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Affective Neuroscience of Loneliness: Potential Mechanisms underlying the Association between Perceived Social Isolation, Health, and Well-Being. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2022; 7:e220011. [PMID: 36778655 PMCID: PMC9910279 DOI: 10.20900/jpbs.20220011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Loneliness, or the subjective feeling of social isolation, is an important social determinant of health. Loneliness is associated with poor physical health, including higher rates of cardiovascular disease and dementia, faster cognitive decline, and increased risk of mortality, as well as disruptions in mental health, including higher levels of depression, anxiety, and negative affect. Theoretical accounts suggest loneliness is a complex cognitive and emotional state characterized by increased levels of inflammation and affective disruptions. This review examines affective neuroscience research on social isolation in animals and loneliness in humans to better understand the relationship between perceptions of social isolation and the brain. Loneliness associated increases in inflammation and neural changes consistent with increased sensitivity to social threat and disrupted emotion regulation suggest interventions targeting maladaptive social cognitions may be especially effective. Work in animal models suggests the neural changes associated with social isolation may be reversible. Therefore, ameliorating loneliness may be an actionable social determinant of health target. However, more research is needed to understand how loneliness impacts healthy aging, explore the role of inflammation as a potential mechanism in humans, and determine the best time to deliver interventions to improve physical health, mental health, and well-being across a diverse array of populations.
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Bürgin D, Anagnostopoulos D, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry 2022; 31:845-853. [PMID: 35286450 PMCID: PMC9209349 DOI: 10.1007/s00787-022-01974-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.
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Affiliation(s)
- David Bürgin
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany ,grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | | | | | - Benedetto Vitiello
- grid.7605.40000 0001 2336 6580Division of Child Neurology and Psychiatry, Department of Public Health and Pediatric Sciences, Regina Margherita Pediatric Hospital, University of Turin, Turin, Italy
| | - Thorsten Sukale
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
| | - Marc Schmid
- grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M. Fegert
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
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Madison AA, Andridge R, Shrout MR, Renna ME, Bennett JM, Jaremka LM, Fagundes CP, Belury MA, Malarkey WB, Kiecolt-Glaser JK. Frequent Interpersonal Stress and Inflammatory Reactivity Predict Depressive-Symptom Increases: Two Tests of the Social-Signal-Transduction Theory of Depression. Psychol Sci 2022; 33:152-164. [PMID: 34932407 PMCID: PMC8985224 DOI: 10.1177/09567976211031225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
The social-signal-transduction theory of depression asserts that people who experience ongoing interpersonal stressors and mount a greater inflammatory response to social stress are at higher risk for depression. The current study tested this theory in two adult samples. In Study 1, physically healthy adults (N = 76) who reported more frequent interpersonal tension had heightened depressive symptoms at Visit 2, but only if they had greater inflammatory reactivity to a marital conflict at Visit 1. Similarly, in Study 2, depressive symptoms increased among lonelier and less socially supported breast-cancer survivors (N = 79). This effect was most pronounced among participants with higher inflammatory reactivity to a social-evaluative stressor at Visit 1. In both studies, noninterpersonal stress did not interact with inflammatory reactivity to predict later depressive symptoms.
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Affiliation(s)
- Annelise A. Madison
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
- Department of Psychology, The Ohio
State University
| | - Rebecca Andridge
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
- College of Public Health, The Ohio
State University
| | - M. Rosie Shrout
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
| | - Megan E. Renna
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
| | - Jeanette M. Bennett
- Department of Psychological Science,
The University of North Carolina at Charlotte
| | - Lisa M. Jaremka
- Department of Psychology and Brain
Sciences, University of Delaware
| | | | - Martha A. Belury
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
- Department of Human Sciences, The Ohio
State University College of Education and Human Ecology
| | - William B. Malarkey
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
- Department of Internal Medicine, The
Ohio State University College of Medicine
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine
Research, The Ohio State University College of Medicine
- Department of Psychiatry and Behavioral
Health, The Ohio State University College of Medicine
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104
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Slavich GM, Roos LG, Zaki J. Social belonging, compassion, and kindness: Key ingredients for fostering resilience, recovery, and growth from the COVID-19 pandemic. ANXIETY, STRESS, AND COPING 2022; 35:1-8. [PMID: 34369221 PMCID: PMC8792144 DOI: 10.1080/10615806.2021.1950695] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has led to increases in anxiety, depression, posttraumatic stress disorder, burnout, grief, and suicide, particularly for healthcare workers and vulnerable individuals. In some places, due to low vaccination rates and new variants of SARS-CoV-2 emerging, psychosocial strategies for remaining resilient during an ongoing multi-faceted stressor are still needed. Elsewhere, thanks to successful vaccination campaigns, some countries have begun reopening but questions remain regarding how to best recover, adjust, and grow following the collective stress and loss caused by the pandemic. METHOD Here, we briefly describe three evidence-based strategies that can help foster individual and collective recovery, growth, and resilience: cultivating social belonging, practicing compassion, and engaging in kindness. RESULTS Social belonging involves a sense of interpersonal connectedness. Practicing compassion involves perceiving suffering as part of a larger shared human experience and directing kindness toward it. Finally, engaging in kindness involves prosocial acts toward others. CONCLUSIONS Together, these strategies can promote social connectedness and help reduce anxiety, stress, and depression, which may help psychologists, policymakers, and the global community remain resilience in places where cases are still high while promoting adjustment and growth in communities that are now recovering and looking to the future.
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Affiliation(s)
- George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Lydia G. Roos
- Health Psychology PhD Program, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jamil Zaki
- Department of Psychology, Stanford University, Stanford, USA
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105
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Matos M, McEwan K, Kanovský M, Halamová J, Steindl SR, Ferreira N, Linharelhos M, Rijo D, Asano K, Vilas SP, Márquez MG, Gregório S, Brito-Pons G, Lucena-Santos P, Oliveira MDS, de Souza EL, Llobenes L, Gumiy N, Costa MI, Habib N, Hakem R, Khrad H, Alzahrani A, Cheli S, Petrocchi N, Tholouli E, Issari P, Simos G, Lunding-Gregersen V, Elklit A, Kolts R, Kelly AC, Bortolon C, Delamillieure P, Paucsik M, Wahl JE, Zieba M, Zatorski M, Komendziński T, Zhang S, Basran J, Kagialis A, Kirby J, Gilbert P. The role of social connection on the experience of COVID-19 related post-traumatic growth and stress. PLoS One 2021; 16:e0261384. [PMID: 34910779 PMCID: PMC8673633 DOI: 10.1371/journal.pone.0261384] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress. METHODS Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress. RESULTS Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries. CONCLUSIONS Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.
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Affiliation(s)
- Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Kirsten McEwan
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - Martin Kanovský
- Faculty of Social and Economic Sciences, Institute of Social Anthropology, Comenius University, Bratislava, Slovakia
| | - Júlia Halamová
- Faculty of Social and Economic Sciences, Institute of Applied Psychology, Comenius University, Bratislava, Slovakia
| | - Stanley R. Steindl
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Mariana Linharelhos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Kenichi Asano
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo, Japan
| | - Sara P. Vilas
- Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Margarita G. Márquez
- Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Sónia Gregório
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
- Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Gonzalo Brito-Pons
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola Lucena-Santos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal
| | - Margareth da Silva Oliveira
- Evaluation and Treatment in Cognitive and Behavioral Psychotherapies—Research Group (GAAPCC), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Noor Habib
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Reham Hakem
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Hussain Khrad
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Ahmad Alzahrani
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
| | - Elli Tholouli
- Center for Qualitative Research in Psychology and Psychosocial Well-being, National and Kapodistrian University of Athens, Athens, Greece
| | - Philia Issari
- Center for Qualitative Research in Psychology and Psychosocial Well-being, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | | | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Russell Kolts
- Department of Psychology, Eastern Washington University, Cheney, WA, United States of America
| | - Allison C. Kelly
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Catherine Bortolon
- Laboratoire Inter-universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, Grenoble, France
- Centre Hospitalier Alpes Isère, C3R - Réhabilitation psychosociale et remédiation cognitive, Grenoble, France
| | - Pascal Delamillieure
- CHU de Caen, Service de Psychiatrie Adulte, Caen, France
- UNICAEN, ISTS, GIP Cyceron, University of Normandy, Caen, France
| | - Marine Paucsik
- Laboratoire Inter-universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, Grenoble, France
| | - Julia E. Wahl
- The Mind Institute Poland, Warsaw, Poland
- SWPS University of Social Sciences and Humanities, Warsaw & Poznań, Poland
| | - Mariusz Zieba
- SWPS University of Social Sciences and Humanities, Warsaw & Poznań, Poland
| | - Mateusz Zatorski
- SWPS University of Social Sciences and Humanities, Warsaw & Poznań, Poland
| | - Tomasz Komendziński
- Department of Cognitive Science, Nicolaus Copernicus University, Torún, Poland
- Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Torún, Poland
| | - Shuge Zhang
- School of Human Sciences, University of Derby, Derby, United Kingdom
| | - Jaskaran Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
| | - Antonios Kagialis
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - James Kirby
- Compassionate Mind Research Group, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby, United Kingdom
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106
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Moriarity DP, Ellman LM, Coe CL, Olino TM, Alloy LB. A physiometric investigation of inflammatory composites: Comparison of "a priori" aggregates, empirically-identified factors, and individual proteins. Brain Behav Immun Health 2021; 18:100391. [PMID: 34877552 PMCID: PMC8628205 DOI: 10.1016/j.bbih.2021.100391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 01/03/2023] Open
Abstract
Most research testing the association between inflammation and health outcomes (e.g., heart disease, diabetes, depression) has focused on individual proteins; however, some studies have used summed composites of inflammatory markers without first investigating dimensionality. Using two different samples (MIDUS-2: N = 1255 adults, MIDUS-R: N = 863 adults), this study investigates the dimensionality of eight inflammatory proteins (C-reactive protein (CRP), interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-α (TNF-α), fibrinogen, E-selectin, and intercellular adhesion molecule (ICAM)-1) and compared the resulting factor structure to a) an "a priori"/tau-equivalent factor structure in which all inflammatory proteins equally load onto a single dimension (comparable to the summed composites) and b) proteins modeled individually (i.e., no latent variable) in terms of model fit, replicability, reliability, and their associations with health outcomes. An exploratory factor analysis indicated a two-factor structure (Factor 1: CRP and fibrinogen; Factor 2: IL-8 and IL-10) in MIDUS-2 and was replicated in MIDUS-R. Results did not clearly indicate whether the empirically-identified factor structure or the individual proteins modeled without a latent variable had superior model fit, but both strongly outperformed the "a priori"/tau-equivalent structure (which did not achieve acceptable model fit in any models). Modeling the empirically-identified factors and individual proteins (without a latent factor) as outcomes of medical diagnoses resulted in comparable conclusions. However, modeling individual proteins resulted in findings more robust to correction for multiple comparisons despite more conservative adjustments. Further, reliability for all latent variables was poor. These results indicate that modeling inflammation as a unidimensional construct equally associated with all available proteins does not fit the data well. Instead, individual inflammatory proteins or, potentially (if empirically supported and biologically-plausible) empirically-identified inflammatory factors should be used in accordance with theory.
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Affiliation(s)
- Daniel P. Moriarity
- Temple University, USA
- McLean Hospital, Harvard Medical School
- Corresponding author. Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA 19122, USA.
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107
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Best T, Herring L, Clarke C, Kirby J, Gilbert P. The experience of loneliness: The role of fears of compassion and social safeness. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.111161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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108
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Madison AA. Boosting stress resilience using flexibility as a framework to reduce depression risk. Brain Behav Immun Health 2021; 18:100357. [PMID: 34632428 PMCID: PMC8493491 DOI: 10.1016/j.bbih.2021.100357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/22/2022] Open
Abstract
Stress exposure is inevitable, and major life events often precede depression onset. However, a majority do not develop depression after a major life event. Inflexible physiological responses to stress, in which the magnitude or duration is disproportionate to the stressor, may increase risk for depression - especially in the context of frequent or repetitive stress. Although past psychoneuroimmunology (PNI) research focused primarily on stress response magnitude, two relatively recent stress theories - the Perseverative Cognition Hypothesis and Generalized Unsafety Theory - shift the focus to response duration, including anticipatory reactivity and poor recovery. Using these theories as framework, this article reviews evidence suggesting that psychological inflexibility, such as perseverative cognition, and the inability to recognize safety promote heightened and prolonged (i.e., inflexible) physiological stress responses. Moreover, interventions that increase psychological flexibility or safety recognition may foster more flexible physiological responses to psychological stress. By adopting the lens of flexibility to examine physiological responses to stress, PNI will speak the same language as clinical psychology, which has identified inflexibility as an etiological and maintenance factor of depression.
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Affiliation(s)
- Annelise A. Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, 460 Medical Center Drive, USA
- Department of Psychology, The Ohio State University, Columbus, OH, 43210, USA
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109
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Milas G, Martinović Klarić I, Malnar A, Saftić V, Šupe-Domić D, Slavich GM. The impact of stress and coping strategies on life satisfaction in a national sample of adolescents: A structural equation modelling approach. Stress Health 2021; 37:1026-1034. [PMID: 33876570 PMCID: PMC8523576 DOI: 10.1002/smi.3050] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/27/2021] [Accepted: 04/08/2021] [Indexed: 11/06/2022]
Abstract
Although stress strongly predicts life satisfaction, the psychosocial mechanisms underlying this association remain unclear. To investigate the possible mediating role of coping, we conducted a cross-sectional study that assessed youths' life stress levels, propensity to engage in three different coping styles (i.e., active coping, internal coping, & withdrawal), and life satisfaction in a probabilistic, two-stage stratified cluster sample of 1830 high school seniors (986 females; age range: 17-22 years old) from 26 schools in or around the four largest cities in Croatia. We used correlational analyses and structural equation modelling to test the hypothesis that coping mediates the relation between stress and life satisfaction. The tested model was marginally acceptable: χ2 = 1613.85, df = 177, p < 0.001, goodness-of-fit-index = 0.92, Comparative Fit Index = 0.91, Tucker-Lewis Index = 0.89, root mean square error of approximation = 0.067 (90% CI = 0.064 to 0.070), standardized root mean squared residual = 0.056. As hypothesized, stress was related to life satisfaction directly (βc' = -0.22, p < 0.01) but also indirectly (βab = -0.05, p < 0.01) by affecting youths' likelihood of engaging in withdrawal behaviours, such as avoiding problems, distracting, or using anger, alcohol, or drugs. The proportion of the total effect mediated by withdrawal was 19.4%. In contrast, neither active nor internal coping were significant mediators. Based on these results, we conclude that preventive and educational programs for enhancing youth mental health may benefit from reducing adolescents' stress levels and stress-related withdrawal behaviour, and by encouraging youth to use active coping strategies instead.
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Affiliation(s)
- Goran Milas
- Institute of Social Sciences ‘Ivo Pilar’, Zagreb, Croatia
| | | | - Ana Malnar
- Institute for Migration and Ethnic Studies, Zagreb, Croatia
| | - Vanja Saftić
- Child and Youth Protection Center of Zagreb, Zagreb, Croatia,Croatian Catholic University, Zagreb, Croatia
| | - Daniela Šupe-Domić
- Department of Medical Laboratory Diagnostics, University Hospital Center Split, Split, Croatia,Department of Health Studies, University of Split, Split, Croatia
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Memmott‐Elison MK, Jorgensen MA, Padilla‐Walker LM. Growth in positive relationship quality with mothers, fathers, and siblings and associations with depressive symptoms and emotionally supportive prosocial behaviors during the transition to adulthood. SOCIAL DEVELOPMENT 2021. [DOI: 10.1111/sode.12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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111
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Shattuck EC. Networks, cultures, and institutions: Toward a social immunology. Brain Behav Immun Health 2021; 18:100367. [PMID: 34761241 PMCID: PMC8566934 DOI: 10.1016/j.bbih.2021.100367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/08/2021] [Accepted: 10/08/2021] [Indexed: 12/26/2022] Open
Abstract
This paper calls for increased attention to the ways in which immune function – including its behavioral aspects – are responsive to social contexts at multiple levels. Psychoneuroimmunology has demonstrated that the quantity and quality of social connections can affect immune responses, while newer research is finding that sickness temporarily affects these same social networks and that some aspects of culture can potentially “get under the skin” to affect inflammatory responses. Social immunology, the research framework proposed here, unifies these findings and also considers the effects of structural factors – that is, a society's economic, political, and environmental landscape – on exposure to pathogens and subsequent immune responses. As the COVID-19 pandemic has highlighted, a holistic understanding of the effects of social contexts on the patterning of morbidity and mortality is critically important. Social immunology provides such a framework and can highlight important risk factors related to impaired immune function.
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Affiliation(s)
- Eric C Shattuck
- Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX, USA.,Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
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112
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Sichko S, Bui TQ, Vinograd M, Shields GS, Saha K, Devkota S, Olvera-Alvarez HA, Carroll JE, Cole SW, Irwin MR, Slavich GM. Psychobiology of Stress and Adolescent Depression (PSY SAD) Study: Protocol overview for an fMRI-based multi-method investigation. Brain Behav Immun Health 2021; 17:100334. [PMID: 34595481 PMCID: PMC8478351 DOI: 10.1016/j.bbih.2021.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/22/2022] Open
Abstract
Depression is a common, often recurrent disorder that causes substantial disease burden worldwide, and this is especially true for women following the pubertal transition. According to the Social Signal Transduction Theory of Depression, stressors involving social stress and rejection, which frequently precipitate major depressive episodes, induce depressive symptoms in vulnerable individuals in part by altering the activity and connectivity of stress-related neural pathways, and by upregulating components of the immune system involved in inflammation. To test this theory, we recruited adolescent females at high and low risk for depression and assessed their psychological, neural, inflammatory, and genomic responses to a brief (10 minute) social stress task, in addition to trait psychological and microbial factors affecting these responses. We then followed these adolescents longitudinally to investigate how their multi-level stress responses at baseline were related to their biological aging at baseline, and psychosocial and clinical functioning over one year. In this protocol paper, we describe the theoretical motivations for conducting this study as well as the sample, study design, procedures, and measures. Ultimately, our aim is to elucidate how social adversity influences the brain and immune system to cause depression, one of the most common and costly of all disorders.
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Affiliation(s)
- Stassja Sichko
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Theresa Q. Bui
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Meghan Vinograd
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, and Department of Psychiatry, University of California, San Diego, CA, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Krishanu Saha
- Wisconsin Institute for Discovery and Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Suzanne Devkota
- Department of Medicine, F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Judith E. Carroll
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Steven W. Cole
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Michael R. Irwin
- Department of Psychology, University of California, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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113
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Zainal NH, Newman MG. Increased inflammation predicts nine-year change in major depressive disorder diagnostic status. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:829-840. [PMID: 34618490 PMCID: PMC8629837 DOI: 10.1037/abn0000716] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cytokine theory of depression proposes that increased baseline inflammatory activity may accumulate over time and lead to future major depressive disorder (MDD). However, most research conducted on this topic has been cross-sectional and examined between- (vs. within-) persons and symptom severity (vs. diagnosis). Therefore, we tested if elevated inflammatory activity at Time 1 (T1) would predict future within-person 9-year change in MDD diagnosis. Community-dwelling adults (n = 945) participated in the Midlife Development in the United States (MIDUS) study. T1 and Time 2 (T2) MDD status was assessed using the Composite International Diagnostic Interview-Short Form, and markers of inflammatory activity at T1 were measured (e.g., levels of serum interleukin-6 [IL-6], C-reactive protein [CRP], fibrinogen). Latent change score modeling was conducted. Higher T1 IL-6, CRP, and fibrinogen levels of inflammatory activity predicted T1-T2 development/relapse of MDD within persons. This effect occurred more strongly among women (vs. men; d = .149 vs. .042), younger (vs. older) adults (d = .137 vs. .119), persons with more (vs. less) chronic health issues (d = .133 vs. .065), low- (vs. middle- or high-) income earners (d = .161 vs. .050), and persons with more (vs. less) frequent childhood trauma (d = .156 vs. .017). Findings aligned with expanded cytokine theories, which posit that the impact of increased T1 inflammatory activity on future change in MDD status will be larger for subgroups vulnerable to increased stress exposure. Cognitive-behavioral or pharmacological approaches to reduce markers of inflammatory activity may prevent development/relapse of MDD. General Scientific Summary: Increased C-reactive protein (CRP), fibrinogen, and interleukin-6 (IL-6) levels predicted 9-year major depressive disorder (MDD) diagnostic status change more strongly in younger than older adults, women but not men, those with low (vs. high) income, as well as persons with high (vs. low) childhood trauma frequency and number of chronic illnesses. Findings aligned with expanded cytokine theories (e.g., social signal transduction theory of depression), which posit that markers of inflammatory activity predict future change in MDD status especially for populations vulnerable to heightened, chronic, and long-term exposure to environmental stressors. Continued efforts to empirically test expanded cytokine theories of depression may improve delineation of patterns of health disparities and facilitate effective measures to prevent the onset or recurrence of MDD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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114
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Arroyo-Belmonte M, Natera-Rey G, Tiburcio-Sainz M, Martínez-Vélez N. Development and Psychometric Properties of the Adversity and Stress Scale (ASS): Validation in the Adult Mexican Population. Int J Ment Health Addict 2021; 21:1-15. [PMID: 34720773 PMCID: PMC8544184 DOI: 10.1007/s11469-021-00669-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/02/2022] Open
Abstract
Since stress is known to play a role in the development of physical and mental illness, empirically validated measurements are required to assess the effect of adverse events such as the COVID-19 pandemic. The purpose of this study was to develop and evaluate the psychometric properties of the Adversity and Stress Scale (ASS). A sample of 3937 adults living in Mexico was used. The structure of the instrument was evaluated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Construct validity was measured through associations between the ASS and psychological symptoms. In the EFA, the relational and contextual dimensions of stress were identified. A good fit was obtained in the CFA (CFI = 0.980, RMSEA = 0.040). The ASS score was associated with all the selected variables in the expected direction, and internal consistency was α = .86. The ASS is a valid, reliable measure, with the potential to be used in other adverse events.
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Affiliation(s)
| | - Guillermina Natera-Rey
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, 14370 Mexico City, CP Mexico
| | - Marcela Tiburcio-Sainz
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, 14370 Mexico City, CP Mexico
| | - Nora Martínez-Vélez
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco No. 101, Col. San Lorenzo Huipulco, 14370 Mexico City, CP Mexico
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115
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Low SK, Cheng MY, Pheh KS. A thematic analysis of older adult’s perspective of successful ageing. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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116
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Lee DS, Way BM. Social media use and systemic inflammation: The moderating role of self-esteem. Brain Behav Immun Health 2021; 16:100300. [PMID: 34589792 PMCID: PMC8474231 DOI: 10.1016/j.bbih.2021.100300] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/14/2022] Open
Abstract
Social media use has become an important part of social life. However, little is known about its relation to physical health. Extending prior work on social media use and psychological well-being, the present research investigated how social media use is associated with a key indicator of health, systemic inflammation. Based on research on self-esteem and work on inflammation, the current study examined whether the link between social media use and inflammatory biomarkers would be moderated by self-esteem. A nationally probablistic sample of middle-aged adults (N = 863) completed self-report questionnaires on social media use, self-esteem, socio-demographic information, and health related behaviors. Approximately two years later, they provided a blood sample that was analyzed for C-reactive protein (CRP) and interleukin-6 (IL-6), biomarkers of systemic inflammation. Consistent with our hypothesis, self-esteem moderated the association between social media use and these markers of inflammation. Specifically, as self-esteem decreased, the positive association of social media use with CRP and IL-6 became stronger. These results held after controlling for socio-demographic information, health status, depressive symptoms, and medication usage. Social media use was not significantly correlated with either CRP or IL-6. The present research demonstrates physical health correlates of social media use and suggests self-esteem as a key variable that can moderate the relation between social media use and health. Very little is known about how social media use is associated with physical health. Social media use may be especially stressful for people lower in self-esteem. Self-esteem moderated the link between social media use and systemic inflammation. People with lower self-esteem had higher CRP and IL-6 levels from social media use.
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Affiliation(s)
- David S Lee
- University at Buffalo, The State University of New York, Buffalo, NY, USA
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117
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O'Shields JD, Mowbray OP. Difficulties in psychosocial functioning due to current depressive symptoms: What can C-Reactive protein tell us? Brain Behav Immun Health 2021; 16:100316. [PMID: 34589806 PMCID: PMC8474419 DOI: 10.1016/j.bbih.2021.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023] Open
Abstract
Background Multiple empirical studies and meta-analyses have examined how inflammation may be associated with various aspects of major depression, with older adults being particularly at risk for the effects of inflammation-related depression. Despite this wide area of research, no study has examined how depression-related inflammation impacts psychosocial functioning. Methods Data from the National Health and Nutrition Examination Survey, years 2007–2008, were utilized to examine whether adults over the age of 40 experienced difficulty in their work, taking care of things at home, or getting along with other people due to current depressive symptoms through a logistic regression analysis. We selected C-reactive protein (CRP), a common marker of immune system activation, as our primary predictor of interest while controlling for relevant covariates. Results Greater CRP was positively associated with a greater risk for individuals experiencing difficulties in psychosocial functioning due to depressive symptoms. While current number and severity of depressive symptoms was also found to be significant in the model, comparison of effect sizes identified that CRP appears to be a more relevant marker for experiencing difficulty than a number of relevant biopsychosocial covariates. Conclusion Inflammation as measured by CRP may be a helpful tool in understanding how depressive symptoms are associated with an individual's ability to successfully navigate their social environment. Results here demonstrate the emerging utility of CRP in helping to assess the risk for negative outcomes in those experiencing depressive symptoms, especially as it pertains to older adults. Aimed to evaluate the role of CRP in psychosocial functioning of older adults experiencing current depressive symptoms. Higher CRP levels were positively associated with risk for experiencing psychosocial difficulty due to depressive symptoms. CRP levels above 10 mg/L were associated with a 13.7–55.6% increased risk for experiencing psychosocial difficulties.
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118
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Moriarity DP. Building a replicable and clinically-impactful immunopsychiatry: Methods, phenotyping, and theory integration. Brain Behav Immun Health 2021; 16:100288. [PMID: 34589785 PMCID: PMC8474613 DOI: 10.1016/j.bbih.2021.100288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 10/25/2022] Open
Abstract
Immunopsychiatry is a subfield of psychoneuroimmunology that integrates immunological and psychopathological processes with promise for improving the classification, identification, and treatment of psychopathology. Using research on the relationship between inflammation and depression as a running example, this mini-review will discuss three areas of work that should be emphasized in future research to maximize the replicability and clinical impact of the field: 1) methodology with respect to planning data collection and statistical analyses with measurement properties and conceptually important sources of variance in mind, 2) characterizing inflammatory phenotypes of psychopathology, and 3) the integration of inflammatory processes into robust, extant psychosocial theoretical frameworks of psychopathology risk. Consistent, parallel growth in all three areas will ensure immunopsychiatry research is replicable, contributes to understanding of how (and for whom) the immune system is associated with psychiatric symptoms, and increases the flexibility and power of personalized treatment planning.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA, 19122, USA
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119
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Muscatell KA, Inagaki TK. Beyond social withdrawal: New perspectives on the effects of inflammation on social behavior. Brain Behav Immun Health 2021; 16:100302. [PMID: 34589794 PMCID: PMC8474589 DOI: 10.1016/j.bbih.2021.100302] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 12/30/2022] Open
Abstract
Decades of research in animals and humans show that inflammation is an important regulator of social behavior. While much research in this area has concluded that inflammation causes a withdrawal from social interaction, closer examination of the literature reveals that the effects of inflammation on social behavior are much more nuanced. Indeed, while many studies do show that increases in inflammation lead to social withdrawal, other studies show the exact opposite, finding that inflammation leads to an increase in social approach behavior. Critically, whether an organism withdraws or approaches when inflamed may depend on the whether the target of the behavior is a close other or a stranger. In the present paper, we review both animal research and our initial research in humans that has utilized experimental manipulations of inflammation and examined their effects on social approach behavior. We argue, based on complementary theoretical perspectives and supporting evidence from the literature, that there are three critical next steps for translational work examining the effects of inflammation on social behavior: (1) We need to study actual social behavior, as expressed toward both close others and strangers; (2) We should examine not just the social behavior of the inflamed individual, but also the behavior of others interacting with an inflamed individual; and (3) We must consider the relative increases in inflammation (i.e., higher vs. lower) as a contributor to social withdrawal vs. approach. Ultimately, we urge the field to move beyond a singular focus on inflammation and social withdrawal so that we can develop a more comprehensive understanding of the effects of inflammation on a variety of social behaviors.
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Affiliation(s)
- Keely A. Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, USA
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120
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Palamarchuk IS, Vaillancourt T. Mental Resilience and Coping With Stress: A Comprehensive, Multi-level Model of Cognitive Processing, Decision Making, and Behavior. Front Behav Neurosci 2021; 15:719674. [PMID: 34421556 PMCID: PMC8377204 DOI: 10.3389/fnbeh.2021.719674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Aversive events can evoke strong emotions that trigger cerebral neuroactivity to facilitate behavioral and cognitive shifts to secure physiological stability. However, upon intense and/or chronic exposure to such events, the neural coping processes can be maladaptive and disrupt mental well-being. This maladaptation denotes a pivotal point when psychological stress occurs, which can trigger subconscious, "automatic" neuroreactivity as a defence mechanism to protect the individual from potential danger including overwhelming unpleasant feelings and disturbing or threatening thoughts.The outcomes of maladaptive neural activity are cognitive dysfunctions such as altered memory, decision making, and behavior that impose a risk for mental disorders. Although the neurocognitive phenomena associated with psychological stress are well documented, the complex neural activity and pathways related to stressor detection and stress coping have not been outlined in detail. Accordingly, we define acute and chronic stress-induced pathways, phases, and stages in relation to novel/unpredicted, uncontrollable, and ambiguous stressors. We offer a comprehensive model of the stress-induced alterations associated with multifaceted pathophysiology related to cognitive appraisal and executive functioning in stress.
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Affiliation(s)
- Iryna S Palamarchuk
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
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121
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Cao B, Zhao Y, Ren Z, McIntyre RS, Teopiz KM, Gao X, Ding L. Are Physical Activities Associated With Perceived Stress? The Evidence From the China Health and Nutrition Survey. Front Public Health 2021; 9:697484. [PMID: 34414158 PMCID: PMC8369204 DOI: 10.3389/fpubh.2021.697484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Psychological stress is a negative affective state. The association between physical activity and psychological stress was commonly reported in previous researches. Few published studies with large sample sizes have explored such an association in Chinese population. The current research aims to assess the association between perceived stress and physical activity preferences, as well as the association between risk of high perceived stress and physical activity behaviors (e.g., sports-, transport-, occupational-related physical activity, sedentary activities and time in bed). The data were collected from the China Health and Nutrition Survey (CHNS) in 2015. Generalized linear models and logistic regression models were used to explore the association between perceived stress and physical activity. In total, 11,066 participants were included in the current analysis. For physical activity preferences, we found that “like” preference of all six mentioned domains of activities contributed to lower perceived stress (i.e., lower perceived stress scale −14 score, all β < 0 and p < 0.05). For physical activity behaviors, the results indicated that none/low intensity physical activity behaviors (e.g., sports-, occupational- related, sedentary) were associated with risk of high perceived stress, except that low intensity of transport-related activities seemed to be protective from high stress. However, the association between intensity of physical activity behaviors and perceived stress was not simply the higher the better. High intensity of all these physical activity behaviors was also associated with high perceived stress. Our findings suggest that positive preferences and moderate physical activity behaviors were associated with low perceived stress. The findings herein highlight the effect of regulating physical activity on perceived stress, as well as inform potential strategies to reduce psychological stress.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Yuxiao Zhao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Zhongyu Ren
- College of Physical Education, Southwest University, Chongqing, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.,National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Ling Ding
- Pharmacy Department, The Central Hospital of Jiangjin, Chongqing, China
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122
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Bickman L. Improving Mental Health Services: A 50-Year Journey from Randomized Experiments to Artificial Intelligence and Precision Mental Health. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 47:795-843. [PMID: 32715427 PMCID: PMC7382706 DOI: 10.1007/s10488-020-01065-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This conceptual paper describes the current state of mental health services, identifies critical problems, and suggests how to solve them. I focus on the potential contributions of artificial intelligence and precision mental health to improving mental health services. Toward that end, I draw upon my own research, which has changed over the last half century, to highlight the need to transform the way we conduct mental health services research. I identify exemplars from the emerging literature on artificial intelligence and precision approaches to treatment in which there is an attempt to personalize or fit the treatment to the client in order to produce more effective interventions.
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Affiliation(s)
- Leonard Bickman
- Center for Children and Families; Psychology, Academic Health Center 1, Florida International University, 11200 Southwest 8th Street, Room 140, Miami, FL, 33199, USA.
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123
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Mac Giollabhui N. Inflammation and depression: Research designs to better understand the mechanistic relationships between depression, inflammation, cognitive dysfunction, and their shared risk factors. Brain Behav Immun Health 2021; 15:100278. [PMID: 34589778 PMCID: PMC8474663 DOI: 10.1016/j.bbih.2021.100278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/28/2022] Open
Abstract
There is convergent evidence that the immune system is dysregulated in some depressed individuals. A psychoneuroimmunology-based understanding of depression is advancing rapidly; however, a question of fundamental importance is poorly understood: does inflammation play a causal role in the etiology of depression or are elevated inflammatory biomarkers a downstream effect of depressive behaviors? Although longitudinal studies suggest that the relationship between depression and inflammation is characterized by complex bidirectional associations, existing prospective, longitudinal research designs are poorly equipped to investigate the dynamic interplay of depression and inflammation that unfolds over a relatively short time period. In addition, the precise role played by multiple, shared, and overlapping risk factors (e.g., diet, adiposity, stress, sleep dysregulation) in the etiology of depression and a pro-inflammatory phenotype (or both) is poorly understood. In this manuscript, I highlight the benefits of research designs that (i) manipulate constructs of interest (depression/inflammation) using intervention or treatment designs and (ii) use intensive sampling approaches with an ultimate goal of better understanding the temporal sequence and causal relationships of depression, inflammation, cognitive dysfunction, and their shared risk factors. For instance, are improved depressive symptoms a downstream effect of changes in inflammatory activity caused by increases in exercise or, alternatively, are changes in inflammatory activity and depression sequelae of improvements in sleep quality caused by increases in exercise? Potential benefits of these research designs are discussed in terms of their contribution to a better understanding of the etiology of depression and a pro-inflammatory phenotype, their relevance to structural health inequalities, and better characterizing the heterogeneous clinical presentation of depression, particularly relating to the etiology of cognitive dysfunction in depression.
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Affiliation(s)
- Naoise Mac Giollabhui
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St, Philadelphia, PA, 19122, USA
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124
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Moseley RL, Turner-Cobb JM, Spahr CM, Shields GS, Slavich GM. Lifetime and perceived stress, social support, loneliness, and health in autistic adults. Health Psychol 2021; 40:556-568. [PMID: 34618502 PMCID: PMC8513810 DOI: 10.1037/hea0001108] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Although the health consequences of life stress exposure in the general population are well known, how different stressors occurring over the lifetime cause morbidity and mortality in autism is unclear, as are the factors that moderate and mediate these associations. The few studies that have compared autistic and nonautistic individuals have used instruments that yield few stress exposure indices and assess stressors occurring over short time periods. METHOD To address these issues, we used the Stress and Adversity Inventory to assess lifetime stressor exposure and perceived stressor severity in 127 autistic and 104 nonautistic adults. Moderated mediation analysis examined associations between stressor exposure and physical and mental ill-health with respect to the hypothesized mediating role of stressor perception, and moderation effects of loneliness and social support. RESULTS Autistic adults experienced more lifetime stressors and generally perceived stressors as being more severe. Greater perceived stressor severity was related to poorer physical and mental health and to greater loneliness and lower social support for both groups. An additional post hoc analysis of the association between diagnostic status and mental ill-health revealed that loneliness mediated the relation between being autistic and having poorer mental health. CONCLUSION Autistic individuals experienced more lifetime stressors, and their impact on physical and mental health was mediated by perceived stressor severity. Moreover, loneliness and low social support were associated with greater negative impact of lifetime stress exposure on mental health. Interventions that reduce cognitive-perceptual stress appraisals, and that target loneliness and social support, may help reduce risk for stress-related disease in autistic individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Chandler M. Spahr
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Arkansas, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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125
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Lamontagne SJ, Pizzagalli DA, Olmstead MC. Does inflammation link stress to poor COVID-19 outcome? Stress Health 2021; 37:401-414. [PMID: 33315291 DOI: 10.1002/smi.3017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/03/2020] [Accepted: 12/09/2020] [Indexed: 12/11/2022]
Abstract
Coronavirus disease 2019 (COVID-19) continues to ravage communities across the world. Despite its primary effect on the respiratory system, the virus does not solely impact those with underlying lung conditions as initially predicted. Indeed, prognosis is worsened (often fatal) in patients with pre-existing hyperinflammatory responses (e.g., hypertension, obesity and diabetes), yet the mechanisms by which this occurs are unknown. A number of psychological conditions are associated with inflammation, suggesting that these may also be significant risk factors for negative outcomes of COVID-19. In this review, we evaluate preclinical and clinical literature suggesting that chronic stress-induced hyperinflammation interacts synergistically with COVID-19-related inflammation, contributing to a potentially fatal cytokine storm syndrome. In particular, we hypothesize that both chronic stress and COVID-19-related hyperinflammation are a product of glucocorticoid insufficiency. We discuss the devastating effects of SARS-CoV-2 on structural and functional aspects of the biological stress response and how these induce exaggerated inflammatory responses, particularly interleukin (IL)-6 hypersecretion. We postulate that chronic stress should be considered a significant risk factor for adverse COVID-19-related health outcomes, given overlapping peripheral and central immune dysregulation in both conditions. We conclude by discussing how people with a history of chronic stress could mitigate their risk for COVID-19 complications, identifying specific strategies that can be implemented during self-isolation.
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Affiliation(s)
- Steven J Lamontagne
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.,Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, Belmont, Massachusetts, USA
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, Belmont, Massachusetts, USA
| | - Mary C Olmstead
- Department of Psychology, Queen's University, Kingston, Ontario, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
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Kim S, Zhang W, Pak V, Aqua JK, Hertzberg VS, Spahr CM, Slavich GM, Bai J. How stress, discrimination, acculturation and the gut microbiome affect depression, anxiety and sleep among Chinese and Korean immigrants in the USA: a cross-sectional pilot study protocol. BMJ Open 2021; 11:e047281. [PMID: 34290066 PMCID: PMC8296781 DOI: 10.1136/bmjopen-2020-047281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Although a considerable proportion of Asians in the USA experience depression, anxiety and poor sleep, these health issues have been underestimated due to the model minority myth about Asians, the stigma associated with mental illness, lower rates of treatment seeking and a shortage of culturally tailored mental health services. Indeed, despite emerging evidence of links between psychosocial risk factors, the gut microbiome and depression, anxiety and sleep quality, very few studies have examined how these factors are related in Chinese and Korean immigrants in the USA. The purpose of this pilot study was to address this issue by (a) testing the usability and feasibility of the study's multilingual survey measures and biospecimen collection procedure among Chinese and Korean immigrants in the USA and (b) examining how stress, discrimination, acculturation and the gut microbiome are associated with depression, anxiety and sleep quality in this population. METHOD AND ANALYSIS This is a cross-sectional pilot study among first and second generations of adult Chinese and Korean immigrants in the greater Atlanta area (Georgia, USA). We collected (a) gut microbiome samples and (b) data on psychosocial risk factors, depression, anxiety and sleep disturbance using validated, online surveys in English, Chinese and Korean. We aim to recruit 60 participants (30 Chinese, 30 Korean). We will profile participants' gut microbiome using 16S rRNA V3-V4 sequencing data, which will be analysed by QIIME 2. Associations of the gut microbiome and psychosocial factors with depression, anxiety and sleep disturbance will be analysed using descriptive and inferential statistics, including linear regression. ETHICS AND DISSEMINATION This study has been approved by the Institutional Review Board at Emory University (IRB ID: STUDY00000935). Results will be made available to Chinese and Korean community members, the funder and other researchers and the broader scientific community.
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Affiliation(s)
- Sangmi Kim
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Center for Data Science, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Victoria Pak
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jasmine Ko Aqua
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Vicki Stover Hertzberg
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Center for Data Science, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Chandler M Spahr
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Diamond LM, Dehlin AJ, Alley J. Systemic inflammation as a driver of health disparities among sexually-diverse and gender-diverse individuals. Psychoneuroendocrinology 2021; 129:105215. [PMID: 34090051 DOI: 10.1016/j.psyneuen.2021.105215] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
Sexually-diverse individuals (those who seek sexual or romantic relationships with the same and/or multiple genders) and gender-diverse individuals (those whose gender identity and/or expression differs from their birth-assigned sex/gender) have disproportionately high physical health problems, but the underlying biological causes for these health disparities remain unclear. Building on the minority stress model linking social stigmatization to health outcomes, we argue that systemic inflammation (the body's primary response to both physical and psychological threats, indicated by inflammatory markers such as C-reactive protein and proinflammatory cytokines) is a primary biobehavioral pathway linking sexual and gender stigma to physical health outcomes. Expectations and experiences of social threat (i.e., rejection, shame, and isolation) are widespread and chronic among sexually-diverse and gender-diverse individuals, and social threats are particularly potent drivers of inflammation. We review research suggesting that framing "minority stress" in terms of social safety versus threat, and attending specifically to the inflammatory consequences of these experiences, can advance our understanding of the biobehavioral consequences of sexual and gender stigma and can promote the development of health promoting interventions for this population.
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128
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Caldwell JZ, Kinney JW, Ritter A, Salazar A, Wong CG, Cordes D, Slavich GM. Inflammatory cytokine levels implicated in Alzheimer's disease moderate the effects of sex on verbal memory performance. Brain Behav Immun 2021; 95:27-35. [PMID: 33301871 PMCID: PMC8793982 DOI: 10.1016/j.bbi.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/24/2020] [Accepted: 12/04/2020] [Indexed: 12/01/2022] Open
Abstract
Despite having an initial verbal memory advantage over men, women have greater rates of Alzheimer's disease and more rapid cognitive decline once diagnosed. Moreover, although Alzheimer's disease is influenced by inflammation, which itself has known sex differences, no study has investigated whether sex differences in memory are moderated by peripheral inflammatory activity. To address this issue, we analyzed data from 109 individuals (50 women, Mage = 71.62, range = 55-87) diagnosed as cognitively normal, or having mild cognitive impairment or Alzheimer's disease dementia. We then followed the sample for 12 months, as part of a longitudinal study of aging and Alzheimer's disease. At baseline, we assessed levels of the inflammatory cytokines interleukin (IL)-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) in plasma. At baseline and 12 months, we assessed verbal memory using the Rey Auditory Verbal Learning Test and nonverbal memory using the Brief Visuospatial Memory Test-Revised. As hypothesized, for the full sample, women exhibited stronger verbal (but not nonverbal) memory than men. In women, but not men, higher IL-1β at baseline related to poorer verbal learning across both time points and delayed recall at 12 months. The effect of sex on memory also differed by IL-1β level, with women exhibiting a memory advantage both at baseline and 12 months, but only for those with low-to-moderate IL-1β levels. Therefore, high peripheral inflammation levels may lead to a sex-specific memory vulnerability relevant for Alzheimer's disease.
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Affiliation(s)
- Jessica Z.K. Caldwell
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA,Corresponding author. (J.Z.K. Caldwell)
| | | | - Aaron Ritter
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Arnold Salazar
- Department of Brain Health, University of Nevada, Las Vegas, NV, USA
| | - Christina G. Wong
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Dietmar Cordes
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Kuchenbecker SY, Pressman SD, Celniker J, Grewen KM, Sumida KD, Jonathan N, Everett B, Slavich GM. Oxytocin, cortisol, and cognitive control during acute and naturalistic stress. Stress 2021; 24:370-383. [PMID: 33632072 PMCID: PMC8254750 DOI: 10.1080/10253890.2021.1876658] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Although stress is a strong risk factor for poor health, especially for women, it remains unclear how stress affects the key neurohormones cortisol and oxytocin, which influence stress-related risk and resilience. Whereas cortisol mediates energy mobilization during stress, oxytocin has anti-inflammatory, anxiolytic, and analgesic effects that support social connection and survival across the lifespan. However, how these neurohormones interrelate and are associated with cognitive control of emotional information during stress remains unclear. To address these issues, we recruited 37 college-aged women (Mage = 19.19, SD = 1.58) and randomly assigned each to a one-hour experimental session consisting of either an acute stress (emotionally stressful video) or control (non-stressful video) condition in a cross-sectional manner across the semester. Salivary cortisol and oxytocin samples were collected at baseline and after the video, at which point participants also completed measures assessing affect and an emotional Stroop task. As hypothesized, the emotional stressor induced negative emotions that were associated with significant elevations in cortisol and faster Stroop reaction times. Moreover, higher baseline oxytocin predicted greater positive affect after the stressor and also better cognitive accuracy on the Stroop. Analyses examining the naturalistic stress effects revealed that basal oxytocin levels rose steeply three weeks before the semester's end, followed by rising cortisol levels one week later, with both neurohormones remaining elevated through the very stressful final exam period. Considered together, these data suggest that women's collective experiences of stress may be potentially buffered by a synchronous oxytocin surge that enhances cognitive accuracy and reduces stress "when the going gets tough".
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Affiliation(s)
- Shari Young Kuchenbecker
- Department of Psychology, Chapman University, Orange, CA, USA
- Western Positive Psychology Association, Claremont, CA, USA
| | - Sarah D. Pressman
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Jared Celniker
- Department of Psychology, Chapman University, Orange, CA, USA
- Department of Psychological Science, University of California, Irvine, CA, USA
| | - Karen M. Grewen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Naveen Jonathan
- Department of Marriage and Family Therapy, Chapman University, Orange, CA, USA
| | - Brendan Everett
- Department of Psychology, Chapman University, Orange, CA, USA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Hazlett LI, Moieni M, Irwin MR, Haltom KEB, Jevtic I, Meyer ML, Breen EC, Cole SW, Eisenberger NI. Exploring neural mechanisms of the health benefits of gratitude in women: A randomized controlled trial. Brain Behav Immun 2021; 95:444-453. [PMID: 33932527 DOI: 10.1016/j.bbi.2021.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/05/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Gratitude has received growing interest as an emotion that can bring greater happiness and health. However, little is known about the effects of gratitude on objective measures of physical health or the neural mechanisms that underlie these effects. Given strong links between gratitude and giving behavior, and giving and health, it is possible that gratitude may benefit health through the same mechanisms as giving to others. Thus, this study investigated whether gratitude activates a neural 'caregiving system' (e.g., ventral striatum (VS), septal area (SA)), which can downregulate threat responding (e.g., amygdala) and possibly cellular inflammatory responses linked to health. METHODS A parallel group randomized controlled trial examined the effect of a six-week online gratitude (n = 31) vs. control (n = 30) writing intervention on neural activity and inflammatory outcomes. Pre- and post-intervention, healthy female participants (ages 35-50) reported on support-giving behavior and provided blood samples to assess circulating plasma levels and stimulated monocytic production of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)). Post-intervention, participants completed a gratitude task and a threat reactivity task in an fMRI scanner. RESULTS There were no significant group differences (gratitude vs. control intervention) in neural responses (VS, SA, or amygdala) to the gratitude or threat tasks. However, across the entire sample, those who showed larger pre- to- post-intervention increases in self-reported support-giving showed larger reductions in amygdala reactivity following the gratitude task (vs. control task). Additionally, those who showed larger reductions in amygdala reactivity following the gratitude task showed larger pre-to-post reductions in the stimulated production of TNF-α and IL-6. Importantly, gratitude-related reductions in amygdala reactivity statistically mediated the relationship between increases in support-giving and decreases in stimulated TNF-α production. CONCLUSION The observed relationships suggest that gratitude may benefit health (reducing inflammatory responses) through the threat-reducing effects of support-giving.
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Affiliation(s)
- Laura I Hazlett
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Mona Moieni
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Michael R Irwin
- Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA 90095, United States
| | - Kate E Byrne Haltom
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Ivana Jevtic
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Meghan L Meyer
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States
| | - Elizabeth C Breen
- Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA 90095, United States
| | - Steven W Cole
- Semel Institute for Neuroscience and Human Behavior, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA 90095, United States; Department of Medicine, Division of Hematology-Oncology, University of California, Los Angeles, 10833 Le Conte Ave., 60-054, Los Angeles, CA 90095, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza #4, Los Angeles, CA 90095, United States
| | - Naomi I Eisenberger
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, United States.
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131
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Davis AJ, Crittenden B, Cohen E. Effects of social support on performance outputs and perceived difficulty during physical exercise. Physiol Behav 2021; 239:113490. [PMID: 34139269 DOI: 10.1016/j.physbeh.2021.113490] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 12/28/2022]
Abstract
Perceptions of social support influence adaptive self-regulatory processes that maintain health, produce feelings, and motivate behavior. Although associations between sociality and health are increasingly well-understood, there is little systematic research into the effects of social support on fatigue, physical discomfort, exertion, and output regulation in physical activity. We conducted an experimental study to investigate the effect of social support on performance and perceived difficulty in a handgrip force task while controlling for audience and reputational factors. Effects were compared with those of another established psychogenic performance enhancer (a placebo ergogenic supplement). During handgrip trials over varying levels of objective difficulty, participants viewed photographs of a support figure or stranger while in a placebo or control condition. Results revealed a significant main effect of the social support cue on handgrip performance outputs, and a significant interaction with objective trial difficulty - relative to the stranger cue, the support-figure cue significantly increased handgrip performance outputs and the effect was larger in more objectively difficult trials. Moreover, despite producing greater handgrip outputs, participants perceived trials to be significantly less difficult in the social support condition. Though there was a non-significant main effect of placebo (vs. control) on performance outputs, participants perceived trials in the placebo condition to be significantly less difficult. The research contributes new evidence and theory on the role of perceived social support - an important (energetic) resource - in human performance and motivates further enquiry into how cues to support alter perceived effort and performance outputs in strenuous physical challenges.
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Affiliation(s)
- Arran J Davis
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, United Kingdom.
| | - Ben Crittenden
- Nuffield Department of Clinical Neurosciences, University of Oxford, Level 6, West Wing, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Emma Cohen
- Institute of Cognitive and Evolutionary Anthropology, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, United Kingdom; Wadham College, Parks Road, Oxford, OX1 3PN, United Kingdom
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132
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Lamarche VM. Interdependent transformations: Integrating insights from relationship science to advance post-traumatic growth and personality change research. EUROPEAN JOURNAL OF PERSONALITY 2021. [DOI: 10.1177/08902070211022119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
People have a tremendous ability to grow and change for the better following adverse life events. This capacity for growth has captured the attention of psychologists interested in understanding the mechanisms underpinning both personality and well-being. This paper advocates for a greater integration of relationship science into this area of study as a means of advancing post-traumatic growth and personality change research. Relationships, both as an impetus for change and as evidence of growth, have featured consistently in the post-traumatic growth and adversity literatures. Drawing from interdependence theory in particular, this paper highlights how the unique structure of close relationships and relationship dynamics can be applied to address outstanding theoretical questions related to the advancement of post-traumatic growth research as well as offers a critique of the practice of using relationship outcomes (e.g., connection) as evidence of post-traumatic growth. Finally, this paper encourages psychologists across subdisciplines to share their unique skills and insights to help generate more robust psychological theories and methods.
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133
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Mental health during the COVID-19 pandemic and beyond: The importance of the vagus nerve for biopsychosocial resilience. Neurosci Biobehav Rev 2021; 125:1-10. [PMID: 33582230 PMCID: PMC8106638 DOI: 10.1016/j.neubiorev.2021.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic has led to widespread increases in mental health problems, including anxiety and depression. The development of these and other psychiatric disorders may be related to changes in immune, endocrine, autonomic, cognitive, and affective processes induced by a SARS-CoV-2 infection. Interestingly, many of these same changes can be triggered by psychosocial stressors such as social isolation and rejection, which have become increasingly common due to public policies aimed at reducing the spread of SARS-CoV-2. The present review aims to shed light on these issues by describing how viral infections and stress affect mental health. First, we describe the multi-level mechanisms linking viral infection and life stress exposure with risk for psychopathology. Then, we summarize how resilience can be enhanced by targeting vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation and targeting lifestyle factors, such as exercise. With these biopsychosocial insights in mind, researchers and healthcare professionals will be better equipped to reduce risk for psychopathology and increase resilience during this challenging pandemic period and beyond.
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134
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Cooper JA, Nuutinen MR, Lawlor VM, DeVries BAM, Barrick EM, Hossein S, Cole DJ, Leonard CV, Hahn EC, Teer AP, Shields GS, Slavich GM, Ongur D, Jensen JE, Du F, Pizzagalli DA, Treadway MT. Reduced adaptation of glutamatergic stress response is associated with pessimistic expectations in depression. Nat Commun 2021; 12:3166. [PMID: 34039978 PMCID: PMC8155144 DOI: 10.1038/s41467-021-23284-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 04/19/2021] [Indexed: 01/20/2023] Open
Abstract
Stress is a significant risk factor for the development of major depressive disorder (MDD), yet the underlying mechanisms remain unclear. Preclinically, adaptive and maladaptive stress-induced changes in glutamatergic function have been observed in the medial prefrontal cortex (mPFC). Here, we examine stress-induced changes in human mPFC glutamate using magnetic resonance spectroscopy (MRS) in two healthy control samples and a third sample of unmedicated participants with MDD who completed the Maastricht acute stress task, and one sample of healthy control participants who completed a no-stress control manipulation. In healthy controls, we find that the magnitude of mPFC glutamate response to the acute stressor decreases as individual levels of perceived stress increase. This adaptative glutamate response is absent in individuals with MDD and is associated with pessimistic expectations during a 1-month follow-up period. Together, this work shows evidence for glutamatergic adaptation to stress that is significantly disrupted in MDD.
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Affiliation(s)
| | | | | | | | - Elyssa M Barrick
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Shabnam Hossein
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Daniel J Cole
- Department of Psychology, Emory University, Atlanta, GA, USA
| | | | - Emma C Hahn
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Andrew P Teer
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Grant S Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Dost Ongur
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - J Eric Jensen
- McLean Imaging Center, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Fei Du
- McLean Imaging Center, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital/Harvard Medical School, Belmont, MA, USA
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, MA, USA
- McLean Imaging Center, McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | - Michael T Treadway
- Department of Psychology, Emory University, Atlanta, GA, USA.
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
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135
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Robles TF. Annual Research Review: Social relationships and the immune system during development. J Child Psychol Psychiatry 2021; 62:539-559. [PMID: 33164229 DOI: 10.1111/jcpp.13350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/22/2020] [Accepted: 10/16/2020] [Indexed: 12/15/2022]
Abstract
A child's social relationships serve critical functions during development. The interface between a child's social world and their immune system, particularly innate immunity, which helped children survive in the face of infections, nutritional scarcity, and violence throughout human history, is the focus of this Annual Research Review. This article reviews the state of research on social relationships and innate immune inflammation during childhood. Warmth and rejection in childhood social relationships, as well as physical trauma and unpredictable social environments, were not consistently related to circulating inflammatory markers such as interleukin-6 and C-reactive protein during childhood. Instead, links between social environments and inflammation were observed in studies that focus on children with greater background risk factors, such as low family socioeconomic status, family history of mood disorders, or presence of chronic interpersonal stressors combined with acute episodic stressors. In addition, studies on worse childhood social environments and greater inflammation in adulthood were more consistent. Warmth and rejection in the social environment may be related to sensitivity of immune cells to the anti-inflammatory actions of glucocorticoids, though this is primarily observed in adolescent women at risk for depression. Additional mechanistic evidence suggests that greater warmth and less rejection are related to processes that regulate inflammation, including greater expression of the glucocorticoid receptor gene and lower expression of genes that are responsive to the pro-inflammatory transcription factor NF-kappa B. The article concludes by discussing implications of the interface between a child's social relationships and inflammation for mental health and other recent (on evolutionary timescales) health threats, as well as recommendations for future research, and recommendations for researchers interested in integrating inflammatory measures in developmental research.
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Affiliation(s)
- Theodore F Robles
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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136
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Allen KA, Kern ML, Rozek CS, McInereney D, Slavich GM. Belonging: A Review of Conceptual Issues, an Integrative Framework, and Directions for Future Research. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021; 73:87-102. [PMID: 33958811 DOI: 10.1080/00049530.2021.1883409] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective A sense of belonging-the subjective feeling of deep connection with social groups, physical places, and individual and collective experiences-is a fundamental human need that predicts numerous mental, physical, social, economic, and behavioural outcomes. However, varying perspectives on how belonging should be conceptualised, assessed, and cultivated has hampered much-needed progress on this timely and important topic. To address these critical issues, we conducted a narrative review that summarizes existing perspectives on belonging, describes a new integrative framework for understanding and studying belonging, and identifies several key avenues for future research and practice. Method We searched relevant databases, including Google Scholar, PubMed, Scopus, PsycInfo, and ClinicalTrials.gov, for articles describing belonging, instruments for assessing belonging, and interventions for increasing belonging. Results By identifying the core components of belonging, we introduce a new integrative framework for understanding, assessing, and cultivating belonging that focuses on four interrelated components: competencies, opportunities, motivations, and perceptions. Conclusion This integrative framework enhances our understanding of the basic nature and features of belonging, provides a foundation for future interdisciplinary research on belonging and belongingness, and highlights how a robust sense of belonging may be cultivated to improve human health and resilience for individuals and communities worldwide.
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Affiliation(s)
- Kelly-Ann Allen
- Educational Psychology and Inclusive Education, Faculty of Education, Monash University, Clayton Australia.,Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Parkville, Australia
| | - Margaret L Kern
- Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Parkville, Australia
| | | | - Dennis McInereney
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, U.S.A
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137
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Morais AHDA, Aquino JDS, da Silva-Maia JK, Vale SHDL, Maciel BLL, Passos TS. Nutritional status, diet and viral respiratory infections: perspectives for severe acute respiratory syndrome coronavirus 2. Br J Nutr 2021; 125:851-862. [PMID: 32843118 PMCID: PMC7542326 DOI: 10.1017/s0007114520003311] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022]
Abstract
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was recognised by the WHO as a pandemic in 2020. Host preparation to combat the virus is an important strategy to avoid COVID-19 severity. Thus, the relationship between eating habits, nutritional status and their effects on the immune response and further implications in viral respiratory infections is an important topic discussed in this review. Malnutrition causes the most diverse alterations in the immune system, suppressing of the immune response and increasing the susceptibility to infections such as SARS-CoV-2. On the other hand, obesity induces low-grade chronic inflammation caused by excess adiposity, which increases angiotensin-converting enzyme 2. It decreases the immune response favouring SARS-CoV-2 virulence and promoting respiratory distress syndrome. The present review highlights the importance of food choices considering their inflammatory effects, consequently increasing the viral susceptibility observed in malnutrition and obesity. Healthy eating habits, micronutrients, bioactive compounds and probiotics are strategies for COVID-19 prevention. Therefore, a diversified and balanced diet can contribute to the improvement of the immune response to viral infections such as COVID-19.
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Affiliation(s)
- Ana Heloneida de Araújo Morais
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Jailane de Souza Aquino
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Paraíba, João Pessoa, PB58050-085, Brazil
| | - Juliana Kelly da Silva-Maia
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Sancha Helena de Lima Vale
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Bruna Leal Lima Maciel
- Nutrition Postgraduate Program, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
| | - Thaís Sousa Passos
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, RN59078-970, Brazil
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138
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Cicchella A, Stefanelli C, Massaro M. Upper Respiratory Tract Infections in Sport and the Immune System Response. A Review. BIOLOGY 2021; 10:biology10050362. [PMID: 33922542 PMCID: PMC8146667 DOI: 10.3390/biology10050362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 02/07/2023]
Abstract
Simple Summary This review aims at clarifying the relationships of heavy training with the upper respiratory tract infections (URTI), a topic which has reach the public awareness with the recent outbreaks of Covid 19. The URTIs are quite common in several sport activities among athletes who undergo heavy training. Causes of URTI are still poorly understood, because can be related with innate and genetic susceptibility and with several environmental factors connected with training load and nutrition. The time course of the inflammation process affecting URTI after training, has been also reviewed. After a survey of the possible physiological and psychological causes (stressors), including a survey of the main markers of inflammation currently found in scientific literature (mainly catecholamines), we provided evidence of the ingestion of carbohydrates, C, D, and E vitamins, probiotics and even certain fat, in reducing URTI in athletes. Possible countermeasures to URTI can be a correct nutrition, sleep hygiene, a proper organization of training loads, and the use of technique to reduce stress in professional athletes. There is a lack of studies investigating social factors (isolation) albeit with Covid 19 this gap has been partially fill. The results can be useful also for non-athletes. Abstract Immunity is the consequence of a complex interaction between organs and the environment. It is mediated the interaction of several genes, receptors, molecules, hormones, cytokines, antibodies, antigens, and inflammatory mediators which in turn relate and influence the psychological health. The immune system response of heavily trained athletes resembles an even more complex conditions being theorized to follow a J or S shape dynamics at times. High training loads modify the immune response elevating the biological markers of immunity and the body susceptibility to infections. Heavy training and/or training in a cold environment increase the athletes’ risk to develop Upper Respiratory Tract Infections (URTIs). Therefore, athletes, who are considered healthier than the normal population, are in fact more prone to infections of the respiratory tract, due to lowering of the immune system in the time frames subsequent heavy training sessions. In this revision we will review the behavioral intervention, including nutritional approaches, useful to minimize the “open window” effect on infection and how to cope with stressors and boost the immune system in athletes.
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Affiliation(s)
- Antonio Cicchella
- Department for Quality of Life Studies, University of Bologna, 40127 Bologna, Italy;
- Correspondence: ; Tel.: +39-051-2088772
| | - Claudio Stefanelli
- Department for Quality of Life Studies, University of Bologna, 40127 Bologna, Italy;
| | - Marika Massaro
- Institute of Clinical Physiology, National Research Council (CNR), 73047 Lecce, Italy;
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139
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Gruber J, Prinstein MJ, Clark LA, Rottenberg J, Abramowitz JS, Albano AM, Aldao A, Borelli JL, Chung T, Davila J, Forbes EE, Gee DG, Hall GCN, Hallion LS, Hinshaw SP, Hofmann SG, Hollon SD, Joormann J, Kazdin AE, Klein DN, La Greca AM, Levenson RW, MacDonald AW, McKay D, McLaughlin KA, Mendle J, Miller AB, Neblett EW, Nock M, Olatunji BO, Persons JB, Rozek DC, Schleider JL, Slavich GM, Teachman BA, Vine V, Weinstock LM. Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action. AMERICAN PSYCHOLOGIST 2021; 76:409-426. [PMID: 32772538 PMCID: PMC7873160 DOI: 10.1037/amp0000707] [Citation(s) in RCA: 272] [Impact Index Per Article: 90.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- June Gruber
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine
| | - Tammy Chung
- Institute for Health, Healthcare Policy and Aging Research, Rutgers, The State University of New Jersey
| | | | | | | | | | | | | | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University
| | | | | | | | | | | | | | | | - Dean McKay
- Department of Psychology, Fordham University
| | | | - Jane Mendle
- Department of Human Development, Cornell University
| | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | | | | | | | | | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
| | | | - Vera Vine
- Department of Psychiatry, University of Pittsburgh
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140
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Gruber J, Prinstein MJ, Clark LA, Rottenberg J, Abramowitz JS, Albano AM, Aldao A, Borelli JL, Chung T, Davila J, Forbes EE, Gee DG, Hall GCN, Hallion LS, Hinshaw SP, Hofmann SG, Hollon SD, Joormann J, Kazdin AE, Klein DN, La Greca AM, Levenson RW, MacDonald AW, McKay D, McLaughlin KA, Mendle J, Miller AB, Neblett EW, Nock M, Olatunji BO, Persons JB, Rozek DC, Schleider JL, Slavich GM, Teachman BA, Vine V, Weinstock LM. Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action. AMERICAN PSYCHOLOGIST 2021; 76:409-426. [PMID: 32772538 DOI: 10.31234/osf.io/desg9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- June Gruber
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine
| | - Tammy Chung
- Institute for Health, Healthcare Policy and Aging Research, Rutgers, The State University of New Jersey
| | | | | | | | | | | | | | - Stefan G Hofmann
- Department of Psychological and Brain Sciences, Boston University
| | | | | | | | | | | | | | | | - Dean McKay
- Department of Psychology, Fordham University
| | | | - Jane Mendle
- Department of Human Development, Cornell University
| | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | | | | | | | | | | | - George M Slavich
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles
| | | | - Vera Vine
- Department of Psychiatry, University of Pittsburgh
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141
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Kilius E, Abbas NH, McKinnon L, Samson DR. Pandemic Nightmares: COVID-19 Lockdown Associated With Increased Aggression in Female University Students' Dreams. Front Psychol 2021; 12:644636. [PMID: 33746860 PMCID: PMC7973031 DOI: 10.3389/fpsyg.2021.644636] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 pandemic and its associated stressors have impacted the daily lives and sleeping patterns of many individuals, including university students. Dreams may provide insight into how the mind processes changing realities; dreams not only allow consolidation of new information, but may give the opportunity to creatively "play out" low-risk, hypothetical threat simulations. While there are studies that analyze dreams in high-stress situations, little is known of how the COVID-19 pandemic has impacted dreams of university students. The aim of this study was to explore how the dream content of students was affected during the university COVID-19 lockdown period (March-July, 2020). Using online survey methods, we analyzed dream recall content (n = 71) using the Hall-Van de Castle dream coding system and Fisher's exact tests for sex comparisons. Preliminary results indicate that female students experienced more nightmares as compared to male students. Dream analysis found that, relative to normative American College Student (ACS) samples generated pre-COVID-19, women were more likely to experience aggressive interactions in their dream content, including increased physical aggression. Results indicate that university students did experience changes in dream content due to the pandemic lockdown period, with women disproportionally affected. These findings can aid universities in developing support programs for students by bringing forth an understanding of students' concerns and anxieties as they process the "new normal" of social distancing.
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Affiliation(s)
- Erica Kilius
- Sleep and Human Evolution Lab, Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Noor H Abbas
- Sleep and Human Evolution Lab, Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Leela McKinnon
- Sleep and Human Evolution Lab, Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - David R Samson
- Sleep and Human Evolution Lab, Department of Anthropology, University of Toronto Mississauga, Mississauga, ON, Canada
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142
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Kunz N, Kemper C. Complement Has Brains-Do Intracellular Complement and Immunometabolism Cooperate in Tissue Homeostasis and Behavior? Front Immunol 2021; 12:629986. [PMID: 33717157 PMCID: PMC7946832 DOI: 10.3389/fimmu.2021.629986] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/13/2021] [Indexed: 12/20/2022] Open
Abstract
The classical liver-derived and serum-effective complement system is well appreciated as a key mediator of host protection via instruction of innate and adaptive immunity. However, recent studies have discovered an intracellularly active complement system, the complosome, which has emerged as a central regulator of the core metabolic pathways fueling human immune cell activity. Induction of expression of components of the complosome, particularly complement component C3, during transmigration from the circulation into peripheral tissues is a defining characteristic of monocytes and T cells in tissues. Intracellular complement activity is required to induce metabolic reprogramming of immune cells, including increased glycolytic flux and OXPHOS, which drive the production of the pro-inflammatory cytokine IFN-γ. Consequently, reduced complosome activity translates into defects in normal monocyte activation, faulty Th1 and cytotoxic T lymphocyte responses and loss of protective tissue immunity. Intriguingly, neurological research has identified an unexpected connection between the physiological presence of innate and adaptive immune cells and certain cytokines, including IFN-γ, in and around the brain and normal brain function. In this opinion piece, we will first review the current state of research regarding complement driven metabolic reprogramming in the context of immune cell tissue entry and residency. We will then discuss how published work on the role of IFN-γ and T cells in the brain support a hypothesis that an evolutionarily conserved cooperation between the complosome, cell metabolism and IFN-γ regulates organismal behavior, as well as immunity.
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Affiliation(s)
- Natalia Kunz
- Complement and Inflammation Research Section (CIRS), National Heart, Lung and Blood Institute, Bethesda, MD, United States
| | - Claudia Kemper
- Complement and Inflammation Research Section (CIRS), National Heart, Lung and Blood Institute, Bethesda, MD, United States.,Institute for Systemic Inflammation Research, University of Lübeck, Lübeck, Germany
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143
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Gilbert P. Creating a Compassionate World: Addressing the Conflicts Between Sharing and Caring Versus Controlling and Holding Evolved Strategies. Front Psychol 2021; 11:582090. [PMID: 33643109 PMCID: PMC7902494 DOI: 10.3389/fpsyg.2020.582090] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
For thousands of years, various spiritual traditions and social activists have appealed to humans to adopt compassionate ways of living to address the suffering of life. Yet, along with our potential for compassion and self-sacrifice, the last few thousand years of wars, slavery, tortures, and holocausts have shown humans can be extraordinarily selfish, callous, vicious, and cruel. While there has been considerable engagement with these issues, particularly in the area of moral psychology and ethics, this paper explores an evolutionary analysis relating to evolved resource-regulation strategies that can be called "care and share" versus "control and hold." Control and hold are typical of primates that operate through intimidatory social hierarchies. Care and share are less common in non-human primates, but evolved radically in humans during our hunter-gatherer stage when our ancestors lived in relatively interdependent, small, mobile groups. In these groups, individualistic, self-focus, and self-promoting control and hold strategies (trying to secure and accumulate more than others) were shunned and shamed. These caring and sharing hunter-gatherer lifestyles also created the social contexts for the evolution of new forms of childcare and complex human competencies for language, reasoning, planning, empathy, and self-awareness. As a result of our new 'intelligence', our ancestors developed agriculture that reduced mobility, increased group size, resource availability and storage, and resource competition. These re-introduced competing for, rather than sharing of, resources and advantaged those who now pursue (often aggressively) control and hold strategies. Many of our most typical forms of oppressive and anti-compassionate behavior are the result of these strategies. Rather than (just) thinking about individuals competing with one another, we can also consider these different resource regulation strategies as competing within populations shaping psychophysiological patterns; both wealth and poverty change the brain. One of the challenges to creating a more compassionate society is to find ways to create the social and economic conditions that regulate control and hold strategies and promote care and share. No easy task.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Derby, United Kingdom
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144
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Abstract
Social robots that can interact and communicate with people are growing in popularity for use at home and in customer-service, education, and healthcare settings. Although growing evidence suggests that co-operative and emotionally aligned social robots could benefit users across the lifespan, controversy continues about the ethical implications of these devices and their potential harms. In this perspective, we explore this balance between benefit and risk through the lens of human-robot relationships. We review the definitions and purposes of social robots, explore their philosophical and psychological status, and relate research on human-human and human-animal relationships to the emerging literature on human-robot relationships. Advocating a relational rather than essentialist view, we consider the balance of benefits and harms that can arise from different types of relationship with social robots and conclude by considering the role of researchers in understanding the ethical and societal impacts of social robotics.
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Affiliation(s)
- Tony J. Prescott
- Department of Computer Science, University of Sheffield, Sheffield, UK
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145
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Concurrent and Longitudinal Associations of Sex and Race with Inflammatory Biomarkers during Adolescence. J Youth Adolesc 2021; 50:711-723. [PMID: 33449289 DOI: 10.1007/s10964-020-01369-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/03/2020] [Indexed: 01/15/2023]
Abstract
Chronic, systemic inflammation is implicated in physical and mental health; little is known about whether sex and racial differences detected in adulthood are observed during adolescence or about normative changes occurring during adolescence. This longitudinal, United States-based study examined four biomarkers of systemic inflammation [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and IL-8) in 315 adolescents (51% female; 58% black; baseline age = 16.49 years (SD = 1.56; range: 12.14-21.28)] at three timepoints. Notable results included: general decline in inflammatory biomarkers in older adolescents, lower levels of TNF-α/IL-8 in black adolescents, elevated CRP/IL-6 in females, and especially higher levels of IL-6 in black, female adolescents. Implications are discussed, particularly the potential health implications of elevated IL-6 in black females.
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146
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Yan S, Xu R, Stratton TD, Kavcic V, Luo D, Hou F, Bi F, Jiao R, Song K, Jiang Y. Sex differences and psychological stress: responses to the COVID-19 pandemic in China. BMC Public Health 2021; 21:79. [PMID: 33413224 DOI: 10.1101/2020.04.29.20084061] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/16/2020] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. METHODS In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic "snowball" or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) - along with residential living arrangements and conditions - were measured along with psychological stress and emotional responses to the COVID-19 pandemic. RESULTS Three thousand eighty-eight questionnaires were returned: 1749 females (56.6%) and 1339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD = 2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (< 45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19, completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). "Protective" factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. CONCLUSIONS The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
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Affiliation(s)
- Shiyan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Rui Xu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Terry D Stratton
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40536, USA
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, 48202, USA
| | - Dan Luo
- School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Fengsu Hou
- Shenzhen Kangning Hospital, Guangzhou, 518020, China
| | - Fengying Bi
- School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Rong Jiao
- The First Clinical College, Hainan Meidical University, Haikou, 570100, China
| | - Kangxing Song
- The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yang Jiang
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40536, USA
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147
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Yan S, Xu R, Stratton TD, Kavcic V, Luo D, Hou F, Bi F, Jiao R, Song K, Jiang Y. Sex differences and psychological stress: responses to the COVID-19 pandemic in China. BMC Public Health 2021; 21:79. [PMID: 33413224 PMCID: PMC7789895 DOI: 10.1186/s12889-020-10085-w] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/16/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. METHODS In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic "snowball" or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) - along with residential living arrangements and conditions - were measured along with psychological stress and emotional responses to the COVID-19 pandemic. RESULTS Three thousand eighty-eight questionnaires were returned: 1749 females (56.6%) and 1339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD = 2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (< 45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19, completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). "Protective" factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. CONCLUSIONS The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
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Affiliation(s)
- Shiyan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Rui Xu
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Terry D Stratton
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40536, USA
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, 48202, USA
| | - Dan Luo
- School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Fengsu Hou
- Shenzhen Kangning Hospital, Guangzhou, 518020, China
| | - Fengying Bi
- School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Rong Jiao
- The First Clinical College, Hainan Meidical University, Haikou, 570100, China
| | - Kangxing Song
- The First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Yang Jiang
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, 40536, USA
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148
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McLoughlin E, Fletcher D, Slavich GM, Arnold R, Moore LJ. Cumulative lifetime stress exposure, depression, anxiety, and well-being in elite athletes: A mixed-method study. PSYCHOLOGY OF SPORT AND EXERCISE 2021; 52:101823. [PMID: 33281503 PMCID: PMC7710337 DOI: 10.1016/j.psychsport.2020.101823] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Research suggests that elite athletes are at increased risk of poor mental health, partly due to the intense demands associated with top-level sport. Despite growing interest in the topic, the factors that influence the mental health and well-being of elite athletes remain unclear. From a theoretical perspective, the accumulation of stress and adversity experienced over the life course may be an important factor. To investigate this possibility, we employed a mixed-method design to: (a) examine whether cumulative lifetime stress predicted depression, anxiety, and well-being in elite athletes; and (b) help explain why cumulative lifetime stress exposure might have resulted in poor mental health and well-being. Ninety-five elite athletes (M age = 29.81, SD = 10.88) completed the Stress and Adversity Inventory, Patient Health Questionnaire, Generalized Anxiety Disorder 7-item scale, and the Scales of General Well-Being. Hierarchical regression analyses revealed that total count and severity of lifetime stressor exposure significantly predicted greater depression (β = .42, p < .001; β = .46, p < .001) and anxiety symptoms (β = .34, p = .003; β = .28, p = .018), and worse well-being (β = -.42, p < .001; β = -.30, p = .015). Semi-structured interviews were then conducted with six athletes. Thematic analysis revealed that cumulative lifetime stress exposure fostered poor mental health and well-being by promoting maladaptive long-term coping strategies, increasing susceptibility to future stress, and limiting interpersonal relationships. We believe these findings can help practitioners identify, and intervene accordingly with, elite athletes at risk of experiencing stress-related mental health problems.
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Affiliation(s)
- Ella McLoughlin
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
- Corresponding author. Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom. (E. McLoughlin)
| | - David Fletcher
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Rachel Arnold
- Department for Health, University of Bath, United Kingdom
| | - Lee J. Moore
- Department for Health, University of Bath, United Kingdom
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149
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Gilbert P. Compassion: From Its Evolution to a Psychotherapy. Front Psychol 2020; 11:586161. [PMID: 33362650 PMCID: PMC7762265 DOI: 10.3389/fpsyg.2020.586161] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022] Open
Abstract
The concept, benefits and recommendations for the cultivation of compassion have been recognized in the contemplative traditions for thousands of years. In the last 30 years or so, the study of compassion has revealed it to have major physiological and psychological effects influencing well-being, addressing mental health difficulties, and promoting prosocial behavior. This paper outlines an evolution informed biopsychosocial, multicomponent model to caring behavior and its derivative "compassion" that underpins newer approaches to psychotherapy. The paper explores the origins of caring motives and the nature and biopsychosocial functions of caring-attachment behavior. These include providing a secure base (sources of protection, validation, encouragement and guidance) and safe haven (source of soothing and comfort) for offspring along with physiological regulating functions, which are also central for compassion focused therapy. Second, it suggests that it is the way recent human cognitive competencies give rise to different types of "mind awareness" and "knowing intentionality" that transform basic caring motives into potentials for compassion. While we can care for our gardens and treasured objects, the concept of compassion is only used for sentient beings who can "suffer." As psychotherapy addresses mental suffering, cultivating the motives and competencies of compassion to self and others can be a central focus for psychotherapy.
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Affiliation(s)
- Paul Gilbert
- Centre for Compassion Research and Training, College of Health and Social Care Research Centre, University of Derby, Derby, United Kingdom
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150
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Yue JL, Yan W, Sun YK, Yuan K, Su SZ, Han Y, Ravindran AV, Kosten T, Everall I, Davey CG, Bullmore E, Kawakami N, Barbui C, Thornicroft G, Lund C, Lin X, Liu L, Shi L, Shi J, Ran MS, Bao YP, Lu L. Mental health services for infectious disease outbreaks including COVID-19: a rapid systematic review. Psychol Med 2020; 50:2498-2513. [PMID: 33148347 PMCID: PMC7642960 DOI: 10.1017/s0033291720003888] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/05/2020] [Accepted: 09/28/2020] [Indexed: 12/27/2022]
Abstract
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.
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Affiliation(s)
- Jing-Li Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yan-Kun Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Si-Zhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Han
- National Institute on Drug Dependence, Peking University, Beijing, China
| | | | - Thomas Kosten
- Division of Alcohol and Addiction Psychiatry, Baylor College of Medicine, Houston, Texas, USA
| | - Ian Everall
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christopher G Davey
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Edward Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Research and Development, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Xiao Lin
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Lin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking-Tsinghua Centre for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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