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Louise Linka
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
| | - Nadine Skoluda
- Department of Clinical and Health Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Urs M. Nater
- Department of Clinical and Health Psychology, Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Susanne Knake
- Epilepsy Center Hessen, Department of NeurologyPhilipps‐University MarburgMarburgGermany
- Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany
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Coffman DL, Dziak JJ, Litson K, Chakraborti Y, Piper ME, Li R. A Causal Approach to Functional Mediation Analysis with Application to a Smoking Cessation Intervention. MULTIVARIATE BEHAVIORAL RESEARCH 2023; 58:859-876. [PMID: 36622859 PMCID: PMC10966971 DOI: 10.1080/00273171.2022.2149449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The increase in the use of mobile and wearable devices now allows dense assessment of mediating processes over time. For example, a pharmacological intervention may have an effect on smoking cessation via reductions in momentary withdrawal symptoms. We define and identify the causal direct and indirect effects in terms of potential outcomes on the mean difference and odds ratio scales, and present a method for estimating and testing the indirect effect of a randomized treatment on a distal binary variable as mediated by the nonparametric trajectory of an intensively measured longitudinal variable (e.g., from ecological momentary assessment). Coverage of a bootstrap test for the indirect effect is demonstrated via simulation. An empirical example is presented based on estimating later smoking abstinence from patterns of craving during smoking cessation treatment. We provide an R package, funmediation, available on CRAN at https://cran.r-project.org/web/packages/funmediation/index.html, to conveniently apply this technique. We conclude by discussing possible extensions to multiple mediators and directions for future research.
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Affiliation(s)
- Donna L Coffman
- Department of Epidemiology and Biostatistics, Temple University
| | - John J Dziak
- Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University
| | - Kaylee Litson
- Instructional Technology & Learning Sciences Department, Utah State University
| | | | - Megan E Piper
- Center for Tobacco Research Intervention, University of Wisconsin
| | - Runze Li
- Department of Statistics, The Pennsylvania State University
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Gump BB, Hruska B, Heffernan K, Brann LS, Voss M, Labrie-Cleary C, Cheng H, MacKenzie JA, Woolf-King S, Maisto S, Bendinskas K. Race, cortisol, and subclinical cardiovascular disease in 9- to 11-year-old children. Health Psychol 2023; 42:657-667. [PMID: 37410422 PMCID: PMC10601363 DOI: 10.1037/hea0001300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Non-Hispanic Black Americans have a greater risk for certain subtypes of cardiovascular disease (CVD; e.g., stroke and heart failure) relative to non-Hispanic White Americans. Moreover, Black relative to White adults consistently show elevated cortisol, a CVD risk. The impact of race, environmental stress, and cortisol on subclinical CVD has yet to be fully researched in children. METHOD We assessed diurnal salivary cortisol slopes and hair cortisol in a sample of 9- to 11-year-old children (N = 271; 54% female) with roughly half self-identifying as either Black (57%) or White (43%). Two subclinical CVD indicators were assessed: carotid-femoral pulse wave velocity (cfPWV) and carotid intima-media thickness (cIMT). We assessed numerous environmental stress indicators. RESULTS After adjusting for covariates, we found that Black children had significantly flatter diurnal cortisol slopes, higher hair cortisol, and thicker IMT than White children. Significant pathways were found: race → salivary cortisol slope → cfPWV (effect = -0.059, 95% CI [-0.116, -0.002]) and race → hair cortisol → cIMT (effect = -0.008, [-0.016, -0.002]). Black children also experienced significantly more environmental stress than White children; however, only income inequality served as a significant indirect pathway from race to salivary cortisol (effect = 0.029, [0.003, 0.060]). CONCLUSIONS Relative to White children, Black children had significantly greater hair cortisol and flatter diurnal slopes which, in turn, were associated with greater subclinical CVD. As suggested by a significant indirect pathway, income inequality might partially explain the race-cortisol association. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Brooks B. Gump
- Department of Public Health, Syracuse University, United States
| | - Bryce Hruska
- Department of Public Health, Syracuse University, United States
| | - Kevin Heffernan
- Department of Exercise Science, Syracuse University, United States
| | - Lynn S. Brann
- Department of Nutrition and Food Studies, Syracuse University, United States
| | - Margaret Voss
- Department of Nutrition and Food Studies, Syracuse University, United States
| | | | - Hanna Cheng
- Department of Chemistry, State University of New York College at Oswego, United States
| | - James A. MacKenzie
- Department of Biological Sciences, State University of New York College at Oswego, United States
| | | | - Stephen Maisto
- Department of Psychology, Syracuse University, United States
| | - Kestutis Bendinskas
- Department of Chemistry, State University of New York College at Oswego, United States
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Gettler LT, Samson DR, Kilius E, Sarma MS, Miegakanda V, Lew-Levy S, Boyette AH. Hormone physiology and sleep dynamics among BaYaka foragers of the Congo Basin: Gendered associations between nighttime activity, testosterone, and cortisol. Horm Behav 2023; 155:105422. [PMID: 37683498 DOI: 10.1016/j.yhbeh.2023.105422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/24/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023]
Abstract
Sleep quality is an important contributor to health disparities and affects the physiological function of the immune and endocrine systems, shaping how resources are allocated to life history demands. Past work in industrial and post-industrial societies has shown that lower total sleep time (TST) or more disrupted nighttime sleep are linked to flatter diurnal slopes for cortisol and lower testosterone production. There has been little focus on these physiological links in other socio-ecological settings where routine sleep conditions and nighttime activity demands differ. We collected salivary hormone (testosterone, cortisol) and actigraphy-based sleep data from Congolese BaYaka foragers (N = 39), who have relatively short and fragmented nighttime sleep, on average, in part due to their typical social sleep conditions and nighttime activity. The hormone and sleep data collections were separated by an average of 11.23 days (testosterone) and 2.84 days (cortisol). We found gendered links between nighttime activity and adults' hormone profiles. Contrary to past findings in Euro-American contexts, BaYaka men who were more active at night, on average, had higher evening testosterone than those with lower nighttime activity, with a relatively flat slope relating nighttime activity and evening testosterone in women. Women had steeper diurnal cortisol curves with less disrupted sleep. Men had steeper cortisol diurnal curves if they were more active at night. BaYaka men often hunt and socialize when active at night, which may help explain these patterns. Overall, our findings indicate that the nature of nighttime activities, including their possible social and subsistence contexts, are potentially important modifiers of sleep quality-physiology links, meriting further research across contexts.
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Affiliation(s)
- Lee T Gettler
- University of Notre Dame, Department of Anthropology, Notre Dame 46556, USA; University of Notre Dame, Eck Institute for Global Health, Notre Dame 46556, USA.
| | - David R Samson
- University of Toronto Mississauga, Department of Anthropology, Mississauga L5L1C6, Canada
| | - Erica Kilius
- University of Toronto Mississauga, Department of Anthropology, Mississauga L5L1C6, Canada
| | - Mallika S Sarma
- Johns Hopkins University, School of Medicine, Baltimore 21287, USA
| | - Valchy Miegakanda
- Laboratoire National de Sante Publique, Brazzaville, Republic of the Congo
| | - Sheina Lew-Levy
- Department of Psychology, Durham University, Durham DH1 3LE, UK
| | - Adam H Boyette
- Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology and Culture, Leipzig 04103, Germany
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Reid BM, Georgieff MK. The Interaction between Psychological Stress and Iron Status on Early-Life Neurodevelopmental Outcomes. Nutrients 2023; 15:3798. [PMID: 37686831 PMCID: PMC10490173 DOI: 10.3390/nu15173798] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
This review presents evidence from animal and human studies demonstrating the possible connection and significant impact of poor iron status and psychological distress on neurocognitive development during pregnancy and the neonatal period, with implications for long-term cognition. Stress and iron deficiency are independently prevalent and thus are frequently comorbid. While iron deficiency and early-life stress independently contribute to long-term neurodevelopmental alterations, their combined effects remain underexplored. Psychological stress responses may engage similar pathways as infectious stress, which alters fundamental iron metabolism processes and cause functional tissue-level iron deficiency. Psychological stress, analogous to but to a lesser degree than infectious stress, activates the hypothalamic-pituitary-adrenocortical (HPA) axis and increases proinflammatory cytokines. Chronic or severe stress is associated with dysregulated HPA axis functioning and a proinflammatory state. This dysregulation may disrupt iron absorption and utilization, likely mediated by the IL-6 activation of hepcidin, a molecule that impedes iron absorption and redistributes total body iron. This narrative review highlights suggestive studies investigating the relationship between psychological stress and iron status and outlines hypothesized mechanistic pathways connecting psychological stress exposure and iron metabolism. We examine findings regarding the overlapping impacts of early stress exposure to iron deficiency and children's neurocognitive development. We propose that studying the influence of psychological stress on iron metabolism is crucial for comprehending neurocognitive development in children exposed to prenatal and early postnatal stressors and for children at risk of early iron insufficiency. We recommend future directions for dual-exposure studies exploring iron as a potential mediating pathway between early stress and offspring neurodevelopment, offering opportunities for targeted interventions.
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Affiliation(s)
- Brie M. Reid
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI 02912, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI 02906, USA
| | - Michael K. Georgieff
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
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Watts P, Menon M, Netuveli G. Depression Earlier on in Life Predicts Frailty at 50 Years: Evidence from the 1958 British Birth Cohort Study. J Clin Med 2023; 12:5568. [PMID: 37685635 PMCID: PMC10487987 DOI: 10.3390/jcm12175568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Frailty and depression in older ages have a bidirectional relationship, sharing some symptoms and characteristics. Most evidence for this has come from cross-sectional studies, or longitudinal studies with limited follow-up periods. We used data from the National Child Development Study (1958 Birth Cohort) to investigate the relationship between depression and early-onset frailty using a life course perspective. The primary outcome was frailty based on a 30-item inventory of physical health conditions, activities of daily living and cognitive function at 50 years. The main exposure was depression (based on a nine-item Malaise score ≥ 4) measured at 23, 33 and 42 years. We investigated this relationship using multiple logistic regression models adjusted for socio-demographic factors, early life circumstances and health behaviours. In fully adjusted models, when modelled separately, depression at each timepoint was associated with around twice the odds of frailty. An accumulated depression score showed increases in the odds of frailty with each unit increase (once: OR 1.92, 95%CI 1.65, 2.23; twice OR 2.33, 95%CI 1.85, 2.94; thrice: OR 2.95, 95%CI 2.11, 4.11). The public health significance of this finding is that it shows the potential to reduce the physical burden of disease later in life by paying attention to mental health at younger ages.
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Affiliation(s)
- Paul Watts
- School of Health, Sport and Bioscience, University of East London, London E16 2RD, UK;
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Zhu C, Lian Z, Huang Y, Zhong Q, Wang J. Association between subjective well-being and all-cause mortality among older adults in China. BMC Psychiatry 2023; 23:624. [PMID: 37626305 PMCID: PMC10463678 DOI: 10.1186/s12888-023-05079-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Although several studies in high-income countries have suggested a positive association between subjective well-being (SWB) and mortality, studies conducted in low- and middle-income countries, such as China, are scarce. The purpose of this study is to examine the association between SWB and all-cause mortality among the older Chinese population. METHODS Data were from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a population-based longitudinal cohort study in 22 of 31 provinces in mainland China. A total of 13,282 individuals aged 65 ≥ years who were recruited in 2002 and followed-up until 2018 were included. SWB was assessed with an eight-item tool covering life satisfaction, positive affect (including optimism, happiness, personal control and conscientiousness) and negative affect (including anxiety, loneliness and uselessness). Cox proportional hazards regression methods were carried out to estimate the association between SWB and total mortality, adjusting for a wide range of potential confounders. Subgroup analyses and interaction analyses were further conducted. RESULTS During the 16.5 years of follow-up, 8459 deaths were identified. Greater SWB was independently associated with a reduced risk of all-cause mortality (adjusted hazard ratio [HR] = 0.85, 95% confidence interval [CI] = 0.81-0.89) after adjustment for age, sex, marital status, education level, place of residence, smoking status, drinking, exercise, diet, BMI, hypertension, diabetes, heart disease, cerebrovascular diseases and cancer. Of the eight individual SWB symptoms, only 2 items, feelings of uselessness (adjusted HR = 0.94, 95% CI = 0.89-0.99) and happiness (adjusted HR = 0.91, 95% CI = 0.86-0.95), were significantly associated with total mortality. Associations remained significant across all subgroups regardless of different characteristics. CONCLUSIONS Higher SWB overall and 2 certain symptoms (feelings of uselessness and happiness) were independently associated with all-cause mortality risk among older Chinese adults. The association was consistent across different groups, suggesting that promoting a healthier SWB may be beneficial to all older individuals irrespective of their characteristics.
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Affiliation(s)
- Chunsu Zhu
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
- Fujian Key Laboratory of Advanced Technology for Cancer Screening and Early Diagnosis, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
| | - Zhiwei Lian
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China.
| | - Yongying Huang
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
| | - Qiaofeng Zhong
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
| | - Jianmin Wang
- Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, No. 420, Fuma Road, Jinan District, Fuzhou, 350014, China
- Fujian Key Laboratory of Advanced Technology for Cancer Screening and Early Diagnosis, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China
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Gan L, Li N, Heizhati M, Li M, Yao L, Hong J, Wu T, Wang H, Liu M, Maitituersun A. Diurnal Cortisol Features and Type 2 Diabetes Risk in Patients With Hypertension and Obstructive Sleep Apnea: A Cohort Study. J Clin Endocrinol Metab 2023; 108:e679-e686. [PMID: 37022782 DOI: 10.1210/clinem/dgad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
CONTEXT The hypothalamic-pituitary-adrenal (HPA) axis may be associated with type 2 diabetes (T2D); however, whether HPA axis dysfunction is associated with incident T2D remains unclear in patients with hypertension and obstructive sleep apnea (OSA). OBJECTIVE To investigate the relationship between the diurnal cortisol features and the risk of incident T2D in patients with hypertension and OSA. METHODS Participants with cortisol rhythm test at baseline in the Urumqi Research on Sleep Apnea and Hypertension cohort were enrolled. The Cox regression model was used to evaluate the relationship between ln-transformed diurnal cortisol features and T2D risk. Stratified and sensitivity analyses were also performed. RESULTS A total of 1478 patients with hypertension and OSA were enrolled in this study. During a median follow-up of 7.0 years, 196 participants developed T2D. Overall, a steep diurnal cortisol slope (DCS) was significantly associated with decreased T2D risk (per SD increase, HR 0.88, 95% CI 0.79-0.97, P = .014). Midnight cortisol was positively associated with increased T2D risk (per SD increase, HR 1.25, 95% CI 1.08-1.45, P = .003). Sensitivity analyses showed similar results. Neither DCS nor midnight cortisol was associated with incident T2D in the women's subgroup or participants with mild OSA. CONCLUSION Steeper DCS and higher midnight cortisol levels are associated with lower and higher T2D risks in patients with hypertension and OSA, respectively, at least in men or participants with moderate to severe OSA. Diurnal cortisol features may represent an early prevention target for diabetes in this population.
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Affiliation(s)
- Lin Gan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Ting Wu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Hui Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Miaomiao Liu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
| | - Adalaiti Maitituersun
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang 830001, China
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Nebe S, Reutter M, Baker DH, Bölte J, Domes G, Gamer M, Gärtner A, Gießing C, Gurr C, Hilger K, Jawinski P, Kulke L, Lischke A, Markett S, Meier M, Merz CJ, Popov T, Puhlmann LMC, Quintana DS, Schäfer T, Schubert AL, Sperl MFJ, Vehlen A, Lonsdorf TB, Feld GB. Enhancing precision in human neuroscience. eLife 2023; 12:e85980. [PMID: 37555830 PMCID: PMC10411974 DOI: 10.7554/elife.85980] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023] Open
Abstract
Human neuroscience has always been pushing the boundary of what is measurable. During the last decade, concerns about statistical power and replicability - in science in general, but also specifically in human neuroscience - have fueled an extensive debate. One important insight from this discourse is the need for larger samples, which naturally increases statistical power. An alternative is to increase the precision of measurements, which is the focus of this review. This option is often overlooked, even though statistical power benefits from increasing precision as much as from increasing sample size. Nonetheless, precision has always been at the heart of good scientific practice in human neuroscience, with researchers relying on lab traditions or rules of thumb to ensure sufficient precision for their studies. In this review, we encourage a more systematic approach to precision. We start by introducing measurement precision and its importance for well-powered studies in human neuroscience. Then, determinants for precision in a range of neuroscientific methods (MRI, M/EEG, EDA, Eye-Tracking, and Endocrinology) are elaborated. We end by discussing how a more systematic evaluation of precision and the application of respective insights can lead to an increase in reproducibility in human neuroscience.
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Affiliation(s)
- Stephan Nebe
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
| | - Mario Reutter
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Daniel H Baker
- Department of Psychology and York Biomedical Research Institute, University of YorkYorkUnited Kingdom
| | - Jens Bölte
- Institute for Psychology, University of Münster, Otto-Creuzfeldt Center for Cognitive and Behavioral NeuroscienceMünsterGermany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
- Institute for Cognitive and Affective NeuroscienceTrierGermany
| | - Matthias Gamer
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Anne Gärtner
- Faculty of Psychology, Technische Universität DresdenDresdenGermany
| | - Carsten Gießing
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University of OldenburgOldenburgGermany
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | - Kirsten Hilger
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
- Department of Psychology, Psychological Diagnostics and Intervention, Catholic University of Eichstätt-IngolstadtEichstättGermany
| | - Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Louisa Kulke
- Department of Developmental with Educational Psychology, University of BremenBremenGermany
| | - Alexander Lischke
- Department of Psychology, Medical School HamburgHamburgGermany
- Institute of Clinical Psychology and Psychotherapy, Medical School HamburgHamburgGermany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Maria Meier
- Department of Psychology, University of KonstanzKonstanzGermany
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of BaselBaselSwitzerland
| | - Christian J Merz
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University BochumBochumGermany
| | - Tzvetan Popov
- Department of Psychology, Methods of Plasticity Research, University of ZurichZurichSwitzerland
| | - Lara MC Puhlmann
- Leibniz Institute for Resilience ResearchMainzGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Daniel S Quintana
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
- NevSom, Department of Rare Disorders & Disabilities, Oslo University HospitalOsloNorway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of OsloOsloNorway
- Norwegian Centre for Mental Disorders Research (NORMENT), University of OsloOsloNorway
| | - Tim Schäfer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | | | - Matthias FJ Sperl
- Department of Clinical Psychology and Psychotherapy, University of GiessenGiessenGermany
- Center for Mind, Brain and Behavior, Universities of Marburg and GiessenGiessenGermany
| | - Antonia Vehlen
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-EppendorfHamburgGermany
- Department of Psychology, Biological Psychology and Cognitive Neuroscience, University of BielefeldBielefeldGermany
| | - Gordon B Feld
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychology, Heidelberg UniversityHeidelbergGermany
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
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Kumar L, Verma A, Pal US, Mattoo K, Algarni YA, Bin Hassan SA, Baba SM, Jeri SY, Khateeb SU. Influence of Prosthodontic Rehabilitation Using Zygomatic Implants in Covid 19 Related Mucormycosis (Rhino-Orbital-Cerebral) Maxillectomy Patients Upon Post-Operative Stress, Anxiety and Functional Impairment: A Prospective Cohort Study. Clin Interv Aging 2023; 18:1201-1219. [PMID: 37547381 PMCID: PMC10404046 DOI: 10.2147/cia.s412625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/20/2023] [Indexed: 08/08/2023] Open
Abstract
Purpose To determine the influence of prosthodontic rehabilitation using zygomatic implants in partial maxillectomy upon post-operative stress, anxiety and functional impairment, due to covid 19 associated rhino-orbital-cerebral mucormycosis (ROCM). Patients and Methods Twenty maxillectomy patients fulfilling study criterion, received zygomatic implants (ZI) (quad zygoma) (ZDI Simpladent, Switzerland) retained/supported complete maxillary denture. Assessment of stress, anxiety, masticatory performance and speech were determined using diurnal salivary cortisol level, Appearance Anxiety Inventory, multiple sieve technique and auditory perception analysis, respectively. Data were recorded at 6 different stages of rehabilitation (after maxillectomy, implant placement, and after prosthesis delivery (1 week, 1 month, 6 months and 1 year)). Demographic data were expressed as frequency distribution, while mean values were used to find differences between various rehabilitation stages using Friedman and chi-square test with statistical significance value at p < 0.05. Results Average daily salivary cortisol levels declined from post maxillectomy (22.80 ± 0.902) to 1 year after prosthesis wearing (8.65 ± 0.985), indicating stress reduction after ZI rehabilitation. Mean scores for appearance anxiety reduced from pre-prosthetic rehabilitation (27.350 ± 3.030) to 1 year (8.950 ± 0.887) following prosthesis wearing. Functional parameters for mastication and speech also improved significantly during the course of rehabilitation. All differences between pre-prosthetic to 1-year stage after prosthesis wearing were found to be statistically significant at p < 0.05. Conclusion Post ROCM maxillectomy cases after prosthetic rehabilitation using zygomatic implants showed significant improvement in the psychological (stress and anxiety) as well as function (mastication and speech) characteristics. Rehabilitation post ROCM maxillectomy with the present approach of fixed prosthesis using zygomatic implants mitigates deficient mastication and speech. It also impacts positively on patient psychology by decreasing stress and anxiety.
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Affiliation(s)
- Lakshya Kumar
- Department of Prosthodontics, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India
| | - Aditi Verma
- Department of Prosthodontics, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India
| | - Uma Shanker Pal
- Department of Oral and Maxillofacial Surgery, King George`s Medical University, Lucknow, Uttar Pradesh, 226003, India
| | - Khurshid Mattoo
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, 45142, Kingdom of Saudi Arabia
| | - Youssef Abdullah Algarni
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Kingdom of Saudi Arabia
| | - Saeed Awod Bin Hassan
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Kingdom of Saudi Arabia
| | - Suheel Manzoor Baba
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Kingdom of Saudi Arabia
| | - Sumaya Yousuf Jeri
- Department of Orthodontics and Dentofacial Orthopedics, I.T.S Centre for Dental Studies and Research, Chaudhary Charan Singh University, Ghaziabad, Uttar Pradesh, 201206, India
| | - Shafait Ullah Khateeb
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61421, Kingdom of Saudi Arabia
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81
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Farrell AK, Stimpel AL, Stanton SCE, Slatcher RB. Relationship quality and physical health: Responsiveness as an active ingredient predicting health across the lifespan. Curr Opin Psychol 2023; 52:101628. [PMID: 37413936 DOI: 10.1016/j.copsyc.2023.101628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
A growing body of research has established responsiveness as a robust predictor of physical health. Here, we evaluate the extent to which this work establishes partner responsiveness as an active ingredient- a specific component within the broader construct of relationship quality that accounts for a demonstrated association between relationship quality and health. We review work demonstrating that responsiveness predicts a wide range of physical health outcomes, above and beyond other facets of relationship quality, and that it moderates the effects of other protective processes and risk factors. Finally, we discuss how new methodological and interdisciplinary approaches can provide generalizable, causal, and mechanistic evidence to further validate responsiveness as an active ingredient linking relationships and health.
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82
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Kessler CL, Vrshek-Schallhorn S, Mineka S, Zinbarg RE, Craske M, Adam EK. Experiences of adversity in childhood and adolescence and cortisol in late adolescence. Dev Psychopathol 2023; 35:1235-1250. [PMID: 34743763 DOI: 10.1017/s0954579421001152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Early life adversity influences the diurnal cortisol rhythm, yet the relative influence of different characteristics of adversity remains unknown. In this study, we examine how developmental timing (childhood vs. adolescence), severity (major vs. minor), and domain of early life adversity relate to diurnal cortisol rhythms in late adolescence. We assessed adversity retrospectively in early adulthood in a subsample of 236 participants from a longitudinal study of a diverse community sample of suburban adolescents oversampled for high neuroticism. We used multilevel modeling to assess associations between our adversity measures and the diurnal cortisol rhythm (waking and bedtime cortisol, awakening response, slope, and average cortisol). Major childhood adversities were associated with flatter daily slope, and minor adolescent adversities were associated with greater average daily cortisol. Examining domains of childhood adversities, major neglect and sexual abuse were associated with flatter slope and lower waking cortisol, with sexual abuse also associated with higher cortisol awakening response. Major physical abuse was associated with higher waking cortisol. Among adolescent adversities domains, minor neglect, emotional abuse, and witnessing violence were associated with greater average cortisol. These results suggest severity, developmental timing, and domain of adversity influence the association of early life adversity with stress response system functioning.
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Affiliation(s)
- Courtenay L Kessler
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | | | - Susan Mineka
- Psychology Department, Northwestern University, Evanston, IL, USA
| | - Richard E Zinbarg
- Psychology Department, Northwestern University, Evanston, IL, USA
- The Family Institute at Northwestern University, Evanston, IL, USA
| | | | - Emma K Adam
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
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83
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Nayman S, Beddig T, Reinhard I, Kuehner C. Effects of cognitive emotion regulation strategies on mood and cortisol in daily life in women with premenstrual dysphoric disorder. Psychol Med 2023; 53:5342-5352. [PMID: 35979813 PMCID: PMC10476072 DOI: 10.1017/s0033291722002495] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/14/2022] [Accepted: 07/18/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The psychological risk factors of premenstrual dysphoric disorder (PMDD) are not fully understood, but initial evidence points to a potential role of unfavorable cognitive emotion regulation (ER-) strategies. Given the symptom cyclicity of PMDD, ambulatory assessment is ideally suited to capture psychological and physiological processes across the menstrual cycle. Our study examines habitual ER-strategies in women with PMDD and their predictive value for the course of mood and basal cortisol across the cycle in affected women. METHODS Women with and without PMDD (n = 61 each) were compared regarding habitual mindfulness, reappraisal, and repetitive negative thinking (RNT). Momentary affect and cortisol output were assessed over two consecutive days per cycle phase (menstrual, follicular, ovulatory, late luteal). RESULTS Women with PMDD reported lower mindfulness, less use of reappraisal and stronger RNT than controls (ps < 0.035). In women with PMDD, higher mindfulness and reappraisal and lower RNT predicted decreased negative and increased positive affect across the menstrual cycle (ps < 0.027). However, women using more favorable ER-strategies displayed stronger mood cyclicity, resulting in stronger mood deterioration in the late luteal phase, thereby resembling women with more unfavorable ER-strategies toward the end of the cycle. Lower mindfulness predicted lower cortisol in the menstrual phase. CONCLUSIONS Protective ER-strategies seem to be generally linked to better momentary mood in women with PMDD, but do not appear to protect affected women from premenstrual mood deterioration. Habitual mindfulness, in turn, seems to buffer blunted cortisol activity in women with PMDD, especially in the menstrual phase.
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Affiliation(s)
- Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Theresa Beddig
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
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84
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Aker A, Serghides L, Cotnam J, Jackson R, Robinson M, Gauvin H, Mushquash C, Gesink D, Amirault M, Benoit AC. The impact of a stress management intervention including cultural components on stress biomarker levels and mental health indicators among indigenous women. J Behav Med 2023; 46:594-608. [PMID: 36652086 PMCID: PMC10344996 DOI: 10.1007/s10865-023-00391-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 01/03/2023] [Indexed: 01/19/2023]
Abstract
We examined the effectiveness of a 26-week culture-inclusive intervention on reducing salivary stress biomarker levels, and perceived stress, depressive, and post-traumatic stress disorder (PTSD) symptoms measured using scales in 53 Indigenous women in Ontario, Canada. Statistical analyses compared the average biomarker levels, and the area under the curve (AUC) of biomarkers. Differences in biomarkers and mental health scale scores pre- and post-intervention were compared using mixed models with a random intercept. Interaction terms were included between the intervention and age, education, disability, and HIV status, individually, to test for sub-group differences. Cortisol AUC post-intervention was decreased compared to pre-intervention (β -1.29 µg/dL; 95%CI -2.35, -0.23). There was a slight decrease in perceived stress levels (aOR: -2.80; 95%CI -5.09, -0.50). The associations were stronger among women of younger age, higher education, and no disabilities. These interventions can be effective, but future interventions should target Indigenous population sub-groups to address individual needs.
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Affiliation(s)
- Amira Aker
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Lena Serghides
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Immunology, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Jasmine Cotnam
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Randy Jackson
- McMaster Indigenous Research Institute, McMaster University, Hamilton, ON, Canada
| | - Margaret Robinson
- Department of Sociology and Social Anthropology, Dalhousie University, Nova Scotia, Canada
| | | | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Department of Psychology, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Anita C Benoit
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada.
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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85
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Xie M, Jiang Y, Zilioli S, Xiang S, Zhao S, Lin D. Parent-Child Separation and Diurnal Cortisol Rhythms Among Left-Behind Adolescents: The Moderating Role of Sex. J Youth Adolesc 2023:10.1007/s10964-023-01820-8. [PMID: 37481502 DOI: 10.1007/s10964-023-01820-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/24/2023]
Abstract
Prior research examining parent-child separation and the hypothalamic-pituitary-adrenal (HPA) axis functioning has primarily focused on separation due to parental divorce or loss or forced migration. Less clear is the impact of parental economic migration on adolescents' HPA axis functioning. The present study fills this gap by examining diurnal cortisol patterns among left-behind adolescents who experienced separation from their migrant parents. Participants were 293 Chinese adolescents (33.4% girls, 66.21% left-behind adolescents; Mage = 10.80 years old, SD = 0.82 years). Two-level multilevel modeling was conducted to examine the associations between parent-child separation experiences and diurnal cortisol patterns. Although no significant differences were found between left-behind adolescents and their non-left-behind peers, results revealed that left-behind adolescents who experienced parent-child separation at earlier ages had more blunted diurnal cortisol slopes (usually signaling poorer mental and physical health), compared to their counterparts who experienced separation at older ages. Left-behind adolescent girls who had more adverse separation experiences exhibited smaller waking cortisol and blunted diurnal slopes; these findings were not observed among left-behind adolescent boys. Observing the association between timing of parent-child separation and adolescents' diurnal cortisol and the moderating effects of child sex, this study contributes uniquely to the developmental science of left-behind adolescents' physiological health.
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Affiliation(s)
- Mingjun Xie
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Yanping Jiang
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
- Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit, MI, USA
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA
| | - Shiyuan Xiang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Shan Zhao
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China.
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86
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Darabos K, Faust H. Assessing health, psychological distress and financial well-being in informal young adult caregivers compared to matched young adult non-caregivers. PSYCHOL HEALTH MED 2023; 28:2249-2260. [PMID: 36976715 DOI: 10.1080/13548506.2023.2195671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Young adult caregivers (YACs) are faced with the atypical challenge of providing informal (i.e. not paid) care to a family member, while simultaneously at a critical developmental stage in which many major life decisions and milestones are taking place. Adding the challenge of caring for a family member during this already complex time period may have a detrimental impact on young adults' (YAs) own overall health and well-being. The aim of this study was to examine differences in overall health, psychological distress, and financial strain among a propensity matched sample of YACs compared to young adult non-caregivers (YANCs) from a nationally representative database and to examine differences in these outcomes by caregiving role (caring for a child vs. other family member). YAs (aged 18-39, N = 178) identifying as a caregiver (n = 74) were matched with YANCs (n = 74) on age, gender, and race. Results revealed that YACs exhibited higher psychological distress, lower overall health and more sleep disturbance and higher financial strain compared to YANCs. YAs caring for family members other than children also reported higher anxiety and fewer hours spent caregiving compared to YAs caring for a child. YACs appear to be at risk for impairments in health and well-being compared to their matched peers. Longitudinal research is needed to understand how caregiving during young adulthood impacts health and well-being across time.
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Affiliation(s)
- Katie Darabos
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Haley Faust
- Department of Behavioral Oncology Children's Hospital of Philadelphia, Philadelphia, PA, USA
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87
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Rinne GR, Hartstein J, Guardino CM, Dunkel Schetter C. Stress before conception and during pregnancy and maternal cortisol during pregnancy: A scoping review. Psychoneuroendocrinology 2023; 153:106115. [PMID: 37119659 PMCID: PMC10936734 DOI: 10.1016/j.psyneuen.2023.106115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/10/2023] [Accepted: 04/16/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Stress before conception and during pregnancy is associated with less favorable maternal and child health. Alterations in prenatal cortisol levels may serve as a central biological pathway linking stress to adverse maternal and child health. Research examining associations between maternal stress from childhood through pregnancy and prenatal cortisol has not been comprehensively reviewed. METHOD The current scoping review of 48 papers synthesizes studies reporting on associations between stress before conception and during pregnancy with maternal cortisol in pregnancy. Eligible studies measured childhood, the proximal preconception period, pregnancy, or lifetime stress based on stress exposures or appraisals and measured cortisol in saliva or hair during pregnancy. RESULTS Higher maternal childhood stress was associated with higher cortisol awakening responses and alterations in typical pregnancy-specific changes in diurnal cortisol patterns across studies. In contrast, most studies of preconception and prenatal stress reported null associations with cortisol and those reporting significant effects were inconsistent in direction. A few studies found that the associations between stress and cortisol during pregnancy varied as a function of several moderators including social support and environmental pollution. CONCLUSIONS Although many studies have evaluated effects of maternal stress on prenatal cortisol, this scoping review is the first to synthesize existing literature on this topic. The association between stress before conception and during pregnancy and prenatal cortisol may depend on the developmental timing of stress and several moderators. Maternal childhood stress was more consistently associated with prenatal cortisol than proximal preconception or pregnancy stress. We discuss methodological and analytic factors that may contribute to mixed findings.
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Affiliation(s)
- Gabrielle R Rinne
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Jenna Hartstein
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Mahr F, Waschbusch DA, Vgontzas A. A Pilot Study on the Effectiveness of Prazosin as a Treatment of Post-Traumatic Stress Disorder-Related Nightmares in Women with Bulimia Nervosa. Cureus 2023; 15:e42433. [PMID: 37637523 PMCID: PMC10448916 DOI: 10.7759/cureus.42433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Objectives Post-traumatic stress disorder (PTSD) symptoms are reported in over 36% of individuals with bulimia nervosa. To date, none of the clinical trials have examined nightmare reduction in this population. We evaluated the effectiveness of prazosin in bulimic females experiencing PTSD-related nightmares. We hypothesized that prazosin will decrease nightmares, normalize cortisol levels and secretory patterns, and improve sleep. Methods Our seven-week prospective, randomized, double-blind, placebo-controlled crossover pilot trial recruited eight adult women. Each participant received three weeks of prazosin and a placebo, separated by a one-week washout period. The order of treatment was counterbalanced across participants. Self-reports, clinician-administered scales, and salivary cortisol was collected to measure outcomes. Results A significant treatment effect was seen in nightmare intensity on the Clinician-Administered PTSD Scale (CAPS-I) (p=0.026) and a marginally significant effect on nightmare frequency (p=0.069). The only significant main effect of treatment on self-reported sleep parameters was on nightmares. Cortisol secretory patterns did not change, but on average, study participants had significantly higher cortisol levels compared to normative values. ANOVA showed a significant main effect of time for cortisol (F(4, 28) = 6.15, p=.001) but no within or between groups significant effects (ps>.179). Follow-up tests showed the effect of time was linear (F(1, 7) = 10.77, p=.013). Conclusion Prazosin significantly reduced intensity and marginally reduced the frequency of PTSD-related nightmares in bulimia nervosa but did not affect subjective sleep efficiency, quality, cortisol levels, or diurnal cortisol secretory pattern. Larger trials using objective sleep measures are warranted to replicate these findings.
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Affiliation(s)
- Fauzia Mahr
- Pediatrics and Eating Disorders, Penn State College of Medicine, Hershey, USA
| | - Daniel A Waschbusch
- Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, USA
| | - Alexandros Vgontzas
- Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, USA
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89
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Musacchio S, Kallenbach MD, Huber DL, Raff H, Johnson BD, Leddy J, McCrea MA, Meier TB, Nelson LD. Salivary Cortisol Dynamics After Mild Traumatic Brain Injury. J Head Trauma Rehabil 2023; 38:E318-E327. [PMID: 36696236 PMCID: PMC10329977 DOI: 10.1097/htr.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To assess mild traumatic brain injury (mTBI)-related alterations in baseline (resting) salivary cortisol and cortisol reactivity to cognitive and exercise stressors, which are frequently encountered during mTBI rehabilitation and recovery. SETTING Persons with mTBI were recruited from a level 1 trauma center emergency department. Uninjured controls (UCs) were recruited from the community. PARTICIPANTS Participants were 37 individuals with mTBI and 24 UCs. All patients with mTBI were enrolled at 7 ± 3 days post-injury, met the American Congress of Rehabilitation Medicine definition of mTBI, and had no acute intracranial findings on clinical neuroimaging (if performed). DESIGN A prospective cohort study design was used. All participants provided saliva samples 10 times during each of 2 visits spaced 3 weeks apart (1 week and 1 month post-injury for the mTBI group). Each visit included baseline saliva sampling and sampling to evaluate reactivity to a cognitive stressor (Paced Auditory Serial Addition Test) and physical stressor (Buffalo Concussion Treadmill Test [BCTT]). MAIN OUTCOME MEASURE Natural log-transformed salivary cortisol was measured by enzyme immunoassay. Cortisol was predicted using a linear mixed-effects model by group (mTBI and UC), visit (1 week and 1 month), and saliva sample. RESULTS Mean salivary cortisol was higher in the mTBI group (1.67 nmol/L [95% CI 1.42-1.72]) than in controls (1.30 nmol/L [1.12-1.47]), without an mTBI × time interaction. At 1 week, the mTBI group had greater cortisol reactivity in response to the BCTT. CONCLUSIONS Higher cortisol in individuals with mTBI at 1 week and 1 month post-injury extends previous findings into the subacute recovery period. Furthermore, the mTBI group demonstrated a greater cortisol response to mild-to-moderate aerobic exercise (BCTT) at 1 week post-injury. Given the increasing role of exercise in mTBI rehabilitation, further research is warranted to replicate these findings and identify the clinical implications, if any, of enhanced hypothalamic-pituitary-adrenal axis responses to exercise in civilians with recent mTBI.
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Affiliation(s)
- Sophia Musacchio
- Departments of Neurosurgery (Ms Musacchio, Mx Kallenbach, Mr Huber, and Drs McCrea, Meier, and Nelson) and Medicine, Surgery, and Physiology (Dr Raff), Medical College of Wisconsin, Milwaukee; Endocrine Research Laboratory, Aurora St Luke's Medical Center, Advocate Aurora Research Institute, Milwaukee, Wisconsin (Dr Raff); Department of Kinesiology, Indiana University, Bloomington (Dr Johnson); and UBMD Orthopaedics and Sports Medicine, and SUNY Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York (Dr Leddy)
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90
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Jue H, Fang-fang L, Dan-fei C, Nuo C, Chun-lu Y, Ke-pin Y, Jian C, Xiao-bo X. A bidirectional Mendelian randomization study about the role of morning plasma cortisol in attention deficit hyperactivity disorder. Front Psychiatry 2023; 14:1148759. [PMID: 37389173 PMCID: PMC10303788 DOI: 10.3389/fpsyt.2023.1148759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
Context Cortisol, a hormone regulated by the hypothalamic-pituitary-adrenal (HPA) axis, has been linked to attention deficit hyperactivity disorder (ADHD). The nature of the relationship between cortisol and ADHD, and whether it is causal or explained by reverse causality, remains a matter of debate. Objective This study aims to evaluate the bidirectional causal relationship between morning plasma cortisol levels and ADHD. Methods This study used a bidirectional 2-sample Mendelian randomization (MR) design to analyze the association between morning plasma cortisol levels and ADHD using genetic information from the authoritative Psychiatric Genomics Collaboration (PGC) database (n = 55,347) and the ADHD Working Group of the CORtisol NETwork (CORNET) Consortium (n = 12,597). MR analyses were employed: inverse variance weighting (IVW), MR-Egger regression, and weighted medians. OR values and 95% CI were used to evaluate whether there was a causal association between morning plasma cortisol levels on ADHD and ADHD on morning plasma cortisol levels. The Egger-intercept method was employed to test for level pleiotropy. Sensitivity analysis was performed using the "leave-one-out" method, MR pleiotropy residual sum, and MR pleiotropy residual sum and outlier (MR-PRESSO). Results Findings from bidirectional MR demonstrated that lower morning plasma cortisol levels were associated with ADHD (ADHD-cortisol OR = 0.857; 95% CI, 0.755-0.974; P = 0.018), suggesting there is a reverse causal relationship between cortisol and ADHD. However, morning plasma cortisol levels were not found to have a causal effect on the risk of ADHD (OR = 1.006; 95% CI, 0.909-1.113; P = 0.907), despite the lack of genetic evidence. The MR-Egger method revealed intercepts close to zero, indicating that the selected instrumental variables had no horizontal multiplicity. The "leave-one-out" sensitivity analysis revealed stable results, with no instrumental variables significantly affecting the results. Heterogeneity tests were insignificant, and MR-PRESSO did not detect any significant outliers. The selected single-nucleotide polymorphisms (SNPs) F were all >10, indicating no weak instrumental variables. Thus, the overall MR analysis results were reliable. Conclusion The study findings suggest a reverse causal relationship between morning plasma cortisol levels and ADHD, with low cortisol levels associated with ADHD. No genetic evidence was found to support a causal relationship between morning plasma cortisol levels and the risk of ADHD. These results suggest that ADHD may lead to a significant reduction in morning plasma cortisol secretion.
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Affiliation(s)
- Hu Jue
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Fang-fang
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Dan-fei
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Nuo
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ye Chun-lu
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yu Ke-pin
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Jian
- First Clinical School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xuan Xiao-bo
- Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China
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Zeng S, Lange EC, Archie EA, Campos FA, Alberts SC, Li F. A Causal Mediation Model for Longitudinal Mediators and Survival Outcomes with an Application to Animal Behavior. JOURNAL OF AGRICULTURAL, BIOLOGICAL, AND ENVIRONMENTAL STATISTICS 2023; 28:197-218. [PMID: 37415781 PMCID: PMC10321498 DOI: 10.1007/s13253-022-00490-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 07/08/2023]
Abstract
In animal behavior studies, a common goal is to investigate the causal pathways between an exposure and outcome, and a mediator that lies in between. Causal mediation analysis provides a principled approach for such studies. Although many applications involve longitudinal data, the existing causal mediation models are not directly applicable to settings where the mediators are measured on irregular time grids. In this paper, we propose a causal mediation model that accommodates longitudinal mediators on arbitrary time grids and survival outcomes simultaneously. We take a functional data analysis perspective and view longitudinal mediators as realizations of underlying smooth stochastic processes. We define causal estimands of direct and indirect effects accordingly and provide corresponding identification assumptions. We employ a functional principal component analysis approach to estimate the mediator process and propose a Cox hazard model for the survival outcome that flexibly adjusts the mediator process. We then derive a g-computation formula to express the causal estimands using the model coefficients. The proposed method is applied to a longitudinal data set from the Amboseli Baboon Research Project to investigate the causal relationships between early adversity, adult physiological stress responses, and survival among wild female baboons. We find that adversity experienced in early life has a significant direct effect on females' life expectancy and survival probability, but find little evidence that these effects were mediated by markers of the stress response in adulthood. We further developed a sensitivity analysis method to assess the impact of potential violation to the key assumption of sequential ignorability. Supplementary materials accompanying this paper appear on-line.
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Affiliation(s)
| | | | - Elizabeth A Archie
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, USA
| | - Fernando A Campos
- Department of Antropology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Susan C Alberts
- Department of Biology, Duke University, Durham, NC, USA.; Department of Evolutionary Anthropology, Duke University, Durham, NC, USA
| | - Fan Li
- Department of Statistical Science, Duke University, 214 Old Chemistry Building, Durham, NC 27708, USA
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92
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Zilioli S, Jiang Y, Byrd D, Joseph N. Lifetime discrimination, habitual and daily everyday discrimination, and diurnal cortisol among older African Americans adults. Psychoneuroendocrinology 2023; 152:106089. [PMID: 36965461 PMCID: PMC10164111 DOI: 10.1016/j.psyneuen.2023.106089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/27/2023]
Abstract
Experiences of discrimination can be major life events or daily chronic hassles that occur in various social contexts (e.g., housing, education, employment) and have been found to predict adverse health outcomes, including dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. Previous work on daily cortisol dynamics has generally revealed an association between discrimination and flatter cortisol slopes, particularly among racial minorities. However, most of the existing studies have focused on youth and young adults, with little work among older adults. The current study aimed to investigate the relationship between three measures of discrimination (lifetime discrimination, habitual everyday discrimination, and daily everyday discrimination) and diurnal cortisol secretion in a sample of 203 older African Americans. Study results indicated that individuals reporting higher levels of lifetime discrimination experienced morning hypocortisolism and flatter diurnal cortisol slopes. Exploratory analyses also showed that prior daily everyday discrimination was significantly associated with blunted cortisol awakening response (CAR) the next day. Our findings underline the role of discrimination in modulating daily cortisol dynamics among older African American adults and advance knowledge on how social stressors influence healthy aging.
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Affiliation(s)
- Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
| | - Yanping Jiang
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, United States; Department of Family Medicine and Community Health, Rutgers, The State University of New Jersey, United States
| | - DeAnnah Byrd
- Edson College of Nursing and Health Innovative, Arizona State University, United States; Center of Innovative, Healthy, and Resilient Aging, Arizona State University, United States
| | - Nataria Joseph
- Department of Psychology, Pepperdine University, United States
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93
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Schneider S, Grosse Holtforth M, Wettstein A, Jenni G, Kühne F, Tschacher W, La Marca R. The diurnal course of salivary cortisol and alpha-amylase on workdays and leisure days in teachers and the role of social isolation and neuroticism. PLoS One 2023; 18:e0286475. [PMID: 37256854 DOI: 10.1371/journal.pone.0286475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
Teachers are among the occupational groups with the highest sick leave rates due to workplace stress and burnout symptoms. A substantial body of research has suggested social isolation and neuroticism to be related to physiological stress activity. However, the relationship between such characteristics and stress experiences has rarely been studied in conjunction with physiological stress indicators in the teachers' natural settings. Thus, the present study examines salivary cortisol and α-amylase as physiological stress indicators on teachers' work and leisure days and their relationship with social isolation. Furthermore, we test whether neuroticism moderates the relationship between social isolation and salivary biomarkers. Forty-two teachers completed questionnaires assessing social isolation (Trier Inventory for the Assessment of Chronic Stress) and neuroticism (Big-Five Inventory). Participants collected eight saliva samples on three days, two workdays, and one leisure day to measure the concentration of cortisol and α-amylase as biomarkers of the hypothalamic-pituitary-adrenal (HPA) axis and the autonomic nervous system (ANS), respectively. Results showed a significantly higher Cortisol Awakening Response (CAR) and diurnal cortisol slope (DCS) on workdays than on the leisure day but no significant differences regarding measures of α-amylase. We found a significant positive relationship between social isolation and the CAR on the leisure day but no association with the α-amylase measures. Furthermore, after controlling for confounders, social isolation was unrelated to neuroticism, and the latter did not moderate between social isolation and the CAR. Our findings suggest an association between social isolation and the HPA axis, i.e., the CAR, but do not support an association with the ANS, which would be indicated by the α-amylase assessments. Finally, our findings could not support an association of neuroticism with the HPA axis and ANS.
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Affiliation(s)
- Sandra Schneider
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Bern, Switzerland
- Department of Research and Development, University of Teacher Education Bern, Bern, Switzerland
| | - Martin Grosse Holtforth
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Bern, Switzerland
- Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Wettstein
- Department of Research and Development, University of Teacher Education Bern, Bern, Switzerland
| | - Gabriel Jenni
- Department of Research and Development, University of Teacher Education Bern, Bern, Switzerland
| | - Fabienne Kühne
- Department of Research and Development, University of Teacher Education Bern, Bern, Switzerland
| | - Wolfgang Tschacher
- Experimental Psychology Division, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roberto La Marca
- Department of Research and Development, University of Teacher Education Bern, Bern, Switzerland
- Clinica Holistica Engiadina, Centre for Stress-Related Disorders, Susch, Switzerland
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
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94
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Schricker IF, Nayman S, Reinhard I, Kuehner C. Trait and state effects of different modes of thinking on salivary cortisol in daily life in patients with recurrent major depression and healthy individuals. Psychoneuroendocrinology 2023; 155:106307. [PMID: 37290378 DOI: 10.1016/j.psyneuen.2023.106307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023]
Abstract
Habitual modes of thinking such as repetitive negative thinking (RNT), but also momentary cognitive processes such as mindwandering could be vulnerability factors for the course of Major Depressive Disorder (MDD). On the physiological level, cortisol represents an important biological stress marker of the hypothalamic-pituitary-adrenal (HPA) axis. Being a dynamic and non-invasive measure, salivary cortisol can be assessed in daily life via Ambulatory Assessment (AA). So far, consensus exists on a dysregulation of the HPA axis in MDD. However, findings are ambiguous and AA-studies examining both trait and state level effects of cognitive processes on cortisol release in daily life in patients with recurrent major depression (rMDD) and healthy controls (HCs) are lacking. A sample of 119 (nrMDD=57, nHCs=62) participants underwent a baseline session, including self-rated questionnaires (RNT, mindfulness) followed by a 5-day AA, where participants indicated the occurrence of mindwandering and levels of mentalshift problems ten times per day via smartphone, and collected saliva cortisol samples five times per day. Via multilevel models, we found habitual RNT, but not mindfulness, to predict higher cortisol levels, with the effects being stronger in rMDD patients. State mindwandering and mentalshift problems predicted increased cortisol 20 min later across groups. State cognitions did not mediate the effects of habitual RNT on cortisol release. Our results suggest independent mechanisms of action for trait and state cognitions on cortisol activity in daily life and indicate a greater physiological vulnerability toward trait RNT and the tendency to experience mentalshift problems in patients with recurrent major depression.
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Affiliation(s)
- Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
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95
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Dembo RS, Hong J, DaWalt LS, Berry-Kravis EM, Mailick MR. Health Effects of Sleep Quality in Premutation Carrier Mothers of Individuals With Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:254-268. [PMID: 37104861 PMCID: PMC10506164 DOI: 10.1352/1944-7558-128.3.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 11/15/2022] [Indexed: 05/25/2023]
Abstract
Sleep plays an integral role in supporting well-being, and sleep difficulties are common in mothers of individuals with developmental disabilities, including fragile X syndrome (FXS). This study assessed whether the effects of sleep quality on physical health and depression are exacerbated by genetic risk factors (CGG repeats) in FMR1 premutation carrier mothers of individuals with FXS. Poor sleep quality predicted a greater number of physical health conditions for mothers with CGG repeats in the mid-premutation range (90-110 repeats), but not for those in the lower (< 90 repeats) or higher (> 110 repeats) ends of the range. A significant association between poor sleep quality and maternal depressive symptoms was also observed, but there was no evidence that this effect varied by level of genetic vulnerability. This research extends our understanding of individual differences in the effects of sleep quality among mothers of individuals with FXS.
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Affiliation(s)
- Robert S Dembo
- Robert S. Dembo, Jinkuk Hong, and Leann Smith DaWalt, University of Wisconsin-Madison
| | - Jinkuk Hong
- Robert S. Dembo, Jinkuk Hong, and Leann Smith DaWalt, University of Wisconsin-Madison
| | - Leann Smith DaWalt
- Robert S. Dembo, Jinkuk Hong, and Leann Smith DaWalt, University of Wisconsin-Madison
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96
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Bottaccioli A, Mariani U, Schiralli R, Mari M, Pontani M, Bologna M, Muzi P, Giannoni S, Ciummo V, Necozione S, Cofini V, Chiariotti L, Cuomo M, Costabile D, Bottaccioli F. Empathy at school project: Effects of didactics of emotions® on emotional competence, cortisol secretion and inflammatory profile in primary school children. A controlled longitudinal psychobiological study. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2023; 14:100183. [PMID: 37020722 PMCID: PMC10068011 DOI: 10.1016/j.cpnec.2023.100183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
Background There is mounting evidence of the presence of chronic stress among children during primary school: girls and boys under the age of 15 years often experience anxiety, irritability and sleeping problems with negative consequences on scholastic climate and the spread of bullying and dropping out of school. The promotion of emotion regulation within school environment through innovative didactic methodologies represents a valuable tool for teachers and parents to reduce emotional distress and associated risk behaviours and to promote wellbeing. Aim Our research aims to explore the psychological and biological consequences of teaching emotional training in an experimental group of Italian Primary School children. Methods A sample of pupils (81 children aged between 6 and 8) was divided into an experimental group (33 subjects) and a control group (30 subjects). A further advanced group of 18 subjects, who have experienced the method in the previous school year, was also included. The experimental study lasted one school year (from October 2021 to May 2022). The following psychological tests were administered to all groups: TEC (Test of Emotion Comprehension) to measure the children's different emotional abilities and the Projective test (PT) 'A person in the rain', to identify the coping skills of children in a stressful condition. Morning salivary cortisol, IL-6 and TNF-alpha assays were conducted in all three groups. Psychological and biological tests were administered at the beginning of the study and at the end of the study. Results The MR-Anova model for TEC score showed that there was not a significant group effect [Fgroup = 2.24, p = 0.114]. Pairwise comparisons showed that mean score significantly increased only in the Experimental group (pB < 0.001) and at the end of the project there was a significant difference between Experimental group and Control group (pB = 0.012). The mean score of PT test increased significantly from baseline to the end of the project for the Experimental group (pB < 0.001) and for the Advanced group (pB = 0.004). At the end of the project, there were significant differences between the Experimental group and the Control group (pB = 0.004) and between the Advanced group and the Control group (pB < 0.001). Salivary cortisol analysis revealed a significant effect between subjects [Fgroup = 9.66; p < 0.001] and significant effects within subjects with the main effect of the time [Ftime = 35.41; p < 0.001] and the significant interaction "time x group" [Ftimexgroup = 3.38; p = 0.040]. Pairwise comparisons showed that cortisol levels decreased significantly over time only in the Experimental group (pB < 0.001). Regarding to IL-6 levels, there was not a significant effect between subjects [Fgroups = 0.0481; p = 0.953]. The mean level decreased significantly for each group from baseline to post project (pB < 0.001). With respect to TNF-alpha levels, the mean levels decreased over time for all groups (pB = 0.006 for Experimental group; pB < 0.001 either for the Advanced or Control group). Conclusion the results documented in the experimental groups who experienced didactics of emotion for at least one school year show a significant increase in children's ability to cope with reality, stress and anxiety, and an improvement of their emotional competence. Meanwhile, a significant reduction in the amount of salivary cortisol was observed in the experimental group at the end of the scholastic year; meantime a stable reduced amount of salivary cortisol in advanced group throughout the project was also observed. These findings show that an intervention through an emotional education program is able to regulate interpersonal skills and the stress axis response.
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Affiliation(s)
- A.G. Bottaccioli
- Società Italiana di Psiconeuroendocrinoimmunologia (SIPNEI), Rome, Italy
- “Vita e Salute” San Raffaele University, Milan – Faculty of Psychology, Italy
- Corresponding author. Società Italiana di Psiconeuroendocrinoimmunologia (SIPNEI), Rome, Italy.
| | - U. Mariani
- Emotional Training Center, Viterbo, Italy
| | | | - M.G. Mari
- Emotional Training Center, Viterbo, Italy
| | - M. Pontani
- Emotional Training Center, Viterbo, Italy
| | - M. Bologna
- Società Italiana di Psiconeuroendocrinoimmunologia (SIPNEI), Rome, Italy
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - P. Muzi
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - S.D. Giannoni
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - V. Ciummo
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - S. Necozione
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - V. Cofini
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
| | - L. Chiariotti
- Federico II University of Naples – Department of Medical Biotechnology, and Molecular Medicine, Italy
| | - M. Cuomo
- Federico II University of Naples – Department of Medical Biotechnology, and Molecular Medicine, Italy
| | - D. Costabile
- Federico II University of Naples – Department of Medical Biotechnology, and Molecular Medicine, Italy
| | - F. Bottaccioli
- Società Italiana di Psiconeuroendocrinoimmunologia (SIPNEI), Rome, Italy
- L'Aquila University- Department of Life, Health and Environmental Sciences, Italy
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97
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Stoffel M, Rahn S, Neubauer AB, Moessner M, Aguilar-Raab C, Ditzen B. Associations of SLC6A4 methylation with salivary cortisol, salivary alpha-amylase, and subjective stress in everyday life. Psychoneuroendocrinology 2023; 153:106283. [PMID: 37196602 DOI: 10.1016/j.psyneuen.2023.106283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/19/2023]
Abstract
Dysregulations of the hypothalamic-pituitary-adrenal (HPA) and sympatho-adrenal medullary (SAM) axis are associated with mental and somatic illness. However, there is lack of knowledge regarding the molecular mechanisms underlying these effects. Epigenetic states in the serotonin transporter gene (SLC6A4) were shown to be associated with stress in various forms. We hypothesized that levels of DNA methylation (DNAm) of SLC6A4 would be associated with altered SAM- and HPA regulation in daily life. N = 74 healthy persons participated in the study. An ecological momentary assessment (EMA) approach was used to assess indicators of stress in daily life. Each day included six concurrent assessments of saliva, to quantify cortisol (sCort; HPA axis) and alpha-amylase (sAA; SAM axis), and to assess self-reports on subjective stress. To assess SLC6A4 DNAm, peripheral blood was drawn and analyzed via bisulfite pyrosequencing. All data were assessed in two waves three months apart, each including two days of EMA and the assessment of SLC6A4 DNAm. Data were analyzed using multilevel models. On the between-person level, higher average levels of SLC6A4 DNAm were associated with higher average levels of sAA, but not with average levels of sCort. On the within-person level, higher levels of SLC6A4 DNAm were associated with lower levels of sAA and sCort. There were no associations of subjective stress with SLC6A4 DNAm. The results help to clarify the association between environmental stress and stress axes regulation, pointing towards an important role of differential within- and between-person effects of SLC6A4 DNAm, which might shape this association.
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Affiliation(s)
- Martin Stoffel
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Bergheimer Straße 20, 69115 Heidelberg, Germany.
| | - Stefanie Rahn
- Clinic of Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
| | - Andreas B Neubauer
- Department for Education and Human Development, DIPF | Leibniz Institute for Research and Information in Education, Rostocker Straße 6, 60323 Frankfurt/Main, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Heidelberg University Hospital, Bergheimer Str. 54, 69115 Heidelberg, Germany
| | - Corina Aguilar-Raab
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Bergheimer Straße 20, 69115 Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Bergheimer Straße 20, 69115 Heidelberg, Germany.
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98
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Jovanovic F, Jovanovic V, Knezevic NN. Glucocorticoid Hormones as Modulators of the Kynurenine Pathway in Chronic Pain Conditions. Cells 2023; 12:cells12081178. [PMID: 37190087 DOI: 10.3390/cells12081178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/05/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
The pathogenesis of chronic pain entails a series of complex interactions among the nervous, immune, and endocrine systems. Defined as pain lasting or recurring for more than 3 months, chronic pain is becoming increasingly more prevalent among the US adult population. Pro-inflammatory cytokines from persistent low-grade inflammation not only contribute to the development of chronic pain conditions, but also regulate various aspects of the tryptophan metabolism, especially that of the kynurenine pathway (KP). An elevated level of pro-inflammatory cytokines exerts similar regulatory effects on the hypothalamic-pituitary-adrenal (HPA) axis, an intricate system of neuro-endocrine-immune pathways and a major mechanism of the stress response. As the HPA axis counters inflammation through the secretion of endogenous cortisol, we review the role of cortisol along with that of exogenous glucocorticoids in patients with chronic pain conditions. Considering that different metabolites produced along the KP exhibit neuroprotective, neurotoxic, and pronociceptive properties, we also summarize evidence rendering them as reliable biomarkers in this patient population. While more in vivo studies are needed, we conclude that the interaction between glucocorticoid hormones and the KP poses an attractive venue of diagnostic and therapeutic potential in patients with chronic pain.
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Affiliation(s)
- Filip Jovanovic
- Department of Internal Medicine, Merit Health Wesley, Hattiesburg, MS 39402, USA
| | - Visnja Jovanovic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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99
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Teo CH, Wong ACH, Sivakumaran RN, Parhar I, Soga T. Gender Differences in Cortisol and Cortisol Receptors in Depression: A Narrative Review. Int J Mol Sci 2023; 24:ijms24087129. [PMID: 37108291 PMCID: PMC10138698 DOI: 10.3390/ijms24087129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 04/29/2023] Open
Abstract
Stress is known to have a significant impact on mental health. While gender differences can be found in stress response and mental disorders, there are limited studies on the neuronal mechanisms of gender differences in mental health. Here, we discuss gender and cortisol in depression as presented by recent clinical studies, as well as gender differences in the role of glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs) in stress-associated mental disorders. When examining clinical studies drawn from PubMed/MEDLINE (National Library of Medicine) and EMBASE, salivary cortisol generally showed no gender correlation. However, young males were reported to show heightened cortisol reactivity compared to females of similar age in depression. Pubertal hormones, age, early life stressors, and types of bio-samples for cortisol measurement affected the recorded cortisol levels. The role of GRs and MRs in the HPA axis could be different between males and females during depression, with increased HPA activity and upregulated MR expression in male mice, while the inverse happened in female mice. The functional heterogeneity and imbalance of GRs and MRs in the brain may explain gender differences in mental disorders. This knowledge and understanding will support the development of gender-specific diagnostic markers involving GRs and MRs in depression.
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Affiliation(s)
- Chuin Hau Teo
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Ally Chai Hui Wong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Rooba Nair Sivakumaran
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Ishwar Parhar
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
| | - Tomoko Soga
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Kuala Lumpur 47500, Selangor, Malaysia
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100
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Xiang D, Zhang ZX, Ge S, Wang WN, Lin BL, Chen SY, Guo EF, Zhang PB, Liu ZW, Li H, Mei YX. Physio-psycho-social interaction mechanism in dyadic health of young and middle-aged stroke survivors and their spousal caregivers: a longitudinal observational study protocol. BMJ Open 2023; 13:e065767. [PMID: 37041051 PMCID: PMC10106025 DOI: 10.1136/bmjopen-2022-065767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION In recent years, stroke has become more common among young people. Stroke not only has a profound impact on patients' health but also incurs stress and health threats to their caregivers, especially spousal caregivers. Moreover, the health of stroke survivors and their caregivers is interdependent. To our knowledge, no study has explored dyadic health of young and middle-aged stroke survivors and their spousal caregivers from physiological, psychological and social perspectives. Therefore, this proposed study aims to explore the mechanism of how physiological, psychological and social factors affect dyadic health of young and middle-aged stroke survivors and their spousal caregivers. The findings of this study will provide implications for developing interventions to improve dyadic health of this growing population. METHODS AND ANALYSES We will collect data from 57 dyads of young and middle-aged stroke survivors and their spousal caregivers during hospitalisation and at 1, 3, 6, 9 and 12 months after discharge. Questionnaires will be used to collect participants' demographic information, stress, depression, anxiety, benefit finding, social support, mutuality and quality of life. The following physiological reactions will be collected at baseline, including interleukin 6, tumour necrosis factor-alpha and salivary cortisol. ETHICS AND DISSEMINATION The study was approved by the ethics review committee of life sciences of Zhengzhou University (No. ZZUIRB2020-53). Prior to being enrolled in the study, participants will be given full and detailed information about the possible risks involved, the informed consent process, confidentiality, the study procedure and secure data storage. Participants will be guaranteed that they can withdraw from the study at any time without providing a reason or leading to any consequences. Both oral and written informed consent will be obtained from all participants. The findings of this proposed study will be disseminated through peer-reviewed journals and academic conferences.
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Affiliation(s)
- Dandan Xiang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Song Ge
- Department of Natural Science, University of Houston Downtown, Houston, Texas, USA
| | - Wen Na Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei-Lei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Su-Yan Chen
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Er-Feng Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Peng-Bo Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi-Wei Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
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