Exploring joint HPA-inflammatory stress response profiles in adolescent girls: Implications for developmental models of neuroendocrine dysregulation

Does extreme psychological burden (Hamas terrorist attack on October 7th, 2023) affect in vitro fertilization outcome?

OBJECTIVE

We aim to investigate the effect of extreme emotional and psychological trauma following Hamas terrorist attack on October 7th, 2023, on IVF cycle outcome.

PATIENTS AND METHODS

The study population consisted of all couples undergoing 2 consecutive IVF attempts with ovum pick-up in our institute, before and during the week of October 8th to 12th, 2023. Embryological/ laboratory variables of the IVF cycles were assessed and compared between the patients' IVF cycle before and those that underwent OPU during the spoken week.

RESULTS

Twenty-three couples were eligible for analysis. There were no differences between the cycles in the length of ovarian stimulation, total dose of gonadotropin used, and the peak estradiol and progesterone levels. Furthermore, while no differences were observed in the number of oocytes and mature oocytes retrieved or fertilization rate, the mean number of top-quality embryos per OPU (1.1 ± 1.7 vs. 2.2 ± 2.9; p < 0.02) and ratio of top-quality embryos per number of fertilized oocytes (0.5 ± 0.3 vs. 0.7 ± 0.2; p < 0.01) were significantly lower during the spoken week. Semen total motile count was significantly reduced during the spoken week.

CONCLUSIONS

In the present study, we are witness to the effect of acute emotional and psychological trauma on IVF outcome, as reflected by its detrimental effect on sperm and embryo quality.

Do Hormone Levels Influence Bullying during Childhood and Adolescence? A Systematic Review of the Literature

(1) Background: Bullying is one of the most common forms of aggressive behavior during childhood and adolescence. Some decades ago, researchers began exploring the basis of peer victimization from a biological perspective. Specifically, the Hypothalamic-Pituitary-Adrenal (HPA) and Hypothalamic-Pituitary-Gonadal (HPG) axes have been studied in relation to status-relevant behaviors, such as bullying. (2) Methods: We conducted a systematic review following the PRISMA guide and registered the review protocol at PROSPERO (CRD42023494738). We searched for relevant studies in PubMed, Psycinfo, Scopus, and Web of Science, and assessed them using the Robins E-tool. (3) Results: Our search yielded 152 studies, of which 33 were included in the review. These studies explored the association between testosterone and cortisol levels with bullying behavior, finding diverse results. Most of the studies were rated as having a low risk of bias. (4) Conclusions: This study not only enhances our understanding of bullying, but also provides guidance for the development of prevention and management programs for it. In the future, researchers should continue exploring the joint effects of different hormones on the HPA and HPG axis, using a broader set of biomarkers.

Stress system concordance as a predictor of longitudinal patterns of resilience in adolescence

Resilience promotes positive adaptation to challenges and may facilitate recovery for adolescents experiencing psychopathology. This work examined concordance across the experience, expression, and physiological response to stress as a protective factor that may predict longitudinal patterns of psychopathology and well-being that mark resilience. Adolescents aged 14-17 at recruitment (oversampled for histories of non-suicidal self-injury; NSSI) were part of a three-wave (T1, T2, T3) longitudinal study. Multi-trajectory modeling produced four distinct profiles of stress experience, expression, and physiology at T1 (High-High-High, Low-Low-Low, High-Low-Moderate, and High-High-Low, respectively). Linear mixed-effect regressions modeled whether the profiles predicted depressive symptoms, suicide ideation, NSSI engagement, positive affect, satisfaction with life, and self-worth over time. Broadly, concordant stress response profiles (Low-Low-Low, High-High-High) were associated with resilient-like patterns of psychopathology and well-being over time. Adolescents with a concordant High-High-High stress response profile showed a trend of greater reduction in depressive symptoms (B = 0.71, p = 0.052), as well as increased global self-worth (B = -0.88, p = 0.055), from T2 to T3 compared to the discordant High-High-Low profile. Concordance across multi-level stress responses may be protective and promote future resilience, whereas blunted physiological responses in the presence of high perceived and expressed stress may indicate poorer outcomes over time.

Biological stress responses to multitasking and work interruptions: A randomized controlled trial

In the course of digitalization, new stressors are emerging. In modern working and living environments, two ubiquitous, technology-mediated stressors are multitasking demands and work interruptions. However, biological stress response patterns to multitasking and work interruptions have been sparsely investigated so far. We thus aimed to comprehensively assess biological stress response patterns to both stressors and, additionally, test whether responses differ between digital and partially non-digital settings. A controlled experimental set-up was established and humans' biological markers of the Sympathetic Nervous System (SNS), the hypothalamic-pituitary adrenal (HPA) axis, and the immune system were assessed. N = 186 healthy participants (mean age: 23.2 ± 4.3 years, 74.7% female, body mass-index: 22.3 ± 3.1 kg/m2) took part in this pre-registered study. Each participant was randomly assigned to one of 6 experimental conditions (1 digital single-task, 3 dual-tasks [2 parallel tasks and 1 interruption], 1 multitasking, and 1 passive, control condition). Each one of the dual-tasking as well as the multitasking conditions included a non-digital sub-task, i.e., performing a task in presence of an examiner. All other conditions involved digital tasks only. Salivary alpha-amylase (sAA) levels as a marker for SNS reactivity significantly changed in work interruptions, parallel dual-tasking, and multitasking conditions. No changes were found for control conditions. Furthermore, no significant changes over time and no differences between the conditions were identified for three biological markers: cortisol as marker for HPA axis activity as well as for two immune system markers (secretory Immunoglobulin-A, C-reactive protein). A time course similar to sAA was found for perceived stress: with increases during task execution and decreases afterwards in multitasking and parallel dual-tasking. Yet, it did not change for the work interruption, passive control, and single-tasking condition. Overall, our findings show that dual- and multitasking are perceived as stressful and are associated with an activation of the SNS, but not with responses of HPA axis or immune system. This was consistent for digital as well as partially digital task demands. Our findings will also inform future research into the differential stress effects of digital and non-digital tasks to advance our understanding of biological stress response-patterns to multitasking and work interruptions. Therefore, our findings are highly relevant for understanding the long-term biological health effects of stress in modern (digitalized) environments.

Correlations between negative life events and suicidal ideation among Chinese adolescents: a meta-analysis

Background

Suicide ideation (SI) has become a serious social issue worldwide, and research has found a certain correlation between negative life events (NLE) and SI. Nevertheless, this relationship is still not clear among Chinese adolescents, a special population. Hence, this investigation performed a meta-analysis of observational research on the correlation between NLE and SI among adolescents in China, to further clarify the association.

Methods

We performed an extensive search on seven electronic databases starting from their establishment until March 10, 2023. The research mainly focused on cross-sectional studies conducted on samples of Chinese adolescents. To examine the association between NLE and SI, a meta-analysis model using random effects was utilized. To investigate moderating factors such as age, region, assessment tools for SI, and year of publication, subgroup and meta-regression analyses were performed. The AHRQ evaluated the quality of the study. The synthesis of data was conducted utilizing STATA software (version 16).

Results

Ultimately, a total of 30 cross-sectional studies were selected for this analysis, including 39,602 individuals in the participant sample. The results showed that NLE was moderately positively correlated with SI among Chinese adolescents (r = 0.29, 95% CI: 0.26, 0.32). In addition, this relationship was moderated by regional differences and the measurement tool used for SI. Studies conducted in Western China showed a higher correlation coefficient than those conducted in Eastern and Central China. Moreover, research conducted with the SSIOSS demonstrated a stronger correlation coefficient compared to studies utilizing the BSI-CV or other assessment instruments.

Conclusion

This meta-analysis indicates that NLE is linked to SI in Chinese teenagers, especially those residing in Western regions of China. Identifying and intervening in NLE and associated risk factors are crucial to prevent suicide within this demographic.

Effects of physical activity in child and adolescent depression and anxiety: role of inflammatory cytokines and stress-related peptide hormones

Depression and anxiety are the most common mental illnesses affecting children and adolescents, significantly harming their well-being. Research has shown that regular physical activity can promote cognitive, emotional, fundamental movement skills, and motor coordination, as a preventative measure for depression while reducing the suicide rate. However, little is known about the potential role of physical activity in adolescent depression and anxiety. The studies reviewed in this paper suggest that exercise can be an effective adjunctive treatment to improve depressive and anxiety symptoms in adolescents, although research on its neurobiological effects remains limited.

HPA-SAM co-activation among racially diverse, economically disadvantaged early adolescents: Secondary analysis with a preliminary test of a multisystem, person-centered approach

Investigating the co-activation of hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenomedullary (SAM) responses to acute stress can provide insight into how risk might become biologically embedded during early adolescence and improve understanding of what distinguishes physiological dysregulation from normative/expected physiological responses to stress. Evidence has thus far been mixed as to whether symmetric or asymmetric co-activation patterns are associated with higher exposure to chronic stress and poorer mental health outcomes during adolescence. This study expands on a prior multisystem, person-centered analysis of lower-risk, racially homogenous youth by focusing on HPA-SAM co-activation patterns in a higher-risk, racially diverse sample of early adolescents from low-income families (N = 119, Mage=11.79 years, 55.5% female, 52.7% mono-racial Black). The present study was conducted by performing secondary analysis of data from the baseline assessment of an intervention efficacy trial. Participants and caregivers completed questionnaires; youth also completed the Trier Social Stress Test-Modified (TSST-M) and provided six saliva samples. Multitrajectory modeling (MTM) of salivary cortisol and alpha-amylase levels identified four HPA-SAM co-activation profiles. In accordance with the asymmetric-risk model, youth exhibiting Low HPA-High SAM (n = 46) and High HPA-Low SAM (n = 28) profiles experienced more stressful life events, posttraumatic stress, and emotional and behavioral problems relative to Low HPA-Low SAM (n = 30) and High HPA-High SAM (n = 15) youth. Findings highlight potential differences in biological embedding of risk during early adolescence based on individuals' exposure to chronic stress and illustrate the utility of multisystem and person-centered approaches in understanding how risk might get "underneath the skin" across systems.

Implementing Evidence-Based Suicide Prevention Strategies for Greatest Impact

Suicide remains a leading cause of death in the United States and globally. In this review, epidemiological trends in mortality and suicide risk are presented, with consideration given to the impact of the COVID-19 pandemic. A public health model of suicide prevention with a community and clinical framework, along with advances in scientific discovery, offer new solutions that await widespread implementation. Actionable interventions with evidence for reducing risk for suicidal behavior are presented, including universal and targeted strategies at community, public policy, and clinical levels. Clinical interventions include screening and risk assessment; brief interventions (e.g., safety planning, education, and lethal means counseling) that can be done in primary care, emergency, and behavioral health settings; psychotherapies (cognitive-behavioral, dialectical behavior, mentalization therapy); pharmacotherapy; and systemwide procedures for health care organizations (training, policies, workflow, surveillance of suicide indicators, use of health records for screening, care steps). Suicide prevention strategies must be prioritized and implemented at scale for greatest impact.