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Sanchez N. Suitability of the National Health Care Surveys to Examine Behavioral Health Services Associated with Polycystic Ovary Syndrome. J Behav Health Serv Res 2018; 45:252-268. [PMID: 27966057 PMCID: PMC5869872 DOI: 10.1007/s11414-016-9543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The National Institutes of Health, Office of Disease Prevention, has described polycystic ovary syndrome (PCOS) as a major public health problem for women in the USA. This study examines the suitability of the National Health Care Surveys, collected by the Centers for Disease Control and Prevention, to understand patient demographics and behavioral health services associated with PCOS-related medical visits. Data were from the 2005-2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. PCOS-related medical visits were identified using the International Classification of Diseases, 9th Revision, Clinical Modification code 256.4. Items on mental health and health education ordered or provided did not meet the National Center for Health Statistics criteria necessary to produce reliable national estimates (i.e., at least 30 unweighted records and a relative standard error <30%). Findings underscore the need to strengthen national surveillance to further understand behavioral health care for patients with PCOS.
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Affiliation(s)
- Ninive Sanchez
- School of Social Work, University of Missouri, 712 Clark Hall, Columbia, MO, 65211, USA.
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102
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Recalled early life adversity and pain: the role of mood, sleep, optimism, and control. J Behav Med 2018; 41:504-515. [PMID: 29468533 DOI: 10.1007/s10865-018-9917-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 02/14/2018] [Indexed: 01/22/2023]
Abstract
Early life adversity (ELA) has been associated with pain symptomatology in adulthood, but mechanisms and moderators of these associations are unclear. Using recall based and concurrently assessed self-report data, we examined associations between ELA, mood, sleep, and recent pain intensity and interference, and whether optimism and perceived control weakened these associations in a midlife community sample of diverse adults reporting some ELA. Controlling for demographic variables and BMI, higher levels of ELA were associated with more pain intensity and interference; greater sleep disturbance and negative mood accounted for these associations. When moderation was examined, only the path from sleep disturbance to pain interference was significantly attenuated for those with higher optimism and higher perceived control. These findings suggest that higher levels of ELA may link with pain in adulthood through poorer mood and sleep, and that resilience resources such as optimism and control may buffer some of these pathways.
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103
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Doktorchik C, Premji S, Slater D, Williamson T, Tough S, Patten S. Patterns of change in anxiety and depression during pregnancy predict preterm birth. J Affect Disord 2018; 227:71-78. [PMID: 29053978 DOI: 10.1016/j.jad.2017.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 08/28/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND To determine whether changes in anxiety and depression during pregnancy influence the risk of having a preterm birth (PTB), and whether chronic stress modifies this relationship. METHODS The data source for the current study is the All Our Babies prospective cohort (AOB). Anxiety and depression were measured at 17-24 weeks and again at 32-36 weeks' gestation using the Spielberg State Anxiety Scale and the Edinburgh Postnatal Depression Scale, respectively. Chronic stress was assessed at 17-24 weeks' gestation as a potential covariate, and was measured using the Perceived Stress Scale. Multivariable logistic regression modeling was used to assess each relationship RESULTS: Women who experienced an increase in anxiety scores, (time point 32-36 weeks, compared to the earlier time point 17-24 weeks), had 2.70 times higher odds of preterm delivery, compared to those with a reduction in anxiety scores (95% CI 1.28, 5.69). Consistent low or high depression scores did not significantly influence the odds of PTB compared to a decrease in depression scores. A co-occurring increase in anxiety and depression scores was not found to increase the risk of PTB, and chronic stress did not modify any of these relationships. LIMITATIONS This study was limited by a relatively small sample of women who delivered preterm, and therefore it was not possible to conduct additional analyses. Further, the analyses were limited to mostly late preterm infants (32-36 weeks' gestation). CONCLUSIONS These findings should be validated with additional cohorts and a larger sample size. Ultimately, primary prevention could address anxiety during pregnancy.
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Affiliation(s)
- Chelsea Doktorchik
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6.
| | - Shahirose Premji
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6; Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4; Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Room 293 Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1.
| | - Donna Slater
- Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Room 293 Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; Departments of Physiology & Pharmacology and Obstetrics & Gynecology, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1.
| | - Tyler Williamson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6; Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Room 293 Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6.
| | - Suzanne Tough
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6; Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Room 293 Heritage Medical Research Building, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1; Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8.
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW Building 3rd Floor, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6; O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, 3rd Floor TRW Building, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6; Department of Psychiatry, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, Canada T2N 2T9.
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104
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Elliot AJ, Turiano NA, Infurna FJ, Lachman ME, Chapman BP. Lifetime trauma, perceived control, and all-cause mortality: Results from the Midlife in the United States Study. Health Psychol 2018; 37:262-270. [PMID: 29369676 DOI: 10.1037/hea0000585] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate whether lifetime-trauma exposure predicts all-cause mortality and whether this association is mediated or moderated by perceived control. METHOD A sample of middle-aged and older adults (N = 4,961) who participated in the second wave of the Midlife in the United States Study (MIDUS) provided data. Lifetime trauma was operationalized using the reported number of potentially traumatic experiences spanning childhood through adulthood. Both the perceived constraints and mastery dimensions of perceived control were examined. Cox regression models tested main effects and interactions of lifetime trauma with mastery and constraints predicting 10-year mortality risk. RESULTS There was a significant main effect of lifetime trauma, b = .06, hazard ratio (HR) = 1.07, p = .032, and an interaction of trauma with mastery, b = -.08, p = .004. A greater number of traumatic experiences was associated with increased mortality risk at below-average levels of mastery, -1 SD; HR = 1.14, p < .001, but not at above-average levels, +1 SD; HR = 0.97, p = .48. This interaction persisted after further adjustment for health status, psychological, and behavioral covariates. An association of constraints with elevated mortality risk, HR = 1.33, p = .008, was attenuated in a fully adjusted model, HR = 1.06, p = .26. CONCLUSION A strong sense of mastery may buffer elevated mortality risk associated with exposure to traumatic experiences. Findings extend evidence that mastery may foster resilience to the adverse health effects of traumatic stressors, whereas constraints may show stronger independent associations with health outcomes. (PsycINFO Database Record
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Affiliation(s)
- Ari J Elliot
- Department of Psychiatry, University of Rochester Medical Center
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105
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Kuhlman KR, Boyle CC, Irwin MR, Ganz PA, Crespi CM, Asher A, Petersen L, Bower JE. Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer. CHILD ABUSE & NEGLECT 2017; 72:360-369. [PMID: 28888809 PMCID: PMC5659876 DOI: 10.1016/j.chiabu.2017.08.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/21/2017] [Accepted: 08/23/2017] [Indexed: 05/03/2023]
Abstract
Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes.
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Affiliation(s)
- Kate Ryan Kuhlman
- Department of Psychology & Social Behavior, University of California Irvine, Irvine, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.
| | - Chloe C Boyle
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA; Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Arash Asher
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, USA
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106
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Woodward EN, Banks RJ, Marks AK, Pantalone DW. Identifying Resilience Resources for HIV Prevention Among Sexual Minority Men: A Systematic Review. AIDS Behav 2017; 21:2860-2873. [PMID: 27981398 DOI: 10.1007/s10461-016-1608-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Most HIV prevention for sexual minority men and men who have sex with men targets risk behaviors (e.g., condom use) and helps <50% of participants. Bolstering resilience might increase HIV prevention's effectiveness. This systematic review identified resilience resources (protective factors) in high-risk, HIV-negative, sexual minority men. We reviewed PsycINFO, PsycARTICLES, MEDLINE, references, and Listservs for studies including sexual minority men with 1+ HIV risk factor (syndemics): childhood sexual abuse, partner abuse, substance abuse, or mental health symptoms. From 1356 articles screened, 20 articles met inclusion criteria. Across the articles, we identified and codified 31 resilience resources: socioeconomic (e.g., employment), behavioral coping strategies (e.g., mental health treatment), cognitions/emotions (e.g., acceptance), and relationships. Resilience resources were generally associated with lower HIV risk; there were 18 low-risk associations, 4 high-risk associations, 8 non-significant associations). We generated a set of empirically based resilience variables and a hypothesis to be evaluated further to improve HIV prevention.
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107
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Watson B, Osberg L. Healing and/or breaking? The mental health implications of repeated economic insecurity. Soc Sci Med 2017; 188:119-127. [DOI: 10.1016/j.socscimed.2017.06.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/23/2017] [Accepted: 06/30/2017] [Indexed: 10/19/2022]
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108
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Benson PR. The impact of child and family stressors on the self-rated health of mothers of children with autism spectrum disorder: Associations with depressed mood over a 12-year period. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017. [DOI: 10.1177/1362361317697656] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Employing a cohort sequential design and multilevel modeling, the effects of child and family stressors and maternal depressed mood on the self-rated health of 110 mothers of children with autism spectrum disorder were assessed over a 12-year period when children in the study were 7–19 years old. Findings indicate a significant decline in self-rated health over time. In addition, child and family stressors, as well as maternal depressed mood, exerted significant between-persons effects on self-rated health such that mothers who reported more stressors and depressed mood across the study period were less likely to rate themselves in better health across that period. In addition, a significant within-person relationship between maternal depressed mood and self-rated health was found, indicating that at times when mothers reported higher levels of depressed mood than usual (their personal average across the study), they were significantly less likely to report better self-rated health. Finally, maternal depressed mood partially mediated the between-persons effects of child and family stressors on self-rated health such that increased stressors led to increased maternal depressed mood which, in turn, led to poorer maternal self-rated health. Findings suggest that chronic stressors erode maternal health over time and that depression may be an important mechanism linking stressors to decreased maternal health.
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109
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Campo RA, Wu LM, Austin J, Valdimarsdottir H, Rini C. Personal resilience resources predict post-stem cell transplant cancer survivors' psychological outcomes through reductions in depressive symptoms and meaning-making. J Psychosoc Oncol 2017; 35:666-687. [PMID: 28613996 DOI: 10.1080/07347332.2017.1342306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = -0.07, p = 0.005), mediated by reductions in depressive symptoms (b = -0.01, 95% CI: -0.027, -0.003) and in searching for a reason for one's illness (b = -0.01, 95% CI: -0.034, -0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p < 0.001), mediated by reductions in depressive symptoms (b = 0.02, 95% CI: 0.003, 0.033). Having greater personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.
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Affiliation(s)
- Rebecca A Campo
- a Department of Physical Medicine & Rehabilitation , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Lisa M Wu
- b Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine , Chicago , IL , USA
| | - Jane Austin
- c Department of Psychology , William Paterson University , Wayne , NJ , USA
| | | | - Christine Rini
- e John Theurer Cancer Center , Cancer Prevention and Control, Hackensack University Medical Center , Hackensack , NJ , USA
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Abstract
OBJECTIVE Elevated levels of C-reactive protein (CRP) are associated with increased risk of cardiovascular and metabolic disease. The current study tested associations between psychosocial stress and CRP in a large sample of women during the first postpartum year. METHODS We analyzed data collected by the five-site Community Child Health Network study, which studied a predominately poor population. Participants (n = 1206 women; 54% African American, 23% white, 23% Hispanic/Latina) were recruited shortly after the birth of a child. Multiple linear regression analyses tested associations of psychosocial stress in several life domains (financial, neighborhood, family, coparenting, partner relationship, discrimination, and interpersonal violence) with log-transformed CRP concentrations at 6-month and 1-year postpartum. RESULTS Forty-eight percent of participants showed evidence of elevated CRP (≥3 mg/L) at 6-month postpartum, and 46% had elevated CRP at 12-month postpartum. Chronic financial stress at 1-month postpartum predicted higher levels of CRP at 6- (b = .15, SE = .05, p = .006) and 12-month postpartum (b = .15, SE = .06, p = .007) adjusting for race/ethnicity, income, education, parity, health behaviors, and chronic health conditions, though associations became nonsignificant when adjusted for body mass index. CONCLUSIONS In this low-income and ethnic/racially diverse sample of women, higher financial stress at 1-month postbirth predicted higher CRP. Study findings suggest that perceived financial stress stemming from socioeconomic disadvantage may be a particular deleterious form of stress affecting maternal biology during the year after the birth of a child.
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111
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Dougall AL, Swanson J, Kyutoku Y, Belani CP, Baum A. Posttraumatic Symptoms, Quality of Life, and Survival among Lung Cancer Patients. ACTA ACUST UNITED AC 2017; 22. [PMID: 28966544 DOI: 10.1111/jabr.12065] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This longitudinal study characterized psychological adjustment in a sample of lung cancer patients by examining the occurrence of posttraumatic stress and growth and their relationships with mental and physical health quality of life and survival over time. METHODS Two waves of consecutive cohort samples, totaling 115 participants diagnosed with lung cancer, were identified from outpatient oncology clinics. Of these, 93 consented and completed the first of three assessments, and 57 completed the study. Prevalence of posttraumatic stress symptoms (PTSD Checklist) and posttraumatic growth (Posttraumatic Growth Inventory) were assessed and used to predict physical and mental health components of quality of life (Short Form 36) and survival. RESULTS Patients reported both negative and positive psychological sequelae, with prevalence of estimated PTSD ranging from 5-16% at each assessment as determined by symptom and cut-off methods. Posttraumatic stress and growth were positively related, but were differentially associated with outcomes. More posttraumatic stress predicted lower mental health quality of life, whereas more posttraumatic growth predicted better physical health quality of life and longer survival. These relationships persisted after accounting for disease variables and attrition due to death or illness. CONCLUSIONS These findings highlight the importance of using longitudinal designs to identify relationships between stress and resilience factors in predicting outcomes.
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Affiliation(s)
| | - Jeffrey Swanson
- Department of Psychology, The University of Texas at Arlington, Arlington, TX
| | - Yasushi Kyutoku
- Research and Development Initiative, Chuo University, Bunkyo-ku, Tokyo, Japan
| | - Chandra P Belani
- Penn State Cancer Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Andrew Baum
- Department of Psychology, The University of Texas at Arlington, Arlington, TX. Andrew Baum is now deceased
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112
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Nie C, Dai Q, Zhao R, Dong Y, Chen Y, Ren H. The impact of resilience on psychological outcomes in women with threatened premature labor and spouses: a cross-sectional study in Southwest China. Health Qual Life Outcomes 2017; 15:26. [PMID: 28143536 PMCID: PMC5282797 DOI: 10.1186/s12955-017-0603-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 11/17/2022] Open
Abstract
Background Threatened premature labor (TPL) is a severe obstetric complication which affects the mental and physical health of both the mother and fetus. Family resilience may have protective role against psychological distress in women experiencing these pregnancy complications. There may be resilience related risk factors in TPL women, and interplays may exist among psychological variables and within couples. This study aims to examine psychological outcomes influenced by different levels of resilience, and explore psychological interactions in TPL women, spouses, and between women and spouses. Methods Six validated questionnaires were used to measure the psychological outcomes (Connor-Davidson resilience scale CD-RISC, Edinburgh postnatal depression scale EPDS, positive and negative affect scale PANAS, pregnancy pressure scale PPS, simplified coping style questionnaire SCSQ, social support rating scale SSRS) in 126 TPL women hospitalized in three tertiary hospitals and 104 spouses in Southwest China. Results Low resilient women had significantly more complicated placenta praevia, longer pediatric observation, more pressure than high resilient women. They also had significantly less active coping and positive affect, more negative affect and depression compared to high resilient women and their spouses. Although the socio-demographic characteristics of both TPL women and spouses and psychometric parameters of spouses had no significant differences, the prevalence rates of depression in spouses were notable. Compared with spouses, TPL women had a more complex interaction among these psychometric factors, with women’s resilience negatively associated with their partners’ negative affect, and their pressure positively correlated with pressure and negative affect of spouses. Conclusions Pregnancy complicated with placenta praevia and pediatric observation may be risk factors for resilience of women with TPL. Maternal resilience has an important impact on the psychological outcomes in TPL women. A screening for resilience, depression and other psychological outcomes in couples with TPL and early psychological intervention of low resilient couples may be appropriate to promote resilience and well-being of these families. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0603-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chunhua Nie
- School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China
| | - Qin Dai
- Psychological Nursing Office, School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China
| | - Ren Zhao
- Department of Cardiology, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China
| | - Yushu Dong
- Department of Neurosurgery, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China
| | - Yushan Chen
- Department of Cardiology, General Hospital of Shenyang Military Region, No.83 Wenhua Road, Shenyang, 110016, China
| | - Hui Ren
- School of Nursing, Third Military Medical University, No.30 Gaotanyan Street, Chongqing, 400038, China.
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113
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Wang L, Tao H, Bowers BJ, Brown R, Zhang Y. Influence of Social Support and Self-Efficacy on Resilience of Early Career Registered Nurses. West J Nurs Res 2017; 40:648-664. [PMID: 28322660 DOI: 10.1177/0193945916685712] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study was to examine the relationships among social support, self-efficacy, and resilience in early career registered nurses. A cross-sectional study was conducted with a convenience sample of 747 early career registered nurses. Data collection was performed between August and November 2015. Data were analyzed using structural equation modeling. Among the three factors of social support, only the impact of coworker support on nurse resilience is fully mediated by self-efficacy; friend support had a significant positive direct effect on self-efficacy and an indirect effect on nurse resilience. This would suggest the importance of administrators/managers understanding how to promote coworker support, increase self-efficacy, foster a positive work climate, and develop effective mentorship programs to improve early career registered nurses resilience and mitigate factors leading to turnover.
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Affiliation(s)
- Lin Wang
- 1 Shanghai Jiao Tong University, People's Republic of China
| | - Hong Tao
- 2 Florida Hospital, Maitland, USA
| | | | | | - Yaqing Zhang
- 1 Shanghai Jiao Tong University, People's Republic of China
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Mealer M, Hodapp R, Conrad D, Dimidjian S, Rothbaum BO, Moss M. Designing a Resilience Program for Critical Care Nurses. AACN Adv Crit Care 2017; 28:359-365. [PMID: 29212643 PMCID: PMC6080201 DOI: 10.4037/aacnacc2017252] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Workplace stress can affect job satisfaction, increase staff turnover and hospital costs, and reduce quality of patient care. Highly resilient nurses adapt to stress and use a variety of skills to cope effectively. OBJECTIVE To gain data on a mindfulness-based cognitive therapy resilience intervention for intensive care unit nurses to see if the intervention program would be feasible and acceptable. METHODS Focus-group interviews were conducted by videoconference with critical care nurses who were members of the American Association of Critical-Care Nurses. The interview questions assessed the feasibility and acceptability of a mindfulness-based cognitive therapy program to reduce burnout syndrome in intensive care unit nurses. RESULTS Thirty-three nurses participated in 11 focus groups. Respondents identified potential barriers to program adherence, incentives for adherence, preferred qualifications of instructors, and intensive care unit-specific issues to be addressed. CONCLUSIONS The mindfulness-based cognitive therapy pilot intervention was modified to incorporate thematic categories that the focus groups reported as relevant to intensive care unit nurses. Institutions that wish to design a resilience program for intensive care unit nurses to reduce burnout syndrome need an understanding of the barriers and concerns relevant to their local intensive care unit nurses.
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Affiliation(s)
- Meredith Mealer
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Rachel Hodapp
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - David Conrad
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Sona Dimidjian
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Barbara O Rothbaum
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Marc Moss
- Meredith Mealer is Assistant Professor, University of Colorado School of Medicine, 12631 E 17th Ave, F493, Aurora, CO 80045 . Rachel Hodapp, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. David Conrad, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado. Sona Dimidjian, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado. Barbara O. Rothbaum, Department of Psychiatry, Emory University School of Medicine, Atlanta, Georgia. Marc Moss, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
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Bamishigbin ON, Schetter CD, Guardino CM, Stanton AL, Schafer P, Shalowitz M, Lanzi RG, Thorp J, Raju T. Risk, resilience, and depressive symptoms in low-income African American fathers. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:70-80. [PMID: 27244219 PMCID: PMC6644062 DOI: 10.1037/cdp0000088] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Parental depression influences family health but research on low-income African American fathers is limited. The primary goal of the present study was to examine the role of paternal risk factors and resilience resources in predicting depressive symptoms in the year after birth of a child in a sample of African American fathers. We hypothesized that paternal risk factors (low socioeconomic status [SES], perceived stress, negative life events, racism, avoidant coping style) and resources (social support, self-esteem, collective efficacy, approach-oriented coping style) would predict depressive symptoms in fathers at 1 year postbirth controlling for depressive symptoms at 1 month postbirth. METHOD African American fathers (n = 296) of predominantly low SES from 5 U.S. regions were interviewed at 1 and 12 months after birth of a child regarding potential risk factors, resilience resources, and depressive symptoms. RESULTS Depressive symptoms were low on average. However, hierarchical linear regression analyses revealed that avoidant coping style and experiences of racism predicted more depressive symptoms in fathers nearly a year after the birth of a child controlling for symptoms at 1 month. CONCLUSIONS How fathers cope with stress and common everyday experiences of racism contributed to depressive symptoms in the year following birth of a child. Interventions that target race-related stressors and decrease avoidant coping may promote better outcomes in this important and understudied population. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | | | | | | | - John Thorp
- University of North Carolina, Chapel Hill
| | - Tonse Raju
- Eunice Kennedy Shriver National Institute of Child and Health Development
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Pangallo A, Zibarras L, Patterson F. Measuring resilience in palliative care workers using the situational judgement test methodology. MEDICAL EDUCATION 2016; 50:1131-1142. [PMID: 27762011 DOI: 10.1111/medu.13072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 01/03/2016] [Accepted: 03/07/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Relatively little research has been directed toward the assessment of resilience in the health care context. Given the stressors associated with the provision of health care, the present study describes the development and evaluation of a situational judgement test (SJT) designed to assess resilience in palliative care health care workers. METHODS An SJT was developed to measure behaviours associated with resilience in a palliative care context. Next, SJT reliability and validity analyses were assessed in a sample of acute ward, hospice and community palliative care workers (n = 284). RESULTS Findings showed the SJT to have a negative association with self-reported sickness absence and a positive association with well-being and employee attitudes (in terms of turnover intention, organisational commitment and job satisfaction). A series of two-wave longitudinal (hierarchical) regressions showed the SJT was predictive of well-being and employee attitudes at two time-points (4 weeks apart) over and above self-report measures of resilience, education and experience, and the Big Five personality dimensions of Emotional Stability and Openness. Reliability analyses showed the SJT to have acceptable test-retest scores (ρ = 0.71) and high internal consistency (α = 0.91). CONCLUSIONS The study findings suggest that the SJT is a valid assessment of resilience in at-risk workers and can be used in either summative or formative assessment under the right set of conditions. More research is needed to test the hypothesis that the SJT might be used as a formative tool to develop workplace resilience.
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Affiliation(s)
| | - Lara Zibarras
- Department of Psychology, City University London, London, UK
| | - Fiona Patterson
- Department of Psychology, University of Cambridge, Cambridge, UK
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Laurent HK, Harold GT, Leve L, Shelton KH, Van Goozen SHM. Understanding the unfolding of stress regulation in infants. Dev Psychopathol 2016; 28:1431-1440. [PMID: 27020470 PMCID: PMC5301455 DOI: 10.1017/s0954579416000171] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Early identification of problems with psychosocial stress regulation is important for supporting mental and physical health. However, we currently lack knowledge about when reliable individual differences in stress-responsive physiology emerge and which aspects of maternal behavior determine the unfolding of infants' stress responses. Knowledge of these processes is further limited by analytic approaches that do not account for multiple levels of within- and between-family effects. In a low-risk sample (n = 100 dyads), we observed infant cortisol and mother/infant behavior during regular play and stress sessions longitudinally from age 1 to 3, and used a three-level model to separately examine variability in infant cortisol trajectories within sessions, across years, and across infants. Stable individual differences in hypothalamus-pituitary-adrenal axis regulation were observed in the first 3 years of life. Infants of less sensitive and more intrusive mothers manifested stress sensitization, that is, elevated cortisol levels during and following stress exposure, a profile related to behavioral distress. These findings have important practical implications, suggesting that children at risk for long-term stress dysregulation may be identified in the earliest years of life.
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Employee Resilience: A Faceted Analytical Approach. INDUSTRIAL AND ORGANIZATIONAL PSYCHOLOGY-PERSPECTIVES ON SCIENCE AND PRACTICE 2016. [DOI: 10.1017/iop.2016.43] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We share Britt, Shen, Sinclair, Grossman, and Klieger's (2016) concern over the confusion of the conceptual definition of resilience and believe that this thorny issue should be solved. Hence, our objective in this commentary is to dispel to some extent the fuzzy state of the resilience construct content, building on the extant resilience literature. This will help to enhance resilience construct validity.
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Ghanei Gheshlagh R, Sayehmiri K, Ebadi A, Dalvandi A, Dalvand S, Nourozi Tabrizi K. Resilience of Patients With Chronic Physical Diseases: A Systematic Review and Meta-Analysis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e38562. [PMID: 27703800 PMCID: PMC5027800 DOI: 10.5812/ircmj.38562] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 05/24/2016] [Accepted: 06/20/2016] [Indexed: 11/16/2022]
Abstract
Context Resilience can be seen as an adaption to stress, such as that caused by health problems or disease, that attenuates the negative effects of stress. The present research performed a systematic review and meta-analysis to study resilience scores among adults diagnosed with chronic physical diseases. Evidence Acquisition Electronic databases, including Persian language (scientific information database [SID], IranMedex, Magiran, IranDoc, and Medlib) and English language (Google Scholar, Science Direct, PubMed, Pre-Quest, and Scopus), were searched. Fifteen articles were found using the keywords disease or chronic disease, resilience or resiliency, and illness, either alone or in combination, both in Persian and English languages. Data analysis was carried out through meta-analysis (random-effects model), and heterogeneity was investigated by subgroup and meta-regression analyses. The data were analyzed in STAT software (12.0). Results The mean resilience score of the chronic disease patients (n = 3369) was 74.6 (95% CI: 51.8 - 97.4). In terms of diseases, the mean resilience score of cancer patients was 79.6 (95% CI: 48.3 - 111.1), whereas it was 79.6 for cardiovascular disease patients (95% CI: 45.8 - 113.3) and 64.6 for patients with other diseases (95% CI: 6.6 - 122.7). There was no relationship between the resilience of chronic disease patients and the year of the study (P = 0.711) and the sample size in the studies (P = 0.351). Conclusions The mean resilience score of the patients was less than that of healthy individuals. As resilience can be acquired at any stage of life, irrespective of age and disease status, there is a need for training to improve resilience among patients through educational programs.
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Affiliation(s)
- Reza Ghanei Gheshlagh
- PhD Candidate in Nursing Education, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Kourosh Sayehmiri
- Associate Professor, Department of Biostatistics, Prevention of Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, IR Iran
| | - Abbas Ebadi
- Associate Professor, Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Asghar Dalvandi
- Associate Professor, Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran
| | - Sahar Dalvand
- MSc in Biostatics, Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, IR Iran
| | - Kian Nourozi Tabrizi
- Associate Professor, Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran
- Corresponding Author: Kian Nourozi Tabrizi, Assistant Professor, Department of Nursing, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, IR Iran. Tel: +98-9122073826, Fax: +98-2122180036, E-mail:
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Rieger KL, Heaman MI. Factors Associated With High Levels of Perceived Prenatal Stress Among Inner-City Women. J Obstet Gynecol Neonatal Nurs 2016; 45:180-95. [PMID: 26807819 DOI: 10.1016/j.jogn.2015.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To explore the factors associated with high rates of perceived prenatal stress among inner-city women. DESIGN Observational cross-sectional study. SETTING/PARTICIPANTS We conducted a secondary analysis of data from 603 inner-city women. In our study, 330 participants (54.7%) self-identified as First Nations, Metis, or First Nations/Metis. METHODS Prenatal stress was measured with Cohen's Perceived Stress Scale. A social ecological model provided the theoretical framework for the study, and variables representing all levels of the model were selected for study. Data analyses included t tests to compare women with high stress and low/moderate stress, univariable logistic regression analysis to determine the association of selected factors with maternal stress, and multivariable logistic regression analysis to provide adjusted odds ratios and 95% confidence intervals for the factors. RESULTS Of the 603 participants, 17.2% (104) reported high levels of perceived stress, and 82.8% (499) reported low/moderate levels. The high-stress group included a significantly greater proportion of First Nations, Metis, or First Nations/Metis women (76.0%) than the low/moderate-stress group (50.3%). Low rates of self-esteem and social support, residential mobility, abuse before/during pregnancy, and experiencing discrimination were significantly associated with high levels of perceived prenatal stress. CONCLUSION Our findings demonstrated that factors that influence prenatal stress occur at all levels of the social ecological model. The identified factors are amenable to change, and implications for practice include the need for psychosocial risk assessment, alternative forms of prenatal care, relational care, and advocacy initiatives. A greater understanding of the complex factors associated with high rates of perceived prenatal stress can inform the development of effective interventions for inner-city women.
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Nelson N, Shacham R, Ben-ari R. Trait Negotiation Resilience: A measurable construct of resilience in challenging mixed-interest interactions. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.08.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Coleman SRM, Zawadzki MJ, Heron KE, Vartanian LR, Smyth JM. Self-focused and other-focused resiliency: Plausible mechanisms linking early family adversity to health problems in college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2016; 64:85-95. [PMID: 26502997 PMCID: PMC10691655 DOI: 10.1080/07448481.2015.1075994] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. PARTICIPANTS Female students (N = 795) participated between October 2009 and May 2010. METHODS Participants completed self-report measures of early family adversity, self-focused (self-esteem, personal growth initiative) and other-focused (perceived social support, gratitude) resiliency, stress, subjective health, and health behaviors. RESULTS Using structural equation modeling, self-focused resiliency associated with less stress, better subjective health, more sleep, less smoking, and less weekend alcohol consumption. Other-focused resiliency associated with more exercise, greater stress, and more weekend alcohol consumption. Early family adversity was indirectly related to all health outcomes, except smoking, via self-focused and other-focused resiliency. CONCLUSIONS Self-focused and other-focused resiliency represent plausible mechanisms through which early family adversity relates to stress and health in college women. This highlights areas for future research in disease prevention and management.
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Affiliation(s)
- Sulamunn R. M. Coleman
- Department of Biobehavioral Health The Pennsylvania State University University Park, Pennsylvania
| | - Matthew J. Zawadzki
- Department of Psychological Sciences University of California, Merced, Merced, California
| | - Kristin E. Heron
- Department of Psychology Old Dominion University Norfolk, Virginia
| | | | - Joshua M. Smyth
- Department of Biobehavioral Health The Pennsylvania State University University Park, Pennsylvania
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Hsieh HF, Hung YT, Wang HH, Ma SC, Chang SC. Factors of Resilience in Emergency Department Nurses Who Have Experienced Workplace Violence in Taiwan. J Nurs Scholarsh 2015; 48:23-30. [DOI: 10.1111/jnu.12177] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Hsiu-Fen Hsieh
- Assistant Professor, College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yu-Tung Hung
- Assistant Professor, Master degree program in Aging and Long-Term Care; College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Hsiu-Hung Wang
- Dean and Professor, College of Nursing; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Shu-Ching Ma
- Deputy Director; Nursing Department; Chi-Mei Medical Center; Tainan Taiwan
| | - Shu-Chen Chang
- Director and Assistant Professor, Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan and Department of Nursing; Dayeh University; Changhua Taiwan
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Sylvia LG, Bui E, Baier AL, Mehta DH, Denninger JW, Fricchione GL, Casey A, Kagan L, Park ER, Simon NM. Resilient Warrior: A Stress Management Group to Improve Psychological Health in Service Members. Glob Adv Health Med 2015; 4:38-42. [PMID: 26665021 PMCID: PMC4653597 DOI: 10.7453/gahmj.2015.080] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many veterans deployed after 9/11/2001 are impacted by subthreshold levels of posttraumatic stress, anxiety, or other psychological health problems that may interfere with successful reintegration. Conventional treatments, including medication and trauma-focused individual psychotherapies, may not be optimally adapted, accepted, or effective to treat these subsyndromal symptoms. METHODS We developed "Resilient Warrior," a 4-session, group-based, mind-body stress-management and resilience program targeted to build skills and assessed whether its format was accessible and acceptable, and potentially efficacious, to support resilience among service members. RESULTS From April 2014 to October 2014, 15 participants (53.3% women; mean age=36.6 y; SD=6.2) were surveyed for program acceptability and feasibility and completed self-reported psychological health outcomes before and after program participation. The majority (71.4%) of participants reported that the program included the right number of sessions, and all of them reported that it was helpful and relevant and that they would recommend it to others. While changes in self-reported resilience were only marginal, participation was associated with improvements in depressive symptoms, perceived stress, anxiety, and general sense of self efficacy. CONCLUSION These pilot data provide preliminary support that "Resilient Warrior," a group-based, stress reduction and resilience program, may improve psychological health in service members even when delivered in community settings. Randomized controlled trials with longer follow-up periods are needed to establish efficacy and effectiveness for this program.
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Affiliation(s)
- Louisa G Sylvia
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston (Dr Sylvia), United States
| | - Eric Bui
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston (Dr Bui), United States
| | - Allison L Baier
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston (Ms Baier), United States
| | - Darshan H Mehta
- Harvard Medical School, Boston, Massachusetts (Dr Mehta), United States
| | - John W Denninger
- Harvard Medical School, Boston, Massachusetts (Dr Denninger), United States
| | | | - Aggie Casey
- Benson Henry Institute for Mind-Body Medicine, Massachusetts General Hospital, Boston (Ms Casey), United States
| | - Leslee Kagan
- Benson Henry Institute for Mind-Body Medicine, Massachusetts General Hospital, Boston (Ms Kagan), United States
| | - Elyse R Park
- Harvard Medical School, Boston, Massachusetts (Dr Park), United States
| | - Naomi M Simon
- Red Sox Foundation and Massachusetts General Hospital Home Base Program, Boston (Dr Simon), United States
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Factors associated with family resilience during pregnancy among inner-city women. Midwifery 2015; 31:957-64. [DOI: 10.1016/j.midw.2015.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 05/22/2015] [Accepted: 05/25/2015] [Indexed: 11/20/2022]
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Greenhill J, Fielke KR, Richards JN, Walker LJ, Walters LK. Towards an understanding of medical student resilience in longitudinal integrated clerkships. BMC MEDICAL EDUCATION 2015; 15:137. [PMID: 26292832 PMCID: PMC4546182 DOI: 10.1186/s12909-015-0404-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 07/06/2015] [Indexed: 05/11/2023]
Abstract
BACKGROUND Resilience is required to succeed academically, overcome challenges during clinical training and cope positively with stress in future professional life. With medical students at high risk of mental illness, socially accountable medical schools are seeking to foster student resilience. This exploratory study proposes a conceptual framework for student resilience in longitudinal integrated clerkships (LICs). METHODS This qualitative study sought to understand student resilience during the first year of clinical training in a rural LIC where there were consistent anecdotal reports of high student resilience. In-depth interviews were conducted with a purposive sample of 19 medical students, professional staff and clinician teachers. An interpretive approach was used to analyse the data with emerging concepts compared to define evolving theoretical constructs, and develop a conceptual framework. RESULTS LIC students experienced adversity during the first clinical year of the medical course due to challenges encountered in the learning environment. This distress was moderated by: a secure, supportive learning environment; their profound learning journey; and utilisation of organisational structures to stay on course. CONCLUSION This triad of inter-related themes forms a conceptual model that challenges simplistic notions that medical courses should focus solely on providing tangible and emotional supports for students. How LIC programs may contribute to student wellbeing is discussed through the lenses of agentic, reflective and transformative learning.
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Affiliation(s)
- Jennene Greenhill
- Flinders University Rural Clinical School, South Australia, PO Box 852, Renmark, 5341, South Australia.
| | - Ken R Fielke
- Flinders University Rural Clinical School, South Australia, PO Box 852, Renmark, 5341, South Australia.
| | - Janet N Richards
- Flinders University Rural Clinical School, South Australia, PO Box 852, Renmark, 5341, South Australia.
| | - Leesa J Walker
- Flinders University Rural Clinical School, South Australia, PO Box 852, Renmark, 5341, South Australia.
| | - Lucie K Walters
- Flinders University Rural Clinical School, South Australia, PO Box 852, Renmark, 5341, South Australia.
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Tanner Stapleton LR, Dunkel Schetter C, Dooley LN, Guardino CM, Huynh J, Paek C, Clark-Kauffman E, Schafer P, Woolard R, Lanzi RG. The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research. ANXIETY STRESS AND COPING 2015; 29:352-66. [PMID: 26079068 DOI: 10.1080/10615806.2015.1058368] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. DESIGN AND METHODS Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. RESULTS Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. CONCLUSIONS This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.
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Affiliation(s)
- Lynlee R Tanner Stapleton
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | - Christine Dunkel Schetter
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | - Larissa N Dooley
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | - Christine M Guardino
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | - Jan Huynh
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | - Cynthia Paek
- a Department of Psychology , University of California , 1285A Franz Hall, Los Angeles , CA 90095-1563 , USA
| | | | - Peter Schafer
- c New York Academy of Science , 1216 5th Avenue, New York , NY 10029 , USA
| | - Richard Woolard
- d Baby Love Plus Consortium , 1929 Mail Service Center Raleigh, NC 27699-1929 , USA
| | - Robin Gaines Lanzi
- e School of Public Health , University of Alabama at Birmingham , 1665 University Blvd., 227 RPHB, Birmingham , AL 35294 , USA
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Doyle N, MacLachlan M, Fraser A, Stilz R, Lismont K, Cox H, McVeigh J. Resilience and well-being amongst seafarers: cross-sectional study of crew across 51 ships. Int Arch Occup Environ Health 2015; 89:199-209. [DOI: 10.1007/s00420-015-1063-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 05/27/2015] [Indexed: 10/23/2022]
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Gamarel KE, Comfort M, Wood T, Neilands TB, Johnson MO. A qualitative analysis of male couples' coping with HIV: Disentangling the "we". J Health Psychol 2015; 21:2125-37. [PMID: 25721454 DOI: 10.1177/1359105315571975] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research suggests that optimal couple functioning depends on adopting a "we" orientation to health. Using qualitative data from 20 male couples in which at least one partner was HIV-positive, we examined how couples viewed their health involvement and its relation to social support. One group described their health as highly interconnected; in a second group, at least one partner viewed health as a personal responsibility. Results revealed that there was not a uniform "we" approach toward health; rather, sero-concordance, sero-discordance, and coping with other chronic illnesses strongly contributed to orientations toward health. Orientations toward health were not found to determine social support.
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Affiliation(s)
| | | | - Troy Wood
- University of California, San Francisco, USA
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Yim IS, Tanner Stapleton LR, Guardino CM, Hahn-Holbrook J, Dunkel Schetter C. Biological and psychosocial predictors of postpartum depression: systematic review and call for integration. Annu Rev Clin Psychol 2015; 11:99-137. [PMID: 25822344 PMCID: PMC5659274 DOI: 10.1146/annurev-clinpsy-101414-020426] [Citation(s) in RCA: 377] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Postpartum depression (PPD) adversely affects the health and well being of many new mothers, their infants, and their families. A comprehensive understanding of biopsychosocial precursors to PPD is needed to solidify the current evidence base for best practices in translation. We conducted a systematic review of research published from 2000 through 2013 on biological and psychosocial factors associated with PPD and postpartum depressive symptoms. Two hundred fourteen publications based on 199 investigations of 151,651 women in the first postpartum year met inclusion criteria. The biological and psychosocial literatures are largely distinct, and few studies provide integrative analyses. The strongest PPD risk predictors among biological processes are hypothalamic-pituitary-adrenal dysregulation, inflammatory processes, and genetic vulnerabilities. Among psychosocial factors, the strongest predictors are severe life events, some forms of chronic strain, relationship quality, and support from partner and mother. Fully integrated biopsychosocial investigations with large samples are needed to advance our knowledge of PPD etiology.
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Affiliation(s)
- Ilona S Yim
- Department of Psychology and Social Behavior, University of California, Irvine, California 92697;
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Petrowski K, Brähler E, Zenger M. The relationship of parental rearing behavior and resilience as well as psychological symptoms in a representative sample. Health Qual Life Outcomes 2014; 12:95. [PMID: 25381113 PMCID: PMC4289338 DOI: 10.1186/1477-7525-12-95] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 02/11/2014] [Indexed: 11/30/2022] Open
Abstract
Background Recalled parental rearing behavior is one of the factors influencing the strength of resilience. However, it is unclear whether resilience is a relatively stable personality trait or has a relational character whose protective strength changes over the course of life. Therefore, the association between recalled parental rearing and resilience as well as symptoms of anxiety and depression was investigated in respect to age and gender. Methods N = 4,782 healthy subjects aged 14-92 (M = 48.1 years) were selected by the random-route sampling method. In this sample, an ultra-short form of the Recalled Parental Rearing Behavior Questionnaire, the German short version of the resilience scale, and two screening instruments for depression and anxiety (PHQ-2, GAD-2) were filled out. Structural equation modelling was used to analyze the data estimated with the maximum likelihood method approach. Results The data revealed that rejection and punishment were clearly associated with lower resilience. Moreover, resilience had a strong connection to the symptoms of anxiety and depression. Resilience had the same quality of association in both men and women with respect to anxiety and depression. Furthermore, the effect of resilience did not vary across several age groups even though challenges may differ over a lifetime. Conclusion Recalled parental rearing behavior such as rejection and punishment as well as control and overprotection exert a significant association on the strength of resilience. Resilience has an effect independent of gender and does not affect people of different age groups differently.
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Affiliation(s)
- Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Strasse 55, D-04103 Leipzig, Germany.
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133
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Boshoff N, Potgieter JC, van Rensburg E, Ellis S. Occupational stress and mental well-being in a cohort of Black South African teachers. JOURNAL OF PSYCHOLOGY IN AFRICA 2014. [DOI: 10.1080/14330237.2014.903069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Nelmarie Boshoff
- Faculty of Health Sciences, School for Psychosocial Behavioural Sciences, North-West University, Potchefstroom, South Africa
| | - Johan C. Potgieter
- Faculty of Health Sciences, School for Psychosocial Behavioural Sciences, North-West University, Potchefstroom, South Africa
| | - Esme van Rensburg
- Faculty of Health Sciences, School for Psychosocial Behavioural Sciences, North-West University, Potchefstroom, South Africa
| | - Suria Ellis
- Faculty of Health Sciences, School for Psychosocial Behavioural Sciences, North-West University, Potchefstroom, South Africa
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134
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The Preconception Stress and Resiliency Pathways Model: A Multi-Level Framework on Maternal, Paternal, and Child Health Disparities Derived by Community-Based Participatory Research. Matern Child Health J 2014; 19:707-19. [DOI: 10.1007/s10995-014-1581-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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135
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Abstract
Extensive evidence documents that prenatal maternal stress predicts a variety of adverse physical and psychological health outcomes for the mother and baby. However, the importance of the ways that women cope with stress during pregnancy is less clear. We conducted a systematic review of the English-language literature on coping behaviours and coping styles in pregnancy using PsycInfo and PubMed to identify 45 cross-sectional and longitudinal studies involving 16,060 participants published between January 1990 and June 2012. Although results were often inconsistent across studies, the literature provides some evidence that avoidant coping behaviours or styles and poor coping skills in general are associated with postpartum depression, preterm birth and infant development. Variability in study methods including differences in sample characteristics, timing of assessments, outcome variables and measures of coping styles or behaviours may explain the lack of consistent associations. To advance the scientific study of coping in pregnancy, we call attention to the need for a priori hypotheses and greater use of pregnancy-specific, daily process, and skills-based approaches. There is promise in continuing this area of research, particularly in the possible translation of consistent findings to effective interventions, but only if the conceptual basis and methodological quality of research improve.
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136
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Garcia-Dia MJ, DiNapoli JM, Garcia-Ona L, Jakubowski R, O'Flaherty D. Concept analysis: resilience. Arch Psychiatr Nurs 2013; 27:264-70. [PMID: 24238005 DOI: 10.1016/j.apnu.2013.07.003] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/17/2013] [Accepted: 07/23/2013] [Indexed: 11/25/2022]
Abstract
This paper will systematically analyze the concept of resilience using an integrated review of literature. The historical perspective, attributes, antecedents, and consequences of resilience will be reviewed. A theoretical and operational definition will be provided. The Walker and Avant method will be used to describe the cases. Finally, the use of concept map will capture the relationships among the attributes, antecedents, consequences, and empirical indicators through clustering and chaining.
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Affiliation(s)
- Mary Joy Garcia-Dia
- Mount Sinai Medical Center, New York, NY; Case Western Reserve University, Cleveland, OH.
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137
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Dunkel Schetter C, Schafer P, Lanzi RG, Clark-Kauffman E, Raju TNK, Hillemeier MM. Shedding Light on the Mechanisms Underlying Health Disparities Through Community Participatory Methods: The Stress Pathway. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2013; 8:613-33. [PMID: 26173227 PMCID: PMC4505627 DOI: 10.1177/1745691613506016] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative-the Community Child Health Network-to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions.
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Affiliation(s)
| | | | | | - Elizabeth Clark-Kauffman
- Section for Child and Family Health Studies, North Shore University Health System, Evanston, Illinois
| | - Tonse N K Raju
- Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
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138
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McDonald G, Jackson D, Wilkes L, Vickers MH. Personal Resilience in Nurses and Midwives: Effects of a work-based educational intervention. Contemp Nurse 2013. [DOI: 10.5172/conu.2013.3545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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139
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Hahn-Holbrook J, Schetter CD, Arora C, Hobel CJ. Placental Corticotropin-Releasing Hormone Mediates the Association Between Prenatal Social Support and Postpartum Depression. Clin Psychol Sci 2013; 1:253-264. [PMID: 23997996 PMCID: PMC3756599 DOI: 10.1177/2167702612470646] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropin-releasing hormone (pCRH), measured at 19, 29, and 37 weeks' gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks' gestation. Furthermore, steeper increases in pCRH during this same period predicted more depressive symptoms postpartum. Finally, these changes in pCRH in late pregnancy mediated the relationship between prenatal family support and postpartum depressive symptoms. These results suggest that social and biological risk factors for postpartum depressive symptoms are intertwined and move us closer to an integrated biopsychosocial understanding of postpartum depression.
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Affiliation(s)
| | | | - Chander Arora
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Calvin J. Hobel
- Department of Psychology, University of California, Los Angeles, California
- Cedars-Sinai Medical Center, Los Angeles, California
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140
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Laurent HK, Powers SI, Laws H, Gunlicks-Stoessel M, Bent E, Balaban S. HPA regulation and dating couples' behaviors during conflict: gender-specific associations and cross-partner interactions. Physiol Behav 2013; 118:218-26. [PMID: 23711564 PMCID: PMC3744225 DOI: 10.1016/j.physbeh.2013.05.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 01/04/2013] [Accepted: 05/17/2013] [Indexed: 11/23/2022]
Abstract
The way romantic partners behave during conflict is known to relate to stress responses, including activation of the hypothalamic-pituitary-adrenal (HPA) axis; however, little attention has been paid to interactive effects of partners' behaviors, or to behavior outside of marital relationships. This study examined relations between unmarried partners' negative and positive behaviors during discussion of conflict and their HPA responses, including both main effects and cross-partner interactions. Emerging adult opposite-sex couples (n=199) participated in a 15-minute conflict discussion and afterward rated their behavior on 3 dimensions: conflictual, holding back, and supportive. Seven saliva samples collected before and after the discussion were assayed for cortisol to determine HPA response. Quadratic growth models demonstrated associations between male×female partners' behaviors and cortisol trajectories. Two negative dyadic patterns-mutual conflictual behavior (negative reciprocity); female conflictual/male holding back (demand-withdraw)-and one positive pattern-mutual supportive behavior-were identified. Whereas negative patterns related to lower cortisol and impaired post-discussion recovery for women, the positive pattern related to lower cortisol and better recovery for men. Women's conflictual behavior only predicted problematic cortisol responses if their partner was highly conflictual or holding back; at lower levels of these partner behaviors, the opposite was true. This work demonstrates similar costs of negative reciprocity and demand-withdraw and benefits of supportive conflict dynamics in dating couples as found in marital research, but associations with HPA are gender-specific. Cross-partner interactions suggest that behavior during discussion of conflict should not be categorized as helpful or harmful without considering the other partner's behavior.
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141
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McDonald G, Jackson D, Wilkes L, Vickers MH. Personal Resilience in Nurses and Midwives: Effects of a work-based educational intervention. Contemp Nurse 2013. [DOI: 10.5172/conu.2013.3435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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142
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Resilience in the year after cancer diagnosis: a cross-lagged panel analysis of the reciprocity between psychological distress and well-being. J Behav Med 2013; 37:391-401. [DOI: 10.1007/s10865-013-9497-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
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143
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Chen E, Miller GE. Socioeconomic status and health: mediating and moderating factors. Annu Rev Clin Psychol 2012; 9:723-49. [PMID: 23245339 DOI: 10.1146/annurev-clinpsy-050212-185634] [Citation(s) in RCA: 222] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health disparities (differences in health by socioeconomic groups) are a pressing issue in our society. This article provides an overview of a multilevel approach that seeks to understand the mechanisms underlying health disparities by considering factors at the individual, family, and neighborhood levels. In addition, we describe an approach to connecting these factors to various levels of biological processes (systemic inflammation, cellular processes, and genomic pathways) that drive disease pathophysiology. In the second half of the article, we address the question of why some low-socioeconomic-status (low-SES) individuals manage to maintain good physical health. We identify naturally occurring psychosocial factors that help buffer these individuals from adverse physiological responses and pathogenic processes leading to chronic disease. What is protective for low-SES individuals is not the same as what is protective for high-SES individuals, and this needs to be taken into account in interventions aimed at reducing health disparities.
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Affiliation(s)
- Edith Chen
- Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA.
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144
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Uchino BN, Cawthon RM, Smith TW, Light KC, McKenzie J, Carlisle M, Gunn H, Birmingham W, Bowen K. Social relationships and health: is feeling positive, negative, or both (ambivalent) about your social ties related to telomeres? Health Psychol 2012; 31:789-96. [PMID: 22229928 PMCID: PMC3378918 DOI: 10.1037/a0026836] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The quality of one's personal relationships has been linked to morbidity and mortality across different diseases. As a result, it is important to examine more integrative mechanisms that might link relationships across diverse physical health outcomes. In this study, we examine associations between relationships and telomeres that predict general disease risk. These questions are pursued in the context of a more comprehensive model of relationships that highlights the importance of jointly considering positive and negative aspects of social ties. METHOD One hundred thirty-six individuals from a community sample (ages 48 to 77 years) completed the social relationships index, which allows a determination of relationships that differ in their positive and negative substrates (i.e., ambivalent, supportive, aversive, indifferent). Telomere length was determined from peripheral blood mononuclear cells via quantitative polymerase chain reaction. RESULTS Participants who had a higher number of ambivalent ties in their social networks evidenced shorter telomeres. These results were independent of other relationship types (e.g., supportive) and standard control variables (e.g., age, health behaviors, and medication use). Gender moderated the links between ambivalent ties and telomere length, with these associations seen primarily in women. Follow-up analyses revealed that the links between ambivalent ties and telomeres were primarily due to friendships, parents, and social acquaintances. CONCLUSION Consistent with epidemiological findings, these data highlight a novel and integrative biological mechanism by which social ties may affect health across diseases and further suggest the importance of incorporating positivity and negativity in the study of specific relationships and physical health.
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Affiliation(s)
- Bert N Uchino
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA.
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145
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Abstract
Using the 2004 General Social Survey (N = 453), the identity stress process is investigated in terms of crises in intimate relationships and at the workplace. I discuss dispositional optimism as a psychological resource that is relatively independent of the situation and the self, making it ideal for structurally disadvantaged actors and for navigating crises that diminish self-based personal resources such as self-esteem. Consistent with this logic, dispositional optimism was associated with increases in self-esteem and self-rated health net of emotional stability; its effect on these outcomes intensified around the time of relationship crises and was stronger for women than for men. Moreover, optimism was more vital to self-rated health than self-esteem during either type of crisis, suggesting it may be a uniquely durable psychological resource in the stress process.
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146
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Stapleton LRT, Schetter CD, Westling E, Rini C, Glynn LM, Hobel CJ, Sandman CA. Perceived partner support in pregnancy predicts lower maternal and infant distress. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2012; 26:453-63. [PMID: 22662772 PMCID: PMC3992993 DOI: 10.1037/a0028332] [Citation(s) in RCA: 209] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well.
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Affiliation(s)
- Lynlee R Tanner Stapleton
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
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147
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Chen E, Miller GE. "Shift-and-Persist" Strategies: Why Low Socioeconomic Status Isn't Always Bad for Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2012; 7:135-58. [PMID: 23144651 PMCID: PMC3491986 DOI: 10.1177/1745691612436694] [Citation(s) in RCA: 198] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES and poor health and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that, in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low-SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self through reappraisals) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low-SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.
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148
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Abstract
PURPOSE OF REVIEW To briefly review results of the latest research on the contributions of depression, anxiety, and stress exposures in pregnancy to adverse maternal and child outcomes, and to direct attention to new findings on pregnancy anxiety, a potent maternal risk factor. RECENT FINDINGS Anxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children. Anxiety in pregnancy is associated with shorter gestation and has adverse implications for fetal neurodevelopment and child outcomes. Anxiety about a particular pregnancy is especially potent. Chronic strain, exposure to racism, and depressive symptoms in mothers during pregnancy are associated with lower birth weight infants with consequences for infant development. These distinguishable risk factors and related pathways to distinct birth outcomes merit further investigation. SUMMARY This body of evidence, and the developing consensus regarding biological and behavioral mechanisms, sets the stage for a next era of psychiatric and collaborative interdisciplinary research on pregnancy to reduce the burden of maternal stress, depression, and anxiety in the perinatal period. It is critical to identify the signs, symptoms, and diagnostic thresholds that warrant prenatal intervention and to develop efficient, effective and ecologically valid screening and intervention strategies to be used widely.
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